How many people have been failed by the NHS during lockdown?

[Polnm]

My DH has cancer.

His appointment in April was by phone
His appointment in August was postponed until October

How is this acceptable? Hospitals are empty whilst patients can’t access care.

GP appointments by zoom with a 2 week wait for a basic blood pressure check in person or to take bloods

Why isn’t there more publicity and outrage about this?

We can’t be the only family going through this surely?

@GetOffYourHighHorse The thought of Diane Abbott is equally terrifying, agreed!

@elenacampana

The NHS are not to blame and you know this yourself. They have been put in a terrible position and have had to make choices that will haunt them for years to come.

My mum is also waiting for an operation that she really needs so I do get it. I’m waiting for treatment I can’t yet have too. However, the NHS didn’t put themselves, or me and my mum, in this position.

Friends of mine from within the NHS have had the hardest few months of their lives and are going to be struggling with it for years to come. Your frustrations really shouldn’t be at the door of the medical staff who put their lives on the line to treat Covid patients.

I understand how difficult it's been.

What I don't understand is why procedures aren't in place to mitigate many of the issues faced by patients - why aren't waiting lists being properly kept for patients whose appointments have been cancelled and are now many months overdue? Why aren't departments answering e mails or phone calls when patients are trying to chase these missed appointments? Like literally how do patients flag up that they have now missed two three month monitoring appointments? I've been told by a respiratory consultant that I need to be seen urgently (it was an urgent referral in February, apparently it's now more urgent). He's trying 🤔 to get me an appointment and he's spoken to his registrars about me to see what they can do 🤔🤔. How does this even make sense? Surely, if it's urgent it needs to be dealt with urgently?

Accusing people of lying ? Have you examples of this? There are really clear principles in place regarding duty of care and candour. A whole team won’t cover up someone’s lie. Anyone not doing their job will be managed. You should complain if you are not happy. Complain to pals or the service manager or the clinical lead.
People also wouldn’t have been happy if they likely caught covid when on for their routine op. No win situation.

It didnt 'shut up shop' it stopped admitting people for routine surgery

It cleared the elderly patients out directly to nursing homes (this one action probably contributed to our very high rate), redeployed consultants for Covid work and stopped all screening, including red flag symptom screening.

Screening has restarted and they were going to increase capacity in some areas using private hospitals but as many of them want 2 weeks self isolation before arrival they can’t fill the slots.

It was a very comprehensive scaling back of services and the increased death rates From cancer, heart disease and stroke are already starting to show in the stats.

So the NHS certainly didn’t get overwhelmed as it basically just did Covid work for several months

I’m sorry to hear so many have had such bad and sad experiences over the past few months. It shouldn’t be like that and doesn’t have to be like that. We’ve had some excellent care from the NHS lately.

My DD has a heart condition and her cardiology appt in London in June was cancelled, but her cardiologist phoned her from the Covid ward he’d been seconded to and she had a successful telephone appt with him.

My mum had breast cancer last year and after surgery and radiotherapy she’s cancer free. She had her follow-up mammogram in hospital today. She also has Parkinson’s and saw her consultant last week - just a few months late. One of her Parkinson’s medications has suddenly become unavailable. Our surgery has been trying desperately all day today to find her a replacement and talk to her consultant to prevent her having any breaks from it.

My dad is showing some signs of dementia. I spoke to the GP on the phone last week and she’s been wonderful. He had blood tests this week, she referred him to the memory clinic right away because it’s only just reopened and that means there will be a wait. And she’ll see him face to face next week after the blood tests results come back to evaluate him.

I do think depts should have robust systems in place for patient contact. Sound like that is a weakness in some places. I can see how frustrating and fearful that most make people.

@jacks11

But GP’s and hospital doctors are not sitting round doing no work- at least none of the ones I work alongside and know.

All our GP’s surgeries are open. They have a locked door policy to stop people wandering in as they have to know who has been in and also limit footfall as far as possible for the safety of higher risk patients who require to come in and also for staff (especially non-clinical).

However, All patients will either be telephone triaged or seen via video call. The gp will then decide if they need to be seen face to face, and whether that has to be the same day or is a more routine thing which can wait. Data in our area has shown that GP waiting times have dropped noticeably.

