To wonder when the NHS is going to start protecting all the people it dumped back in March?

[Noextremes2017]

Simply that?

You make it sound like this was done just for the lolz and in a state of panic. It wasn't - it was directed from above. Trusts were told to empty their beds for the COVID surge and given a deadline. Trusts were told to suspend elective work. You haven't got a clue.

FWIW our Trust started rebooting shit down service two weeks ago and are going strong. Nobody was 'dumped' and your choice of words is extremely offensive to NHS workers who have been going over and above under very difficult conditions for months now.

My take on the posts above from those inside the NHS is that everything is still in Covid-19 mode; everything is now more difficult and will be going forwards; it's a very complex picture etc etc

In other words waiting lists are now going to get longer and longer (unless of course you are actually dying and make it to A&E)?

If that is the case it is important for the NHS to be upfront about it.

You see from a patient's perspective - when you are told you 'need' an operation then your first instinct is to believe what you are told - that it is 'necessary'.

That is a bit different from being told it might be a good idea for you to have an operation but actually we can't really fit it in for a while because of waiting lists; because we just cancel stuff in the winter anyway; because Covid-19 is really more important; because we need a load of PPE now that we didn't before...….

Instead all we get is a glib statement from the Government/NHS along the lines

'hospitals are being told to re-commence elective surgeries'

I appreciate that is the Johnson Government way of doing things - no detail. But really the NHS needs to be upfront on how all this is going to affect everybody being treated by the NHS who just doesn't happen to be a Covid-19 patient.

So my FIL had his prostate biopsy cancelled a week before it was due. They reinstated that care and had it done with a cancer diagnosis last week. His treatment will start in next few weeks.

Certain things cannot be restarted as yet. It’s a logistical nightmare.

My OH immunology consultant is on the board with PHE about reinstating main hospital care again and there will be huge reshuffling

Sorry to offend you @pointythings.

I am sure you are capable of appreciating that things might look different to how you see them from another position.

And yes I appreciate that the NHS was just following Government orders.

And this is nothing to do with NHS workers - so don't get all defensive.

They have been protecting people by not performing surgery.

All medical procedures are a balance of risk and benefit. No surgery is risk free. However, for the last 3 months, there has been an additional risk of surgery because the chance of catching Covid in hospital is higher than it is in the community.

So performing necessary but non-urgent surgery becomes an unacceptable risk for a period.

There are also, of course, the issues on overloading the system, but it is not as straightforward as that.

But it's obvious it's going to effect people. Yes the waiting lists will get longer, what do you propose we do differently about them? Recruit more doctors - oh wait we can't as there's less and less coming through training thanks to the government? Even if we were funded appropriately to pay for the ones we have let alone the ones we need.

We as managers have been given instructions that we need a plan for business with covid which is essentially do as much work as before, if not more but also manage covid. We're all looking at innovative ways to decrease waiting lists and get people seen on earlier. It's not easy or simple. If you have an idea please share as we are desperate for any ideas from anyone. Quite a lot of patients are going to see a shift from consultant led care to nurse or physician associate led care which I'm sure will cause a kick off even though they are highly trained individuals, but this has been coming for at least 5 years as the number of doctors in the country just isn't enough.

Just because you are told you need an operation does not mean you need one ASAP. In fact very few elective surgeries are that urgent (obviously discounting trauma, cancer, life and limb etc). Appreciate to you that your condition feels horrendous and needs sorting, but I guarantee there are hundreds in a worse of position than you and that's why they are being seen first/prioritised.

Our hospital only has x amount of theatres. How do you propose we increase capacity in there? Hospitals are always trying to maximise capacity - I've been on projects where they have celebrated cutting down turn around time between patients from 20 mins to 17 mins. It's running as tightly as possible in the majority of places (appreciate there's always somewhere not doing so).

re your PPE comment, it's not just about "needing the PPE" do you realise how much longer it takes to don and doff PPE between each patient safely for each member of staff. This adds a lot of time! Full time doctors are contracted to 48 hour weeks, many do many more - especially when surgery or clinics run over. Where do you suggest we get this extra time from?

