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BHB trans-oceanic telestroke service with Johns Hopkins

Thursday 22 July 2021: The Bermuda Hospitals Board (BHB) Primary Stroke Centre is one of the first facilities in the world to offer a trans-oceanic telestroke service. The service is provided through a collaboration with Johns Hopkins Medicine International (JHMI).

Telestroke allows experts anywhere in the world to quickly examine a suspected stroke patient and make the time-sensitive treatment recommendation that can mean the difference between full recovery and permanent disability or death.

Dr Victor Urrutia, director of the Johns Hopkins Hospital’s Comprehensive Stroke Center, and Dr Francene Gayle, BHB consultant neurologist and Primary Stroke Centre medical director at the launch of the stroke programme at BHB

“BHB started a local telestroke service internally between Emergency Department physicians, hospitalists and local neurologists,” explained Dr Francene Gayle, BHB consultant neurologist and Primary Stroke Centre medical director. “Then in December 2020, the telestroke service became trans-oceanic, connecting with Johns Hopkins.

“Not even a pandemic stopped our teams from moving ahead with plans to advance the service. We have up to five patients a week who come to the hospital having suffered a stroke whether there is a pandemic or not, so continuing to develop our services in the Primary Stroke Centre has been so important to the whole team working on this initiative at BHB.”

“This innovate way of managing stroke patients helps us collaborate in real time to care for our patients, despite being over 800 hundred miles apart,” said Dr Victor Urrutia, director of the Johns Hopkins Hospital’s Comprehensive Stroke Center. “Time is one of the most important factors in stroke treatment, so being able to collaborate remotely and make critical decisions about care makes a huge difference in outcomes for the individual patients.”

When the local telestroke service began in June 2020, about 8% of ischemic stroke patients received IV thrombolysis treatment – a significant improvement on the numbers given the drug before the Centre launched. After JHMI neurologists joined the local telestroke team in December 2020, the proportion of stroke patients who were administered the drug continued to rise to 13%. The average for primary stroke centres in the US is 7%.

The benefit is not just for those treated on island, however, but also for those who would benefit from treatment overseas.
“Most recently, we had our first trans-oceanic transfer from BHB to a comprehensive stroke centre in the US for the removal of a large clot that had blocked a major blood vessel in the brain, a procedure called mechanical thrombectomy,” Dr Gayle explained.

“Timing is critical in these cases, as the patient needs to be at the overseas hospital within 16 hours of the start of symptoms. BHB is engaging with the insurance companies to ensure that our airvac turnaround times are efficient in order for us to meet the transfer process within 16 hours,” said Dr Gayle. “We are quite thrilled about this.

“While this overseas relationship has clear clinical benefits, we have to stress the importance of recognising the need to get to hospital immediately if an individual thinks they have had a stroke. We have the clinical processes in place to act quickly, but this can only happen if people get to the hospital in time, so remember the BEFAST acronym – balance, eyes, face, arms, speech and time – to quickly identify and act on the early warning signs of a stroke.”

“We are honoured to collaborate with BHB to improve the care of stroke patients in Bermuda,” concluded Dr Urrutia. “The telestroke work we have done not only benefits people in Bermuda, but has far reaching implications for other remote area facilities. The experiences we gain through this collaboration can be shared globally.”

Editor’s note:

  • About the BHB Primary Stroke Centre: Established in July 2019 as part of a clinical affiliation with Johns Hopkins Medicine International, the BHB Primary Stroke Centre focuses on improving treatments and processes within the hospital, as well as providing education to help the community identify stroke symptoms to ensure timely treatment, and know the risk factors that can help reduce the incidence of stroke altogether.
  • About strokes: Ischemic stroke patients with smaller blockages are also experiencing better outcomes since the telestroke service began. IV thrombolysis is the procedure by which stroke patients receive a drug to dissolve or breakup the clot or blockage in the blood vessel that is restricting the flow of blood and oxygen to the brain. Administering the drug quickly increases the chance of the patient recovering from the stroke with little or no disability at all.
  • Strokes in Bermuda: There are up to five strokes every week in Bermuda, and 25% of strokes in 2020 were in people under 60. Seventy-three percent of strokes are in Black people, 24% are in white people and 2% are in ethnicities classified as ‘other’.
22 July 2021 Home Page, News

BHB announces breast ultrasound service

Wednesday 21 July 2021: Bermuda Hospitals Board (BHB) is on the forefront of breast care with plans to offer breast ultrasound for people with dense breast tissue.