Hospital out-patient clinics are still going ahead- either telephone or video, or if face to face required these are still happening. Waiting times are longer than pre-COVID and are taking longer to get through as everything takes longer- rooms have to be cleaned between each patient and all equipment used disinfected. There are a limited number of patients allowed in the waiting area due to social distancing and we don’t want people waiting for longer than absolutely necessary for obvious reasons. Scan waiting times are also longer in some cases as we cannot do as many per day as we’re fine pre-COVID due to additional cleaning measures etc. There are some investigations (aerosol generating procedures) which we have been told to either stop or only do in an emergency cases.

When it comes to routine/elective care, few people understand that we are essentially having to run 3 hospitals within our hospital. We have to keep a “COVID” ICU, a COVID medical and surgical HDU, a COVID medical admissions with some surgical admissions beds, as well as COVID medicine for the elderly wards. We then have to run “amber” medical and surgical admissions- for the not obviously COVID patients who require emergency admission but we haven’t got a negative test (I.e. all acute admissions who aren’t suspected COVID): acute patients stay until negative swabs, after which they can be moved to the green (COVID free, as far as can possibly be told) wards. Add in that certain wards have to have additional measures (haematology and oncology wards, for example). That’s before we even hit theatre issues- there are COVID and non-COVID emergency theatres, for example. This all has to be done within existing infrastructure and staffing levels. So it is inevitable that waiting times for elective care is longer- we have fewer hospital beds that can be used for elective care; staff split between COVID and non-COVID aspects of the same specialty in some cases; some staff requisitioned (e.g. from community teams) to other posts; and reduced number of theatres. We also have to be more careful with higher risk surgery, for example, because we need to be sure that there will be an HDU (or in some cases ICU) bed for that patient to go into post-operatively.

I absolutely understand that if you or a loved one are waiting on a clinic review or surgery which will prolong and/or improve quality of life, the reasons are not really that important to you- you just want to be seen and treated. In reality, life-saving treatment should still be going ahead, although I know some regions are struggling more than others to keep waiting times down.

Oh come on. I take it you are a health care professional? Has anyone travelled through this system as a patient to experience just how appalling it is?

GPs - patients are triaged via telephone call - yes, at an unspecified time. They can phone you at anytime during the day - what happens if you are at work and aren't allowed your phone on you? How do you make an appointment under these circumstances? And yes, I bet data has shown waiting times have dropped - no one can make an appointment. That's a great plot - make it impossible to make an appointment and then claim success in cutting waiting times (Matt, is that you?)

As for telephone consultations with hospitals - how do you describe swelling over the phone? Or abnormal joint movement? How do you describe what muscles you are using when breathing, whether you are engaging your diaphragm or not (what??? I'm an RGN - I had no clue). I was receiving respiratory physio (over the phone) as a stop gap whilst waiting to see the consultant. I wasn't improving and was unbearably breathless. Physio kept reassuring me that this was ok, push through it. Out of interest one day I measured my sats while doing the exercises. My sats dropped to 83%. Cue panic stations when I told the physio and she told the consultant. That shouldn't be down to the patient to discover, by accident. That's a failing of the system.

Yes of course life saving treatment is a priority but many of us have life altering conditions that we are desperately trying to manage whilst clinging onto our jobs and families. We don't have a buffer to absorb treatment stopping with no support. Just throwing opiates at people as a way of controlling symptoms is not on. My health has massively deteriorated since March. I fear it will never recover and I'll end up with no choice but to give up work. But I won't be dead so it doesn't count if I end up housebound and practically immobile.

Also, FWIW not every area are not treating cancer patients.

My FIL called his GP as he has had a cough for about 8 weeks and had bend noticeably losing weight. He called GP, gp called back same day. GP arranged an appointment that afternoon, too bloods and referred for an x-ray. X-rays used to be drop-in service in our area but due to COVID are now appointment only. He received an appointment 2 days later, gp called the next afternoon to say he needed to have a CT scan. He had the scan within 2 working days abc the results within 24 hours- again go called to say he’d normally break this news face to face but he had done an urgent referral to respiratory as the scan has shown what was almost certainly metastatic lung cancer, and had been told the respiratory team would be in touch the next day and GP did not want FIL to be caught unawares. Respiratory team duly calked, moved over to video call with consultant within minutes and he had an appointment that afternoon for drainage of the fluid accumulation around his tumour, which would also allow sample to be sent for examination to help determine cancer type. A diagnostic bronchoscopy was arranged for 48 hours later. He had this on the Thursday morning, received the full tissue diagnosis and treatment plan from the MDT on the Monday late afternoon . Bloods fine by GP the next day and started immunotherapy on the Wednesday.

