Very little discussion on the lack of non-covid NHS

[sunshinedaisyfatrat]

Last night was the first time I saw a news bit from a paediatric consultant saying they were gravelly worried about the lack of children presenting to hospital etc. We've all heard that outpatients have been cancelled, no ENT, no dentistry, rehab stopped, operations stopped, chemo halted, lack of face to face GP appointments etc but very little reported on regarding the long term effects of this. Hospitals are having few strokes / heart attacks presenting etc. If you have covid and a stroke you get placed on a covid ward and receive no stroke care. It's just awful. Poor nursing staff can't be jack of all trades and know the intricacies of all client group needs at all times.

In my hospital all of the above have stopped bar high emergencies which could result in an admission. We don't even have an outpatient / ENT / paeds department now because it's been repurposed as the covid entrance / assessment area. Lots of people being redeployed but some are still only in the process of shutting it all down and going through redeployment training. This is in place for the long haul and not just the 12 weeks.

How will the NHS ever go back and pick up the work it was doing? All of the above was stopped to ensure covid patient numbers are kept just under the capacity threshold but that won't go away as long as covid is around and cases still occur. Particularly so when lockdown is lifted. Face to face appointment still won't go ahead as transmitting is still a risk and aerosol generating procedures will still be a risk.

Sorry, very rambly, just surprised there hasn't been more reporting / stories / concerns about this whole side of the pandemic.

I may be a bit cynical, but I wonder if the government will use the lower use of these services to cut investment in the nhs in the future.
Eg. during this period less people used a and e so we shut more a and e as they have been proved to not be needed. The same for other departments. This less spending on the nhs is needed.

@Bargebill19 I fear you may be right. Also our children and grandchildren will be the ones who pay the price, while this and successive governments will blame covid and say it was for the greater good. Conveniently escaping all scrutiny.

Very early on my colleagues and I were worried about sick children not presenting. You only have to look at some of the posts on here to see how reluctant people are to go to hospital, when they really need to go. I have no idea how on Earth we are going to catch up on our elective patients. We would usually have 6-7 a day on my ward alone.

I'm so sorry to read all of these stories. My mother has also had appointment, biopsies etc for potential cancer (after a scan last month) indefinitely delayed.

What I don't understand is the idea that, by lockdown, we're preventing the NHS from 'being overwhelmed'. Instead, it seems as if the lockdown has been the PRECISE CAUSE of it being 'overwhelmed'. Not because doctors are too busy to see other patients, but because turning hospitals into specialist treatment centres for a single highly infectious illness automatically shuts down most other business.

Particularly troubling to think that treatments with a high, proven (and in some cases cheap) likelihood of success (and often for people with many remaining life years) are being abandoned to throw everything at ICU treatment of covid-19, when the available treatments are, at present, remarkably ineffective. So constant focus in the media on getting more ventilators, when most people being ventilated die anyway, i.e. there's a one month mortality rate of 60% +. Only a small number of cancers (stomach, brain etc.) have a 5 YEAR survival rate of under 40%.

This really concerns me. Just over a year ago my friend was dx with cancer, and after a very rough time they're now in full remission, and every possibility they'll remain clear and have a full, long life.

The original symptoms weren't concerning enough to remotely be considered an emergency or an indication of anything serious, so I doubt anyone with the same now would even get a gp appointment, let alone a dx before it was too late. And if by any luck they did get an early dx, would they even get the treatment?

What's happening to all those people that normally fill the wards? Has cancer magically disappeared because we're dealing with covid? Ditto all those with other life changing and potentially fatal conditions.

This is why the country will be forced to slowly come out of lockdown. As otherwise there will be nothing left. Spain is slowly reopening as is Italy.

We no longer have the NHS - it's the NCS.

This. I’m a high risk pregnancy and am terrified that my baby isn’t getting the close monitoring they normally would. It’s horrendous.

I may be a bit cynical, but I wonder if the government will use the lower use of these services to cut investment in the nhs in the future.
Eg. during this period less people used a and e so we shut more a and e as they have been proved to not be needed. The same for other departments. This less spending on the nhs is needed

I think this could well be true, and it is scary. It is why we need to start making lots of noise about it right now.

If we don't then the government could very well decide that few other services or disciplines are needed. The money that they are currently throwing at the Covid 19 issue (and not just in the NHS) will eventually need to be recouped and offset from somewhere. For this government, that will probably mean cuts, if they think they can possibly get away with it. More austerity, not an end to it.

I hope to be wrong there, but it currently feels like it is heading that way.

I'm surprised the media haven't started doing stories and finding people who have had cancer input stopped or dental problems left or children with therapy needs unmet etc....it's so strange that no one in real life is talking about it....

I'm not surprised the media haven't made more of this. They do what fits with the government agenda imo

Those statistics are terrifying @hopsalong
I really think we need to start making a lot of noise about this.

