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

[Noextremes2017]

Simply that?

Transplant programmes are running

To those people who think the NHS has ‘dumped’ or ‘binned off’ patients (including seemingly the wife of an oncologist, who you described as ‘idle), I would be interested to know how you personally would have planned for the coming pandemic without the hindsight of what we know now, and with your Italian counterparts warning you that your hospitals will be overwhelmed within the month.

My DH is a hospital doctor on the front line and I can tell you categorically that it was a worrying and uncertain time, and that he would have much preferred to have spent the last couple of months in the garden in receipt of a furlough payment, as many of our friends were.

It is easy to point out that the nightingale hospitals were not necessary, but you have the benefit of hindsight.

So please, do tell me how you’d have done things differently, but only answer if you actually work in the NHS and you understand the complexity of the way it functions and you have the clinical decision making acumen to qualify your opinion.

And if you still think you know better, then why on Earth didn’t they consult you?

I have had investigations for cancer through all this, NHS have been amazing. I know some cancer treatment has been suspended due to making patients more vulnerable to C19, personally I would count that as still being proactive treating. Amazing treatment in A&E and fracture clinic last week too.
So from my experience, I don’t know what you’re talking about.
I know one person who has caught C19, he was in hospital having a hip operation when he caught it so I can understand why they are delaying non-urgent ops.
As hard as the delays are I think you’d have to be a little hard of thinking to call it ‘dumping patients’.

How are staff paying for PPE, OP? In England, by buying it from wherever they can, including from closed dental practices, from resellers (some seeking to profiteer) and ad hoc sources (from a local industrial company who used FFP3 in contaminated environments and who genuinely seemed to want to help). Why, because stocks have repeatedly ran out, including stock that was comedy restickered with new expiry dates [I look forward to the enquiry at the end of this and hope the safety and rigour of the reassessment of those stocks is looked at. I hope the people who said it was OK to restocked those have skin in the game if it wasn't safe)].

As an aside, in England, the NHS is more than acute (hospitals) who seem to have preferential access to PPE. It includes community (GPs) who don't seem to be at the forefront of PPE provision (have visibility across the two sectors). Care homes seem to have had it worse than the community and I saw some figures that care home staff have a worse death rate than that of healthy under-65 HCPs. The picture is mixed as GP friends work on South Coast and they've had PPE to spare from day 1.

I work in NHS therapies and we are literally itching to get back to normal therapy work but it's constantly marred by barriers.

• no clinic space as it's full of displaced or socially distanced departments
• no outpatient department as it falls within red zone and there's no other access route
• need PPE for every appointment - there isn't enough for everyone to resume normal business
• can find a random clinic room empty on a Thursday afternoon - can't socially distance the waiting room properly and no one available to clean the room. And then even when you sort all this - patients are all too scared to come in.
• trust has invested in virtual clinic platform and want everything done over that....so you spend ages trying to get elderly people sorted on it rather than doing it much quicker face to face.

It's exhausting. This is after months of working on the wards covering for people being off sick (not all covid, a lot off with stress and still remains so). No annual leave. No sign of a break. And constant reminders that from September, 'winter' pressures will start so everything will most likely stop again.

It's not all emergency and elective surgery and screening in the nhs, it is so much more.

The system is the people @Noextremes2017. I’m also an anaesthetist like @StonedRoses - restarting elective work is complex. There has been detailed guidance realised by a group of experts on how to restart it and hospitals are working towards that.

We are exhausted and emotionally battered and bruised. I understand the concerns but maybe realise that real people who have given everything to care for patients are reading this and how your words might make them feel. We didn’t dump anyone, quite the opposite.

As an aside, my advice to family would absolutely involve an assessment of urgency. Non-urgent elective would be kicked down the road even if it affected quality of life but didn't impact on life expectancy. Urgent treatment impacting on life expectancy would be sought and has continued to be provided from day 1 in England. COVID does impact on the cost benefit for the individual patient's outcome, including through risk of infection and availability of ITU in case of complications.

Porktangle, 'winter pressures' will be interesting given shielding will potentially affect risk of falls outside and social distancing and hand washing will potentially affect the spread of 'flu. That is unless everyone starts acting how they did before and we get COVID plus usual 'flu and everything else as well as catching up of essential but rightly-delayed work.

Non-urgent elective would be kicked down the road even if it affected quality of life

^ for how long? A year? Two? Indefinitely?