Time from presentation at GP to commencing treatment was just over 2 weeks.

In that time he had seen a go, had bloods done, a chest X-ray, a ct scan, spoken to a GP twice, spoken to a respiratory specialist, had a pleuritic aspiration/drainage, had diagnostic bronchoscopy, further bloods from GP, results discussed by the MDT to decide treatment, discussion of this with him and then commenced treatment. Sadly, treatment is to delay progression and improve symptoms, with the hope of prolonging his life- but no possibility of a cure in his case.

He has a 24 hour access to his oncology ward for advice, the number for respiratory cancer nurse and he has been put in touch with a McMillan nurse. His GP has been in touch on several occasions.

I have nothing but praise for the care he has received.

Yanbu. I'm so sorry for your dh and everyone else awaiting treatment. It isnt acceptable, there is an obsession with covid and nothing else.

@Pomegranatepompom

Accusing people of lying ? Have you examples of this? There are really clear principles in place regarding duty of care and candour. A whole team won’t cover up someone’s lie. Anyone not doing their job will be managed. You should complain if you are not happy. Complain to pals or the service manager or the clinical lead. People also wouldn’t have been happy if they likely caught covid when on for their routine op. No win situation.

Are you referring to me? Sorry, I'm.not accusing people of lying.

I am on the verge of contacting PALS but I do feel guilty because I really appreciate what the drs and nurses have gone through and I don't want to make anyone's job even harder but it's just impenetrable at the moment. I don't know who to contact - the email addresses aren't being responded to and the phone goes to answer machine telling you to email. You can't leave a message.

I'm not accusing anyone of lying though. My emojis were meant to show a puzzled expression - as in, how can a consultant not manage to see a patient they say needs to be seen urgently and what could a registrar organise that the consultant can't?

My dad - he had an eye tumour and whilst having radiotherapy back in March he fell seriously ill & admitted to hospital, none of us were allowed to see him, kept ringing for updates just to be told he was fine - anyway the brought him home & it was very clear he was not fine. Couldn't walk/talk eat, he died the next day - the hospital had told us a pack of lies!! When my sister complained all they could say was sorry but we're just geared up for Covid?!? Like no one else's illnesses matter 😢 x

@jacks11 Exactly. My MIL has had cancer treatment throughout this year inc chemo, radio and immunotherapy. Appts with her consultant a mix of face to face plus video calls.

Hospital out-patient clinics are still going ahead- either telephone or video, or if face to face required these are still happening.

Not everywhere they aren't. They certainly aren't here, it's just one excuse after another.

OP. I work for the NHS. We are seeking direction from the government. These are not the rules of the hospital consultants, doctors and nurses. Please remember that.
In the service I work for we are not seeing patients face to face (not oncology may I add) however if the patient DOES need to be seen face to face following assessment then they are Covid screened and a face to face appointment.
My aunt was also seen face to face last week at The Christie in Manchester near her in relation to her cancer treatment.
All the GP’s in this area are seeing patients face to face if it is necessary to.
My husband has also been contacted by the orthopedic team to make arrangements for a procedure that he has been waiting for since January that was postponed so services are trying to start up again
The service I work for as many have no plans to put any face to face appointments in place unless necessary until October. My two friends work for the local council and they have been told they are not to go back in the office and will be working from home for the remainder of the year at least.
I hope you husband gets some answers soon. If you are worried about a lump growing, take pictures. Keep a diary also helps. If you are worried His blood pressure, buy a monitor as more accurate on a day to day basis
Has he a Macmillan nurse or do the local district nurse team provide support?

Regarding the GP situation, I could understand it at the peak of the crisis - where are the sick with Covid people likely to present? At their GP. Shut down the surgeries so there is no risk of spreading infection. But now? There has been so much publicity about staying at home and not visiting the GP if you have symptoms, that the chance of someone in the waiting room having Covid must be less than the chances of someone sitting next to you in the Eat Out To Help Out restaurant!