BHB provided the service to its first patients last week. The automated breast ultrasound system (ABUS) is a new piece of equipment that is FDA approved for breast cancer screening as an adjunct to mammography for persons with dense breast tissue.

“We are excited to add the automated breast ultrasound system from GE Healthcare to our comprehensive breast cancer screening programme,” said BHB Chief of Radiology Daniel Stovell. “By offering ABUS in addition to mammography for our patients with dense breast tissue, we anticipate improving detection for small cancers that cannot be seen on a mammogram alone.”

Dense breast tissue has been found to be the most common risk factor for the development of cancer and also makes cancer more difficult to detect using mammography alone, according to multiple large studies. As breast density goes up, the accuracy of mammograms goes down. The difficulty radiologists experience when reading mammograms is that both dense tissue and cancer appear white on a mammogram. With ABUS, suspicious masses appear black against the white of the dense tissue.

“Mammography is the gold standard for the detection of breast cancer. However, it doesn’t work equally well in everyone, particularly those with dense breast tissue,” said Dr Stovell. “Designed and built specifically for screening, research shows that ABUS technology as an adjunct to mammography has the potential to find 35.7 percent additional cancers that would not have been found with mammography alone.”

Dr Stovell recommends women get regular mammograms as suggested by their doctor, and if they have been informed that they have dense breast tissue, that they talk to their doctor or radiologist about specific risks and additional screening tests that might be appropriate.

ABUS scanning is part of the comprehensive service offered in the Mammography Department of BHB’s Imaging Services. Services include:

  • annual mammograms (3D)
  • stereotactic breast biopsies (3D)
  • automated breast ultrasound (ABUS)
  • breast MRI
  • bone density with body composition

Pictured from left: BHB imaging technologists Terricca Smith, Terri Farnan and Carla Cann complete their training on the new automated breast ultrasound (ABUS) system with a volunteer patient

21 July 2021 Home Page, News

Stroke patients benefit from improved treatments at BHB

Monday 19 July 2021: Stroke care in Bermuda has dramatically improved since the establishment of Bermuda Hospitals Board’s (BHB) Primary Stroke Centre in July 2019, part of a clinical affiliation with Johns Hopkins Medicine International.

Establishing a Primary Stroke Centre has led to improvements to processes and treatments within the hospital. These clinical improvements, alongside a public awareness campaign about the importance of seeking immediate emergency care at the first signs of stroke, have meant more people get the critical care they need in time to improve their outcome.

About 13% percent of those who experience a stroke now receive a clot-busting drug that increases their chances of making full recoveries, a benchmark that puts BHB’s Stroke Centre in line with outcomes at leading hospitals and stroke facilities around the world. This compares to an average of 7% for primary stroke centres in the USA, with an accepted minimum being 5%.

“This has immediate human impact,” said Medical Director of the BHB Primary Stroke Centre, Dr Francene Gayle. “It means more of our stroke patients than ever before are able to make full recoveries. Three months after having a stroke they are able to return to their pre-stroke functioning levels. This is so important for quality of life, and as 25% of those who had a stroke in 2020 in Bermuda were under the age of 60, these are often people with many years ahead of them.”

Recognising that stroke had become an epidemic on the island, in 2018 BHB took action to turn the tide. Stroke can be debilitating, leaving individuals paralysed and/or significantly impaired. It is also leading cause of death globally.

“Major disability and death are the common consequences of those with a diagnosis of a stroke globally and Bermuda was no exception” said Dr Gayle. “Those who survive are often unable to return to work or their routine way of living. These individuals were oftentimes the bread winners of their households, and required 24-hour care. The financial impact on the families involved and on the local economy was significant,” Dr Gayle continued.

“We needed to change the trajectory of the trend,” she added. “We wanted to create a Primary Stroke Centre to increase and improve the access of all Bermudians to high-level acute stroke care that’s based on the latest research.

There are two types of strokes: ischemic and haemorrhagic. The most common are ischemic and involve a restriction in blood supply and therefore oxygen, to the brain. This can be caused by a blood clot or plaque build-up in the arteries.

In an ischemic stroke, patients who access medical treatment within 4.5 hours of the start of symptoms may be suitable to get a clot-busting medication – called IV thrombolysis tPA (IV tPA). In cases where this medication is given in time and bursts the clot, the patient avoids the major damaging effects of having a stroke and increases their chance of recovering with little or no disability.