I have absolutely no expectation that NHS services will resume anything like normal in the mid term & am anticipating that we will be self funding (assuming of course private facilities are freed up at some point). Once the immediate covid crisis is stabilised there will be a massive backlog coinciding with a devastating recession. Bad times.

@Fridaysgirl

Not fully. Lots of lung transplants patients are on hold.

My DFIL was successfully treated for an incredibly aggressive cancer last year. We thank our lucky stars he wasn't diagnosed 12 months later because we have no idea where he would be with regards to his treatment. As it happens some of the follow up things he needs to continue to be healthy have been postponed until further notice.

Now numbers are dropping there is no reason not to be thinking of all ways to get the system up and running again. Ds (17) had his consultants appointment cancelled - his first since being dx as having pancolitis (ulcerative colitis of the entire bowel) as an inpatient back in January. There is no reason this appointment couldn't be satisfactorily done via a video call. Obviously no palpation examination could be done but it would be better than nothing and would surely help with the massive backlog that must be getting longer and longer!

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

There was also a chap in his 60s with cancer who was scheduled to have an operation which he had a 98% chance of surviving. Of course it was cancelled and he has since died.

But a friend of my mum's who initially had her operation postponed because of covid, has been treated for skin cancer. And she's 98 so they obviously aren't rationing on grounds of age.

Agreed. There was an interesting interview on this morning last week with a senior cancer specialist and he was basically saying the effect this lockdown was having on cancer treatment was sheer madness and more people would die unnecessarily of cancer than of corona virus. He thought we needed to access risks sensibly and be aware of corona virus but to essentially go back to normal. It was the first time I've seen someone speak some sense on this.

I don't get all this misdirected anger at the NHS, why not the government they're the ones who've ballsed up testing, PPE, drained the NHS of resources for years?

Not just the government, but the people who voted them in, despite knowing that the Tories are notorious for starving the NHS of funds,. And not just once, but 3 times.

I am a doctor waiting for a necessary elective surgery. It is not cancer or immediately life threatening, though needs to be done ASAP.
If they’ve offered me a slot for my surgery a few weeks ago I would have politely declined. Absolutely not worth the risk to me or to the staff.

Before anyone else calls me a complete ignorant twat - my name is not Dominic Cummings - and to anyone who found the word 'dumped' in the title offensive - I am sorry. Please read dumped as 'dropped' or whatever you don't find offensive.

Apparently 69% think I am not being unreasonable asking the question (in more polite terms).

What I have taken out of this is (from comments from those on the front line) that the pre-Covid NHS is not going to return anytime soon. Not just because of the disease itself but also because the working procedures are going to so significantly changed and those changes will themselves take a long time to work through the NHS system.

Whilst I don't claim to have read every announcement by this Government over the past couple of weeks I can recall something along the lines 'hospitals are being asked to re-commence elective surgeries as soon as possible'. It seems that statement was as vague as everything else uttered by the Government and that the request to hospitals is one thing but implementing it is something else!

The Govt just want to get the economy moving again so they can stop furlough payments and receive taxes etc

Yes but the taxes are needed to fund the NHS otherwise no-one other than those who can afford private healthcare will be getting treatment. You can't have one without the other.

LakieLady

I don't get all this misdirected anger at the NHS, why not the government they're the ones who've ballsed up testing, PPE, drained the NHS of resources for years?

Not just the government, but the people who voted them in, despite knowing that the Tories are notorious for starving the NHS of funds,. And not just once, but3 times.

I agree completely 👍

onlyreading video calling is in its infancy in the NHS. I wish I could show you round some of our locations, where we have ancient machines, a few of which are still on Windows 7, monitors which do not have built in cameras, no mics available. And of course because of efficiencies, these machines sit in shared office spaces so forget about patient confidentiality. All that has to be overcome before we even get to installing the software, training staff in its use and updating all Trust websites to ensure the online links are available, and then adapting all patient communications.

And of course there are patients who will not be able to access video calls and will still need face to face consultations - we have a larger than average number of those in the services where I work, because these are for older adults.

This is not a simple thing to do.

I work for the NHS and we never stopped treating patients.

@pointythings

I noted your comment about a potential pay freeze for the public sector.

Whilst I agree that will be shit for many people (if it happens),and there are many in the private sector sat around earning 80% for doing sweet FA right now, I do think when the furloughing ends many will find themselves going from 80% to zero. That will be shit too.

And Blondie in No 10 won't make any apology for running the economy onto the rocks - he'll just remind us all that we had to do it to protect the NHS.