TPFS COVID Update May 2020
The Pelvic Floor Society Newsletter
This is the delayed Easter Newsletter. We had hoped to be looking forward to Summer and Autumn courses and our annual conference in this Newsletter. Unfortunately, international events have overtaken us. Although this Newsletter contains a list of cancelled or postponed courses, we are able to report back on changes to the committee and feedback from one of the courses that did manage to take place this year. We have also gathered some news from members to hear how you have been managing during the crisis, continuing to support patients or using transferable skills elsewhere within the NHS. At the same time as compiling this Newsletter, TPFS are also writing a statement to help guide members and Trusts in providing Pelvic Floor Services during the recovery period. Please continue to watch our website for updates. We are keen to hear from the membership about your experiences and what we can learn from this time (see below for contacting us).
Soon to be released: “Advice on management of pelvic floor functional patients during COVID”
We hope to release this guide shortly. It will tackle when and how to resume consultations, MDTs and surgery. Experience has been drawn from clinicians and allied health professionals in different parts of the country with different rates of COVID. It will be designed to complement and expand on statements from ACPGBI, RCS and further afield.
The Chair: Mr Andrew Williams
Hon. Secretary: Miss Karen Telford
Hon Treasurer: Mr Shahab Siddiqi
Research, Audit & Development Committee: Chair Mr Tom Dudding
Training Sub Committee – The Pelvic Floor Society (TPFS): Chair Mr Jonathan Randall
QA & Clinical Governance Committee TPFS: Mr Mark Mercer Jones
Allied Health Professional Sub Committee: Chair Jane Dixon
Membership Secretary: Mr Wesley Lai
Webmaster & Exernal Affairs Officer: Mrs Jennie Grainger
Scientific Committee: Miss Carolynne Vaizey
ACPGBI Council Representative: Mr Mark Chapman
Scottish & SPFN Representative: Miss Dorin Ziyaie
Welsh representative: Miss Julie Cornish
Irish Representative: Mr Reza Kalbassi
UKCS Representative: Mr Philip Tooze Hobson
Dukes Club Trainee Representative: Miss Annabelle Williams
Feedback from Cardiff Faecal Incontinence Course, March 2020.
TPFS funded places and expenses for 3 delegates to attend this course at WIMAT Cardiff.
“The course is very well run by an enthusiastic and extremely competent multi-disciplinary faculty, led by Miss Cornish, covering the breadth of the management of faecal incontinence.
I really enjoyed the mixture of interactive lectures and hands-on experience on models, which was an opportunity for some trainees to get signed off on perineal procedures. I particularly enjoyed the laparoscopic VMR model, which I found quite realistic.
The interaction with the pelvic floor surgeons from UK and international centres allowed me to draw on a wealth of knowledge and experience. Both on procedures and tests not routinely performed in district general hospitals, like ano-rectal physiology and Sacral Nerve Stimulation, as well as getting useful tips on more common procedures like Delorme and Altemeier's.
The lectures by the biofeedback nurses and physiotherapists offered some unique insights on the possible conservative management strategies for the treatment of bowel symptoms. The contribution by a uro-gynaecologist truly reinforced the importance of a holistic approach to pelvic floor.”
“ I feel that this course provides essential tools that a trainee wouldn't get otherwise. This is why I believe that this course would be beneficial for any colorectal trainee, not just those with a specific interest in pelvic floor.”
Poole MDT Course, RNLI (from May 2020). We look forward to rescheduling this course which promised international faculty and interactive sessions involving all aspects of the MDT. Look out for new date!
Dundee TPFS Conference (from October 2020). We hope to come up with a new date in 2021.
Dundee Cadaveric Rectal Prolapse Course (from October 2020) which was due to precede the conference.
ACPGBI Annual Meeting, Edinburgh (from July 2020). The Education and Training Committee are aiming to collate some of the main presentations from this meeting as an ACP e-resource.
Education and Training Update
There is no doubt the cancellation of courses, face to face consultations and elective surgery will have a significant impact on training. TPFS is working directly with the Dukes Club and ACPGBI Education and Training Committee. E-resources are being prepared and pelvic floor topics have been put forward for webinar sessions. Please watch the Dukes and ACPGBI websites and Newsletters as well as the TPFS website.