“This clot-busting drug is integral to the process of full stroke recovery,” said Dr Gayle. “But I can’t stress enough the importance of recognising the signs and getting to the hospital immediately. We have to work together to get IV tPA going within that 4.5 hour window. Remember BEFAST—Balance, Eyes, Face, Arm, Speech, Time. If you think you’ve had a stroke, get to hospital immediately, or call 911.”

“We are thrilled to see the improvement in stroke outcomes take place so quickly,” said Victor Urrutia, MD, Director of Johns Hopkins Hospital’s Comprehensive Stroke Center. “It is a clear indication that collaborations like ours can have a significant impact on the health and stability of individuals, families and communities around the world. We will continue to work closely with BHB to assist in their efforts to reduce the incidence and improve stroke outcomes for Bermudians.”

“We have surpassed our goal and we’re now meeting the benchmark of leading hospitals around the world,” said BHB CEO & President Michael Richmond, MD. “But most importantly, we’re improving quality care and changing lives.”

19 July 2021 Home Page, News

Team established to support adults with intellectual disabilities at home

Monday 19 July 2021: Bermuda Hospitals Board today announced the establishment of a community team that will help and support adult (over 18) intellectual disability clients and their families at home.

The team is part of the Intellectual Disability Directorate, which is based at the Mid-Atlantic Wellness Institute with residential care offered in 14 group homes across Bermuda.

Community Intellectual Disabilities Team (CIDT) clinical manager, Christopher Cunningham, explains: “There is a pressing need for better support for adults with intellectual disability who live at home with their families. People who have intellectual disabilities can live full and wonderful lives at home with their families, and we can help this happen with a strong support service for them. We don’t want families to struggle on their own, or see their loved ones deteriorate because they can’t access the support they need.”

“By providing a support service for clients who live with their families, we want to improve access to safe and equitable care, empower clients and their families to be actively involved in their health care, increase levels of independence, and help clients develop new skills so they can thrive in their community.”

The team is multi-disciplinary, which means that individuals from a number of different professions work together to meet the needs of the clients and their families. The team includes a nurse, rehabilitation therapist, rehab aides, psychology assistant, case manager clinical assistant and is the process of recruiting for an occupational therapist, speech and language pathologist and physiotherapist to complete the group.

Intellectual Disability Director, Morrisa Rogers, adds: “We are thrilled to see the Community Intellectual Disability team established – this has been a long plan in the making. The need is there, and we believe there are many families who could benefit from our support, but who are currently struggling on their own. We want to better support families and their loved ones with intellectual disabilities so they can flourish in their homes. They may have additional needs, but intellectual disabilities should not stop anyone from being able to live a full and loving life on their own terms.”

The service is available via referral from physicians or other agencies, and individuals can contact the service directly if they believe they need it. They should call 249-3807 or 239-3803.

To be eligible, to access the community intellectual disability team service, an individual must be over 18 and have an intellectual disability as defined by the World Health Organisation means an individual has a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence) and a reduced ability to cope independently (impaired social function) which started before adulthood with a lasting effect on development (life-long condition). The individual also needs to have a presenting health need that requires intervention from the CIDT, and the person’s intellectual disability is directly impacting their ability to have this health need met through mainstream service.

19 July 2021 Home Page, News

BHB Pathology Department maintains accreditation

Monday 12 July 2021: The Pathology Department at King Edward VII Memorial Hospital has once more maintained specialised laboratory accreditation with the Joint Commission International (JCI). Accreditation is assessment of patient safety and quality standards. This is Pathology’s sixth JCI survey, which it has successfully achieved each time since 2006.

The Pathology Department at KEMH includes the laboratory areas that do diagnostic testing, from blood and urine to biopsies, the morgue, transfusion services, including the Bermuda Blood Donor Centre, and the phlebotomy staff who draw blood.

This is the first time the accreditation process has been completed remotely for Pathology, due to the pandemic, but this did not diminish its rigor. The survey was carried out in mid-May.

Danee Swan, Quality Manager in Pathology, comments: “The survey was carried out remotely, but was still intense and rigorous. We had to give two detailed presentations to our surveyor and sent a lot of advance documentation. During the survey week, surveyor requested specific tests from specific dates and trace processes, staff competencies and patient results. This was an extremely demanding process that traced tests from the patient – whether in an inpatient bed or outpatient lab – to the delivery of results. We are very pleased to have been awarded accreditation status.”