As per how it's going to affect patients: it will effect you that waiting times may be longer for the next few months whilst we get sorted to manage your condition in the safest environment possible for you, other patients and staff. NHS is a very complex machine it takes a while to change and there are rigorous governance processes and appropriate check and challenge to ensure it is done right.

I'm not sure what else me and other posters can say on the matter as you seem to have just ignored what the majority of people have explained.

@ginfilledcats

I am not ignoring you or other posters at all and I am not applying for a position as an NHS Management Consultant.

It is as curious to me as it must be to you that the NHS is apparently starved of investment for years (hence waiting lists) but as soon as Covid 19 appears the monetary floodgates open. Curious and ludicrous.

I am taking from these comments that for non-elective surgeries things are going to get a lot worse in terms of waiting times. That ties in with my own experience of being told my operation would be early April and now being told I am nowhere near the top of the list. ie I am going backwards. And of course the list has not even started moving yet - it is just being added to.

You'll tell me that means I am lucky because I am not an urgent case. I'd agree.

@ElizabethMountbatten

Sorry to hear that. We are told above by those in the NHS that there are constant reviews going on to establish priorities - I hope she gets seen very soon.

I agree with you OP and I’ve got a horrible feeling there’s going to be a battle from some therapies etc refusing to go start to get back to normal similar to schools.

@queryuiop

Yes I get that point about it being potentially more dangerous to perform surgery in Covid-19 environment. For that reason - if I was called in tomorrow I wouldn't go.

And I guess a lot of people might have the same reservations for many months (which could itself reduce waiting lists).

Well, I’m not sure about the NHS dumping people, but it seems clear that there’s an death toll associated with people being unwilling or unable to access medical care for conditions that aren’t Covid.

I don't understand why NHS can't reorganise in such that they have Covid free hospitals per region, and get those back up and running for the normal service. And use the Nightingales for COVID cases, with main hospital back up for complications. It's no point taking in Covid cases in every hospital. Someone's going to post to tell it's not that simple and it can't be done.

Monetary floodgates opening?! Do you realise many many doctors have been personally funding PPE for their staff?

It will come too late for our neighbour who died last month because essential tests and treatments were cancelled. Lovely woman who should have still been with us today.

Yes... same for DHs aunt. We've no complaint about the NHS staff who looked after her, at the point when she rapidly went downhill, was admitted to a geriatric ward and was very soon on a morphine drip. They were doing what they could to relieve her suffering but if the system had been better organised then there's a good chance she'd still be alive now rather than having effectively been euthanised.

Euthanasia at the right time is not a bad thing ... but it shouldn't have been her time yet.

I would expect schools and supermarkets to go back to normal before healthcare does.

BolloxtoGender - the issue is also that there are not enough medical staff to treat covid patients at the same time as usual work. Even if you could run parallel hospitals, who would staff them all?

But covid case numbers are low.

I have NHS friends who say they are bored in A&E.

They are now, due to lockdown. They will go up again now lockdown is easing

I sounds to be like there are resources that are 'needed' but essentially on standby.

It

Passing NHS Consultant.

A few comments:

Watch for a Lancet paper out this week- I'm sure the press will pick up in it. This shows if you have minor elective surgery and you are under the age of 70- the chance of you dying if you get COVID is 7%. This goes up to 45% if you are over 70 and have major elective surgery: would you want an elective operation with those statistics? Or would you rather wait a few months?

The NHS at the moment is very inefficient. Beds have been stripped out to support social distancing, everything needs PPE or full PPE, we have reduced scans and very little endoscopy. We are able to see very few patients face to face.

NHS clinical staff are broken- emotionally and physically. They have been working hard, unpredictable shift patterns, covering illness (about 30% have had it), goal posts keep changing almost daily. We are tired and there will be no tea and biscuits.

That said I am seeing patients every day who were too terrified to come to hospital several weeks ago. Some have come to harm because of it.

Anyway - regional dedicated Covid hospital, plus Covid free hospitals. Someone in the NHS should be looking at that, if there're not already.

Yabvu using the work dumped. Really disrespectful way to talk about the people who have been putting themselves in harm's way to save strangers lives. There is a cost of lockdown of course but there is no risk free option when dealing with such a dangerous virus.