Everyone will be aware that contact tracing ended on 30th April.
3 days before, the Public Health Directorate held a Development Day where all teams took the time to pause and reflect on the Challenges & Successes of the last two years and what the future looks like.
For the Test & Protect Team it was particularly poignant as our work has now stopped and the team are returning to substantive roles or are looking for new opportunities.
It's fair to say it's been very emotional and as I share our reflections with you I am sure much of this will resonate with many.
The unpredictability of the virus brought the biggest challenge – the pressure of keeping pace with the infection rate and the sheer number of cases meant that the team were not always able to contact all cases or close contacts despite their best efforts.
The unpredictability also brought ever changing guidance making it difficult for staff to keep up to speed. The changes came into effect immediately after a briefing by the First Minister, the next day or a date in the future. Juggling different guidance depending on infection dates became the norm and made it difficult for staff when case numbers were through the roof and so many calls were required.
Staff rotas where challenging when the crystal ball to see case numbers in the future was not working. On many occasions staff gave over and above what was asked working long hours when waves of cases hit.
Contact tracing became an ever changing landscape.
Having time off meant that quite often you came back to a different job.
The team grew and staff changed on regular basis. The growth of the team meant that existing staff became trainers while trying to do their day job. Training strategies had to be pulled together when time allowed.
The team even moved offices in the middle of the pandemic. Staff recall wheeling their chairs and computers along to the new office, plugging in their pc and making calls again!
As the team grew there was a move towards more people working from home and we now have team members who work remotely across the UK and Ireland. This brought the challenge of finding new methods of communication and team working. Our coffee catch up's became a welcome break from constant calls.
Our recording systems also grew & developed. A local IT system soon became a national system know to us as CMS. CMS evolved daily and this lead to the development of online scripts and guidance on how conversations should be structured and what information we needed to gather.
What started as a local team helping to contain the virus in Dumfries & Galloway became part of a national army of Contact Tracers across Scotland. A representative from the team attended national meetings twice a day so we could highlight if we needed support or could offer support to other Boards through mutual aid.
Staff were expected to be an expert on everything!
Random queries became the norm and from all over. The team learned how to adapt and cope, learning as we went and seeking out answers.
When you made a call you had no idea of the personal circumstances of those you were calling. Staff were dealing with their own anxieties about the virus while managing the anxieties of those they were talking to. There were some very difficult conversations and emotions run high – anger, grief and tears. You could be speaking to someone who had just lost a spouse or someone sitting with a loved one in their dying days.
Staff had to deliver bad news too – talking people through the realisation of what that positive result meant – cancelling their wedding, not being able to meet up with extended family they hadn't seen for 9 months or not being able to have the operation they had been waiting 18 months for.
The attitude of the people we called differed over the two years. The majority were very receptive to our calls but we could be seen as the bad guys working on behalf of the government and stopping their independence.
The public struggled to keep pace with the guidance so having to explain the rules had changed again was difficult at times. People were not behaving normally; it wasn't just those who were positive, everyone was behaving out of character.
Despite the challenges there have also been many successes.
The team successfully carried out effective outbreak management and this was a critical tool in containing the virus. From interviews we were able to identify links and could report outbreaks to the Health Protection Team. Our processes moved from diagrams on flip charts to an electronic suite of reports allowing us to see patterns and numbers in a known outbreak setting. The team could draw on these reports when attending PAG's & IMT's. This couldn't have been done without the use of very skilful interview techniques and staff honed these skills.
Staff came from all over to form the Test & Protect team – Environmental Health at the Council, Sexual Health and Public Health staff. As the team grew people who had vastly varied skill sets and different working backgrounds came together with one common goal. They wanted to protect the people of D&G from the Covid 19 virus and they wanted to do their bit for the cause. The team were truly passionate about the service, supporting and learning from each other.
Without a doubt the team can be proud that they have delivered a caring and helpful service for anyone who contacted us. It became much more than providing isolation advice – it was ensuring that people were able to cope with isolation mentally & physically, did they have family or friends to check in with them, were they able to access food and medication, was there money on their electric cards, if they were ill should we call 999 and a whole host of other welfare concerns. The team became adept at finding solutions and regularly drew on the assistance of others.
So many people, teams and departments across the Health Board and other partners were always there to assist. Thank you to each and every one of you – we simply couldn't have done this without you.
Lesley Skilling is the Service Manager for the test & Protect Team at NHS Dumfries and Galloway
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