Kathy Stephens, Pathology Manager, comments: “We are accredited by Accreditation Canada as part of the hospital-wide process, but Pathology has also sought specialised laboratory accreditation with JCI since 2006, and we have successfully achieved it every three years since then. It is a testament to Pathology’s ongoing pursuit of excellence, ensuring we follow the highest patient safety and quality standards.”

Dr Clyde Wilson, Chief of Pathology, comments: “I would like to thank and congratulate the Pathology staff who work tirelessly every day to meet the highest standards to ensure our tests are accurate and timely. Through the year we have had to adapt constantly to the changing restrictions of the pandemic as the surges have come and gone and included new testing for COVID-19. We undertake about 3.5 million tests a year in the lab, but every one is significant to the individual patient, and at the heart of accreditation is our focus on patient care, doing the best we can for the people who need answers about their health.”

12 July 2021 Home Page, News

Blood donor winners announced

Friday 9 July 2021: The Bermuda Blood Donor Centre today was pleased to present blood donors Jason Kyme and Lorraine King with a prize each, donated by Hamilton Princess & Beach Club. The two prizes were a weekend stay at the hotel, and a champagne brunch.

Included in one draw were the most active regular blood donors, and in the other all new donors, based on donations made over the last twelve months.

Dr Eyitayo Fakunle, Consultant Haematolgoist, who oversees the Blood Donor Centre comments: “We would very much like to thank all our new and regular donors who week in and week out help us save lives throughout the year. This raffle was a way for us to recognise the tireless giving of our donors. Thank you to Hamilton Princess for helping us celebrate their generosity.”

From left to right in the photo: Alma Lou Polinar-Swainson (Phlebotomy Nurse), Susan Deverteuil (Phlebotomy Nurse), Lorraine King (blood donor), Dr Clyde Wilson (Chief of Pathology), Tim Morrison (General Manager, Hamilton Princess), Dr Eyitayo Fakunle (Consultant Haematologist), Jason Kyme (blood donor), Dawnette Been (Senior Technologist, Blood Donor Centre and Transfusion Services) and Kathy Stephens (Manager, Pathology)

9 July 2021 Home Page, News

Bermuda Hospitals Board Primary Stroke Centre screens all its patients for depression

Tuesday 6 July 2021: Bermuda Hospitals Board (BHB) will now routinely screen all its stroke patients for depression.

“Experiencing a stroke can dramatically affect a person’s life,” said BHB Primary Stroke Centre Medical Director Dr Francene Gayle. “Strokes can be debilitating, moving a normally functioning person to one with significant function impairment. This can happen suddenly.

“Such a drastic change in a person’s mental and physical condition is understandably often traumatic, not only for the person but also for their family. It’s the reason many stroke patients become depressed in the days, weeks and months following their diagnosis.”

“Depression after a stroke is common,” said BHB Chief of Psychiatry Dr Chantelle Simmons. “In addition to the direct emotional impact, post-stroke depression is also associated with poorer functional outcomes. The good news is that treatment is available and we will provide it.”

“Early identification and treatment of post-stroke depression is critical in optimising patient outcomes,” added Dr Gayle.

The Primary Stroke Centre has implemented a post-stroke depression policy that clearly details how patients will be assessed for depression, when they will be assessed and, based on the assessment, the treatment that will be used. Inpatient and outpatient treatments are available.

The new process involves various hospital departments and disciplines, including allied health professionals (occupational, physical and speech therapists), nurses, physicians, psychiatrists and clinical psychologists.

“Implementation of this policy is another example of how we at BHB continuously strive to give the highest quality and safest care to our patients,” said BHB Chief of Staff Dr Wesley Miller. “We have a vision to pursue excellence through improvement wherever we can. Recognising and attending to the mental health needs of our stroke patients is not only good for our individual stroke patients, but by extension for their families and friends. It’s beneficial to our Bermuda community.”


6 July 2021 Home Page, News

BHB and BIU sign three-year agreement

Thursday 1 July 2021: Bermuda Hospitals Board and Bermuda Industrial Union today announce the completion of negotiations and signing of the three-year collective bargaining agreement on behalf of all BIU staff at KEMH and MWI. The agreement will last up to October 2021.

To officially complete the process, a signing was held at the BIU headquarters in Hamilton for members of the two negotiating teams.