Experiences of our members during the COVID crisis
Whilst many doctors and nurses were put onto emergency cover rotas, many of our allied health professionals continued to support pelvic floor patients. We have collated some of their experiences below. Recording these experiences may help us learn for the future. If you wish to record your own experiences for a future Newsletter, or feel you have learning points of interest to our membership please email: email@example.com
“Anorectal physiology appointments were changed to telephone consultations, with a detailed history being taken and guided bowel management given. Manometry will be offered at a later date. Daily follow up telephone clinics were implemented to discuss the success of previous biofeedback, bowel management advice and irrigation trials. These were supported by documentation in the post. A dedicated email address was also created for any patients with concerns that wanted a direct communication line into the team.
A similar service was set up for the Sacral Neuromodulation patients. Weekly telephone clinics were performed, and a dedicated email account was used to manage concerns.
Over and above supporting our normal service, the team have utilised their transferrable skills in other areas of healthcare. Our nurses have been back to the ward whilst our technicians and clinical scientists have been working in the Intensive Care Unit. Furthermore, two of the clinical scientists have upskilled in ventilator training to perform a critical care scientist role at the London Nightingale. All team members have also volunteered their time to support Bristol’s very own Nightingale.
Throughout everything our admin teams have worked tirelessly to comfort and reassure patients. They have been a constant lifeline for patients calling in with concerns of being missed or forgotten. We simply would not be able to provide the service we do without their support and care.
The team response to COVID-19 has been nothing short of sensational”
Laura Thomas, GI Physiologist. North Bristol NHS Trust
“I am currently supporting patients (via the telephone whilst my son is napping and when my partner who is a nurse can look after him) whom have sacral nerve stimulators, are using rectal irrigation and giving bowel management whilst trying to entertain a 15 month old with nursery rhymes. My patients, and there are a fair number, are incredibly pleased that they are still being supported whilst at home and knowing they have someone to turn to if they have any problems. It is though an isolating experience, I am in regular contact with my colleagues but do not see them regularly, I know I have support but it’s not the same as seeing or talking to someone. I tend to be working at different times of day to what I am used to, it’s stressful but it feel as if I am still doing my bit for the NHS in a different environment.”
Katherine Mabey, GI Physiologist, University Hospitals Bristol
A summary of the impact of COVID 19 on physiotherapy and physiotherapy on COVID 19:
Many specialist Physiotherapy NHS services have temporarily closed so that staff can be redeployed elsewhere. Others have been furloughed. Those that are still functioning are doing telephone assessments and giving advice.
All private practices are currently closed but most are using social media to maintain contacts. Zoom assessments are happening regularly. Blogs / vlogs / FB postings are rife.
Private hospitals have contacted past staff and asked them to return regardless of specialty. They are now covering surgical and medical patients who have been transferred across from the NHS. Some of the staff from the private hospitals have gone back into the NHS to help with COVID patients.
The proning teams on ICU are being run by physiotherapists from all specialties.
The Chartered Society of Physiotherapy has been sending out daily emails.
Some private practices are now facing financial difficulties. The attached article concerns a colleague who herself specialises in all things pelvic floor. She employs other physiotherapists who treat other conditions.
Jane Dixon, AHP lead TPFS
“We have been directing many of our patients through the telephone consultation clinics to the TPFS website and patient information section. We have found this extremely useful and patients are very pleased to have this resource. We have produced small laminated leaflet and send these out in the post.”
Dorin Ziyaie, Consultant Surgeon, Dundee
Message from Manchester:
Telephone clinics are invaluable. I guess we are lucky that this was already set up and we have access to e-systems at home. Discharging some too and managing expectations. Patients value the fact they still have contact and I am preparing having enough stock for irrigation etc. We already have our individual leaflets which I send out and product information. GPs are still prescribing on our behalf and corresponding so I am monitoring or requesting medication
Clare Molyneux, Clinical Specialist Physiotherapist
Most patients are pleased the face to face appointment has been changed to phone appointment. They are able to discuss concerns and get advice. I am sending info, diaries and questionnaires out as before and then following up with another phone call if needed.
Domini Mullins, Advanced Surgical Care Practioner
A tribute written by one of our Executive Committee
https://www.bbc.co.uk/news/live/world-52343301 [scroll halfway down news feed, this is not a reference to Donald Trump’s statements…]
Keep in touch at www.thepelvicfloorsociety.co.uk
Newsletter compiled by: Jonathan Randall, Education Lead TPFS
Artwork: Sophie Randall, Age 6