GWH is prepared for Brexit - whether it's an in-patient Brexit or an out-patient BrexitMany of the NHS's preparations for Brexit have been coordinated nationally - including a six week stockpile of medicines, alternative transit routes, air freight for short shelf life items and, if it becomes necessary, relaxing procurement rules.
But Great Western Hospitals' Brexit Planning Group has been very busy too - making as sure they can that continuing supply lines are robust. As the Group's leader told GWH's board this week: "We can prepare as much as we can, but we don't know how [Brexit] will impact us."
Plans to cope with the March Brexit deadline have been dusted off. With the Prime Minister's new Brexit deadline looming, GWH's 272 staff members who are EU nationals have been offered help with their applications to register for settled or pre-settled status. And the Trust's HR department is tracking the responses from the Home Office to applications.
In August four EU nationals were among staff leaving GWH voluntarily - which is just 1.5 per cent of all its EU employees. Will that low level of departures be maintained past 31 October?
To help them plan, GWH has the experience of the Carillion collapse in January 2018 - their 'closest parallel' to Brexit. Under its PFI contract, Carillion had looked after the buildings, the generators, services, employing cleaners and porters and much more.
Almost overnight GWH had to find ways to ensure the hospital could keep on caring and treating. And that involved maintaining or replacing Carillion services and employees who had been doing vital jobs - like keeping the hospital clean.
Keeping the shelves stocked with everything from rubber gloves to specialist chemicals has been the prime concern: "Procurement is our biggest anxiety."
The GWH procurement team have drawn up a 'comprehensive data base of over 50,000 items' involving 570 suppliers of clinical items and 605 suppliers of non clinical items. Only a very few suppliers have been non-committal about keeping supplies running.
The highest risks from any interruption in supplies comes with items that are uniquely specific - no alternative will do. For example pathology equipment handling blood tests needs chemicals that cannot be substituted.
Any attempt to use alternative chemicals could mean altering the equipment and recalibration that would give results not comparable to previous tests. "GWH has prepared to be as prepared as we can be."
Supplies of drugs and equipment are monitored all the time - and levels can be checked against supplies at neighbouring hospitals. And sharing arrangements have been agreed.
For health services, the choice of 31 October for Brexit is not auspicious. Although it is common currency in the country's hospitals that many of the pressures once associated with winter now hold throughout the year, winter adds extra patients due to flu, other winter illnesses and accidents. "Come 31 October, we are going to be entering real winter..."
Quite separately from GWH's Brexit preparations, Marlborough.news has been hearing that some medicines have not been available locally.
It is not clear whether this is due to the wider manufacturing shortages that have led the government to ban the export of some drugs. However, some people have been told current shortages are down to Brexit.