I’m so sorry for the experiences that some posters have shared, the fear and pain is so upsetting.

I’m a cancer patient, and consider myself extremely lucky to have completed the most crucial parts of my treatment last year. I had very aggressive and fast growing triple negative breast cancer, and was due to have my final reconstruction surgery in April. It was obviously cancelled.

I fully accept that the hospital had no option and other priorities, and as I said, I consider myself incredibly lucky. Whilst the open ended wait for this surgery is a little frustrating, and is a set back mentally in terms of reaching the end of treatment, it isn’t life threatening.

I know that had my diagnosis come 12 months later than it did, I probably would not have survived the current Covid-19 impact on and delays to cancer treatment in my region. Thats an incredibly frightening thought which I try to dwell on as little as possible.

@Hearhoovesthinkzebras

Yes, I’m a physician. Our GP’s are still seeing quite a few patients. I know because if the number if referrals, number of acute admissions and from what GP colleagues tell me. Our GP will make a telephone appointment time- but yes, if you work 8-6 and are not allowed to take a call during that time I can see it may cause you issues. But how would being able to walk into the GP surgery help- if you did not have an appointment they could not see you and the working hours are the same- plus you’d have to take more off to make your way to the surgery from work/take time off work to attend. I cannot speak for all areas, maybe some gp’s won’t make specific times to call.

As for the rest of it- given the restrictions placed upon us (I.e. the fact that fewer face to face appointments and scans can be done in a day than pre-COVID due to restrictions placed upon us; and that changes to hospital set up due to COVID means we have the same infrastructure, equipment and staff resources spread over more than one area), what is your solution?

I would love to be able to get the full complement of staffing in my team back. But I can’t- unless or until we are allowed to stand down the COVID units and all that they entail. I can assure you that I am not sitting twiddling my thumbs whilst patients wait to be seen, though.

'It cleared the elderly patients out directly to nursing homes (this one action probably contributed to our very high rate), redeployed consultants for Covid work and stopped all screening, including red flag symptom screening.'

Patients were discharged by their consultants. Did you want them being kept in an acute setting for 5 months where we knew the risk waa high? The problem is the care homes did not isolate and barrier nurse discharged patients effectively. Why didn't the care home owners make it a priority that they had adequate staffing to ensure this was done properly?!

Routine screening was of course halted to reduce contact and risk for both patient and staff, but new lumps or bleeding would have been investigated.

I would love to be able to get the full complement of staffing in my team back. But I can’t- unless or until we are allowed to stand down the COVID units and all that they entail

Let me give you a window into the experience of a Type 1 diabetic in a functioning health care system in the height of the Corona crisis. Face to face doctor appointments in May? Yep. The usual suite of comprehensive three month blood tests? The only difference? The results were not available on the same day. It took two days. Gosh. I can live with that. Why are people expected to clap for being refused basic medical care because of Covid? Why are you defending this dysfunctional status quo?

@BovaryX Can you rewrite so your post makes more sense?

@Hearhoovesthinkzebras

They’re being directed by other bodies - what don’t you understand about that?

how can a consultant not manage to see a patient they say needs to be seen urgently

@Hearhoovesthinkzebras

I don't know. But I think it's a bloody disgrace hooves. And I think those who seek to dismiss or excuse this indefensible status quo are an impediment to any kind of reform to a seriously flawed institution.

'The usual suite of comprehensive three month blood tests? '

'the usual suite of comprehensive blood tests' .

Do you mean routine bloods?

'Suite'. It's like something Laurence Llewlyn bowen would say .

@gypsywater

If you are struggling to understand, let me spell it out:

A) Covid affected the entire planet
B) healthcare continued as normal for the developed world despite Covid
C) that means routine medical tests, diagnostics, blood tests, cancer treatment went ahead as normal
D) Do you understand A) thru C)?
E) Why is the NHS incapable of maintaining basic services during this crisis?

It's not acceptable. My friend's mother died, at the age of 60. She had slow developing lymphoma, was thought to have 15 years easily. Her treatment was put on hold, she suffered a heart attack.

My cousin has a benign brain tumour, all of his treatment has been cancelled.

I'm sorry about your husband OP. I hope things get moved along for you.