R Scott Pearman, BHB Deputy CEO, comments: “Although negotiations have taken some time, I’d like to recognise the hard work of both BHB and BIU negotiating teams in reaching an amicable agreement.  COVID-19 has been a disruptive force to the process, but we have all adjusted and kept going. I must give a sincere appreciation for the BIU leadership and BIU hospital membership during what has been an incredibly challenging time for people working in healthcare. BIU staff include aides, emergency medical technicians (EMTs), environmental services staff, community care workers, laundry operators, maintenance personnel, orderlies, sterile processing technicians and food services employees. They are very much involved directly or in support of frontline care. Not only have they worked tirelessly to keep services running during the pandemic, but they have also stepped up to the plate in helping the hospital manage costs.  They supported the pension and social insurance holidays, and while base pay remained stable, BIU members agreed last year to a temporary reduction in overtime rates. This has made a huge difference to BHB’s ability to meet its financial obligations to all its staff and keep services running throughout. Truly the BIU and its members have shown strength and compassion, and have played a major role in seeing our community and hospitals through this difficult time.

Chris Furbert, BIU President, agreed: “We are very pleased to be completing the current negotiations, which have reflected the good relationship between the BIU and BHB. We appreciate the good faith with which both parties came to the table. It has been a very difficult 18 months for BHB and Bermuda as well as our membership, but we have stayed at the course and ensured employee rights are supported and fair agreements made. We recognise the financial pressures the hospitals are under because of the pandemic as well as the additional burden BHB and its staff have shouldered. I am very proud of the BIU members’ efforts and commitment in their work, and we all recognised the crisis being faced and so were willing to help out where we could to ease the financial burden. We will all be rolling up our sleeves for the start of the next two year agreement negotiations in a few months, but we have built trusted relationships through this process and this will help us as we move on.”

1 July 2021 Home Page, News

Reduced deferral times for blood donor eligibility criteria

Wednesday 30 June 2021: Bermuda Hospitals Board is today announcing revised blood donor eligibility criteria used in the Bermuda Blood Donor Centre. Eligibility criteria are part of the standards used to ensure the safest possible voluntary blood supply for people in Bermuda who need transfusions. Other standards include having a voluntary (not paid) blood supply, having regular donors and high-quality testing of all donated blood.

The main changes relate to eligibility criteria that protect the blood supply from certain viruses that can be transmitted through blood including malaria, HIV and variant Creutzfeld-Jacob Disease (vCJD), the disease caused by exposure to meat infected with bovine spongiform encephalopathy (mad cow disease).

Dr Eyitayo Fakunle, consultant haematologist who oversees the Blood Donor Centre, comments: “The revised criteria reflect improved testing and research, which means we can safely reduce the wait time after certain activities, such as having tattoos or microblading, from 12 months to 3 months. Residents who previously couldn’t donate because they spent time in the Azores or Portugal between 1980 and 1996 can now donate which is great news.

“We do not want to discriminate against any individual, and we know it can upset people when our eligibility criteria mean they cannot donate blood.  These standards, however, help us manage serious risks and we always err on the side of safety. As we are a small country we do not have national policy-setting bodies on blood donation, so we follow the US and Canada as the two accrediting bodies who asses our safety standards are from those countries. Our expectation is that criteria will continue to evolve and reduce barriers for people who want to donate, while ensuring our blood supplies remain safe.”

Blood donations are used for people who need transfusions to treat conditions such as sickle cell anaemia and cancer, or as life-saving responses to blood loss, such as complications during birth, surgery or trauma.

Click here for the latest blood donor eligibility criteria factsheet.

What is changing?

Reduced deferrals for certain activities:
The following activities used to require a 12-month deferral, and now only have a three-month deferral. This is based on improved testing accuracy.
• Tattoos/microblading
• Travellers to malaria countries
• Men who have sex with other men (MSM)
• Women who have sex with MSM
• Individuals exposed to allergenic tissue through transplant or transfusions
• Contact with an open wound, non-intact skin, blood from another person
• A needle stick or sharp injury from an instrument used on another person
• Individuals treated for syphilis or gonorrhea
• Individuals who receive money, drugs or other payment for sex

vCJD country risks have been re-assessed:
An assessment of risks for variant Creutzfeld Jacob Disease (vCJD) in different countries has led to a change in criteria. People who have spent time in most European countries, including Portugal and the Azores, can now donate with the following exclusions:

• The criteria for the UK has not changed, which means people who spent three months or more (cumulative) in the UK (i.e. England, Northern Ireland, Scotland, and Wales), the Isle of Man, the Channel Islands, Gibraltar, or the Falkland Islands between 1 January 1980 and 31 December 1996 cannot donate.
• The criteria for Ireland and France have changed, and people who spent five years or more (cumulative) in those countries between 1 January 1980 and 31 December 2001 cannot donate.
• Anyone who has had a blood transfusion in the UK, Ireland or France from 1 January 1980 to present day still cannot donate.

