Step-Down COVID-Care Pathway

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Referrals can be submitted 24/7
They can be submitted by a wide range of Homeless teams across London including outreach teams and homeless hostels, when COVID-19 is suspected or confirmed in a homeless individual
Patients are referred if they are experiencing COVID-19 symptoms (cough, breathlessness, temperature above 37.7, changes to taste and sense of smell) and still need a confirmation of their diagnosis OR if their Covid-19 diagnosis has been confirmed
Referring teams have the responsibility to fund and arrange the patient’s transport to Mildmay. Mildmay is unable to fund patient transport on admission or discharge.

Referrals

1-4 beds have been designated for homeless COVID-19 care, according to patient need
COVID-19 patients have a specific nurse allocated to them
PPE is used at all times as per respiratory isolation precautions
Patients are potentially admitted at any time, day or night, although we aim to admit the majority during working hours. This is significantly different from our standard admissions procedure for HIV rehabilitation and Homeless step-down patient pathways
On admission, all patients admitted under this pathway are given the Covid-Care Induction and Behavioural Agreement form. The patient needs to retain this information (due to infection control reasons). On discharge, the patient can take the form with them or it can be destroyed. The form has been translated into several languages including Bengali, French, Polish, Romanian, Russian and Spanish
COVID-19 homeless patients are essentially being admitted to Mildmay in order to facilitate self-isolation safely and rapidly. The primary focus of the nursing and medical team will be observation and monitoring
If a patient is admitted under the COVID-19 Homeless pathway, it is not essential that they are registered with a GP on admission. This differs greatly from our other pathways, where patients need to be registered with a GP prior to admission. COVID-19 patients can be assisted with GP registration during their admission at Mildmay.

Admissions

If a patient is COVID-19 negative, they will be transferred back to their hostel. If a hostel refers a homeless patient to Mildmay for COVID-19 isolation, they need to keep the patient’s bed open for the client for the duration of their admission at Mildmay
If a patient has been admitted from the streets, we will inform hostels such as St Mungo’s that we have a patient who will require a hostel placement

Discharge

Any patient who exhibits chaotic or uncontrolled behaviour due to unmanaged substance use or excessive alcohol use
Any patient who exhibits violent behaviour to others
Any patient who is so physically unwell that an acute hospital admission is indicated

Exclusion citeria

For more detailed information about Mildmay's COVID-Care beds, please contact us using the dedicated COVID-Care number: +44 (0)7895 751 370, or email: covidcare.mildmay@nhs.net

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