Cleaning regimes, PPE, and supporting the NHS: how ReadiBus have adapted their services in response to the coronavirus crisis

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The ReadiBus service has remained available for those who have needed to travel throughout the coronavirus outbreak

In the first two months of the national lockdown, ReadiBus provided over 1,000 essential journeys – for shopping, GP appointments, ongoing treatments, hospital appointments, school and respite – and made over 600 telephone welfare calls to users of the ReadiBus service who were not travelling and known to be on their own. ReadiBus spoke to RVA about how they have adapted their service in response to the crisis.

How has ReadiBus adapted its services during the coronavirus outbreak?

Restrictions on travel had to be introduced: anyone displaying symptoms or living in a household where someone is displaying symptoms is not allowed to travel. Bus capacity was reduced to maintain social distancing for journeys, and intensive cleaning regimes and procedures were put in place – all with a view to making the travelling environment as safe as possible. Operations adapted to a staffing sufficient to meet the requests being made. The ReadiBus office has remained open throughout (with distancing and procedures in place), but visitors have not been allowed. More staff have been enabled to work remotely from home. Vehicles have continued to be maintained.

The aim has been to meet needs and requests during the lockdown, at the same time as keeping everyone safe. As well as responding to the requests that came to ReadiBus directly, it soon became apparent that as NHS resources were being diverted towards meeting the needs of the Covid-19 pandemic, this was leading to difficulties for some people relating to non-Covid-19 treatments and appointments. A referral from Rachel at RVA, via the One Reading Community Hub, focused attention on the need to support the NHS in this regard. The person referred needed transport to get to an appointment at the Royal Berkshire Hospital (RBH). It was a routine appointment that had become urgent because it was a fortnight overdue.

Supporting the NHS

ReadiBus started journeys for cancer patients whose appointments were being transferred from the Macmillan Cancer Unit at the RBH to Bracknell Healthspace, but who had no means of getting there and back.

The full extent of this situation, including re-located appointments and potentially missed treatments, soon became apparent, and there followed further referrals from Rachel at RVA via the support hub. ReadiBus started journeys for cancer patients whose appointments were being transferred from the Macmillan Cancer Unit at the RBH to Bracknell Healthspace, but who had no means of getting there and back. There were similar problems for patients with appointments at other hospitals, some also transferred from the RBH; and ReadiBus started taking local residents as far afield as the King Edward Hospital in Windsor, the Churchill Hospital in Oxford and the Community Hospital in Thatcham for routine but essential appointments.

At the same time, we were on stand-by to take discharged patients home from the overflow hospital facility that had been set up in the Holiday Inn on Basingstoke Road. Discussions began with South Central Ambulance Service (SCAS) about supporting them in meeting non-emergency patient-transport needs that they were facing severe difficulties in meeting. The appointments that SCAS needed help with were mostly for patients needing kidney dialysis and patients going to radiotherapy. SCAS provided training at a local ambulance station to some ReadiBus staff in the safe use of full Personal Protective Equipment (PPE) and this training was then cascaded by those to more at the ReadiBus site. ReadiBus put in place the associated planning, procedures, further training and communications, in readiness for several ReadiBuses going into service as ‘ambulances’ on behalf of SCAS from 27 April, working side-by-side for 5 weeks to get people to their hospital appointments during this crisis period (see photo).

To date, ReadiBus has met every request or referral made (other than a couple of ‘unsafe’ discharges) since the commencement of the lockdown. This has included journeys for essential shopping, journeys to GP appointments (such as for ongoing treatments), journeys to hospital, journeys to school and journeys for respite.

What has been the most challenging part of this?

The strictest discipline at all times has been required with regard to the cleaning regimes and procedures to try to keep everyone safe.

The people needing essential journeys on ReadiBus during the lockdown have been people who are extremely vulnerable in the circumstances of the pandemic. Many precautions had to be taken to make the travelling environment as safe as possible. This has included intensive cleaning regimes and procedures and the appropriate use of PPE (see photos). The strictest discipline at all times has been required with regard to the cleaning regimes and procedures to try to keep everyone safe. It has been a huge effort  – and one that has been met by all those involved in great spirit. The result has been the confidence and trust of those travelling. A passenger attending the cancer clinic with ReadiBus for example said last week: ‘I know I’m safe travelling with you’.

You’ve been staying in touch with service users over the phone too – how have they been coping with lockdown?

The loneliness and social isolation aspect of the current situation  is for many more of a concern than Covid-19 itself. Since the announcement of the lockdown to the end of May, ReadiBus has made 655 telephone welfare calls to users of the ReadiBus service. The most commonly recorded comment is how appreciated the call has been and how welcome the opportunity has been for a conversation. For most of the calls, the person phoning will have been a familiar voice (either from pre-lockdown phone conversations or from the journeys themselves). In addition to these calls made by ReadiBus, some passengers have been supporting each other by phoning one another, where they had come to know each other from previously travelling regularly on the same bus.

In terms of coping, many people have cited family and community support, including from the hub, while some have needed signposting to sources of help and/or have needed some subsequent practical assistance (eg getting to somewhere such as to a surgery). Below is a small cross-section of comments noted from these calls:

“It’s so nice to talk to someone rather than myself.”
“I’m looking forward to getting out again.”
“Neighbours are very good and family help with shopping.”
“I have a parrot for company.”
“I can’t see my husband who is in a care home.”
“I’m finding the situation difficult.”
“I did feel very anxious for a while but I’m coping now.”
“I am lost without going out. I am very lonely and find it a very long day.”
“I am getting low on food.”
“I am lonely but I wouldn’t want the responsibility of anyone visiting.”
“It feels like all the life has been drained out of me and I usually go to bed in the afternoons.”
“I am keeping busy around the house doing all the jobs you never do.”
“I am bored in my flat. I walk up and down the long corridors to keep healthy.”
“I keep busy with my knitting but I’m very bored and I just want to get out.”
“I am finding life confusing sometimes as one day is like another. One of my daughters comes up in her car and we wave to each other. I miss going out on ReadiBus.”
“I am looking forward to going out when it is allowed.”
“We are battling on.”

As we start to look to a future shaped by coronavirus, are there things that the ReadiBus team are particularly concerned about or hopeful for?

We are concerned about the impact of months of social isolation on people who had previously been active and independent through use of the ReadiBus service. We are also concerned that service-delivery capacity will be much smaller for some considerable time because of the need to maintain distancing on journeys and this will need to be factored in to any future resumption of previous activities.

As well as this, the intensive cleaning regimes and procedures also mean a much larger time window is required in order to deliver journeys. This has meant, though, that a safe means of essential travel has bee available for those who have needed it during the pandemic.

See the ReadiBus website for further information. With thanks to Peter Absolon and the ReadiBus team for the incredible work they are doing, and for making the time to answer our questions.