Frequently Asked Questions:

Why are restrictions for vCJD in the UK, Ireland and France still in place?
As this disease has a potential latent period of many decades and there is no way to either test for vCJD or filter blood to capture the prions that cause it, this is the only way we can make sure we keep this disease out of the blood supply for people in Bermuda. The risk in many European countries has been re-assessed, however, including the Azores and Portugal, and no deferral is needed for people who spent time in these countries. Click here for more information about vCJD and blood donation

Why can’t people who are incarcerated donate?
This standard remains in the US. We understand the frustration when criteria require a deferral, and certainly once the deferral period passes we welcome all people who can donate.

Why do men who have sex with men have to wait three months to donate?
The deferral has reduced from 12 months to three months, but we understand the hurt that this criteria causes. We are closely following developments in other countries. The UK first moved to a three month deferral, and saw no increased safety risks. Only just this month (June 2021) the UK removed the deferral and is the first country to do so. At this time the US criteria is three months and we are moving first in line with this standard, with the hope this will change in the future. Click here for more about this criteria.

Who are the accrediting bodies of the Blood Donor Centre? What do they do?
Accrediting bodies assess the Bermuda Blood Donor Centre through a process in surveyors review whether patient safety standards are being adhered to. The Bermuda Blood Donor Centre goes through a specialised lab accreditation with Joint Commission International (US-based) and is included in the hospital-wide accreditation process with Accreditation Canada. The Blood Donor Centre has to pass both accreditation standards.


30 June 2021 Home Page, News

New clinic integrates hospital care in the community

Monday 28 June 2021: Bermuda Hospitals Board is now offering a number of hospital clinics at the Lamb Foggo Urgent Care Centre, where mental health, diabetes, asthma and Patient-Centred Medical Home services are now available by appointment between 9am and 1pm on Wednesdays. The urgent care service will continue as usual, and open at 2pm until 10pm as it normally does on a weekday.

Called the Integrated Health Clinic (IHC), the delivery of these services together outside of the main hospital campuses is the first deliverable of a strategic integrated healthcare programme by BHB, led by Deputy CEO R Scott Pearman. The goal is to better meet the healthcare needs in Bermuda by improving service coordination and care pathways for patients to increase quality and patient outcomes, and decrease system costs.

Project lead for the IHC Dr Anna Neilson-Williams, Deputy Chief of Psychiatry, comments: “By integrating care currently only available at MWI or KEMH at the Lamb Foggo facility, BHB wants to help people manage health conditions nearer home. The overarching goal is to improve outcomes for people with chronic issues and support their needs in the community. This, in turn, will hopefully reduce emergency mental health and medical admissions, which are disruptive to patients’ lives and costly. Co-locating clinics also provides an opportunity for greater coordination and integration between healthcare providers as patients may need multiple services.”

Dr Neilson-Williams adds: “The opportunity in the near future will be to also add consultations for specialists, such as in cardiology and neurology, later on.”

Mr Pearman comments: “The IHC is starting at Lamb Foggo because it is an existing BHB facility and provides the hospital with an opportunity to increase utilisation of the facility by offering clinical services that are needed by the residents of the eastern parishes. The IHC is based on a neighbourhood service model therefore services will be by appointment only for residents of Smiths, Hamilton and St. George’s Parishes. The Urgent Care Centre will continue to serve all Bermuda residents. Residents of non-eastern parishes will continue to be seen at KEMH for their clinic appointments. Based on our experience at Lamb Foggo, our intention is to offer a similar IHC service in the West in the future. We remain very mindful of establishing and gradually building these services based on need.”

Mr Pearman adds: “Integrating care around the patient is at the heart of the new BHB strategy. This includes not just having clinics working together out in the community, but more integrated care pathways for patients within BHB services and in collaboration and partnership with the wider healthcare system. We look forward to keeping the community updated as we make improvements.”

Access to the clinics at the IHC is by referral from a physician. Individuals who are referred to these clinics will have the option of accessing the services at the hospitals or at the Lamb Foggo UCC, if they live in the east, when they are contacted for an appointment.

28 June 2021 Home Page, News