We have been trying to help an elderly neighbour who has had 3 TIAs. Her blood pressure is high and she is very unwell.
Her GP won't even see her.
She is too terrified to go to walk in.

This is actually why I’m quite glad to live in a country with a private healthcare system (as well as a government one), because there are still private specialist clinics open which I can go to without fearing too much contact with Covid patients, eg I am off to my gynae for a smear test next week. (I’m not in America by the way).

GPs should not be refusing appointments, they can do phone appointments but should also still be seeing some patients face to face. We are starting to be told now that the NHS is still “open for business” but that doesn’t seem to be the case. It’s all very well urging people to still attend A&E or call an ambulance if they are very ill but if they can’t even access GPs or 111 then they will think they can’t come to hospital. Their access to healthcare is being cut off.

DD2 went to A&E via ambulance on Saturday night.

She had a high fever (40.6) that was not coming down with Calpol and an aversion to light.

I hesitated ringing 999 as I was worried about exposing her/us to Covid-19.

We were taken to the usual children's A&E, and from what I saw it was all a 'red zone'. There was no one there except us.

Paramedics, nurse and doctor were all wearing wearing PPE.

Thankfully DD1 was discharged from A&E, suspected upper respiratory tract infection, but it's going to be an anxious 2 week wait in case either of us have contracted Covid-19.

I needed my GP and have actually been very impressed by the service which included a phone call on bank holiday Monday after I submitted a form on their website. Now, if I needed hospital treatment I don't think I'd be so lucky. The medics are worried about this and doing their best but the government is driving the agenda. And that's the scary part

Cliff diver, sounds like you got a good service? Am I missing the point you are making?

I think it’s really difficult. We know that lots of people carry the virus without symptoms. There really is no such thing as “ low risk”. We are not testing staff without symptoms.

We know that extended face to face time increases risk. That extra scan/exam/consultation may be very risky for you.

I’m reluctant to spent more time than is essential with patients as I’m very aware I’m a big risk to them.

Im not sure how we start working “normally” again. There have been plenty of people admitted With non corona issues and then found to have Corona virus- again, there is no such thing a low risk for corona virus.

This is the BMA take on it: <a class="break-all" href="https://www.google.com/url?sa=t&source=web&rct=j&url=www.bma.org.uk/media/2226/bma-covid-19-ethics-guidance.pdf&ved=2ahUKEwiDiO34tefoAhVxRhUIHbjaC-8QFjAMegQICBAB&usg=AOvVaw2ihpYy7IGpQxQVuVnnWGBy" rel="nofollow" target="_blank">www.google.com/url?sa=t&source=web&rct=j&url=www.bma.org.uk/media/2226/bma-covid-19-ethics-guidance.pdf&ved=2ahUKEwiDiO34tefoAhVxRhUIHbjaC-8QFjAMegQICBAB&usg=AOvVaw2ihpYy7IGpQxQVuVnnWGBy

We no longer have the NHS - it's the NCS.

Have to agree. My OH had his cancer treatment cancelled. Just a curt phone call from a receptionist to say it was cancelled - she couldn't tell us if/when it would start again. OH has been phoning the oncology dept twice a week since, but can't speak to anyone who knows what their plan is - can't get past the receptionists who keep saying they'll get someone to phone back, but no one ever does. This is treatment that is essential now. With treatment, he has a high chance of survival for 10+ years, without it, he'll probably be dead by Summer. He's deteriorating before our eyes, but the NHS has abandoned him. Just thrown to the wolves.

I'm so sorry @user1497207191 Yours is one of many posts I've seen in the last 24 hours where people are facing losing a family member due to treatment not being available. It's heartbreaking and it's so wrong.

I've just had a letter to say that imaging of my pelvic area for abnormal bleeding is cancelled indefinitely. I think it is probably ok but then my Grandmother had uterine cancer and died in her 40's and so I'd also like to be checked out asap. On the other hand I'm also high risk for the virus and worried about attending a hospital and contracting Covid-19.

@user1497207191 that's absolutely disgusting treatment. Covid or no covid! I don't know where in the country you are but in London cancer treatment has virtually all been moved to the Marsden so it can be kept going as much as possible - I don't see why this couldn't have been done regionally so each county or area of the country had one hospital taking on the cancer treatment. In fact couldn't this have been done with other things too? Obviously there are some things that can wait, without too much detriment to a patient but as other pp's have said - these cases aren't going to go away and how will the backlog be tackled??
I also have concerns about these nightingale hospitals - they've all been built but I'm hearing lots about us nearing the peak and they're empty! Couldn't we have used them for covid and kept the normal hospitals running a more normal service. Also, imo everyone - regardless of reason presenting at hospital should be tested for covid - no matter how long they spend there. That way, clinicians and patients would know if they need to isolate etc. Pretty sure we have the testing capacity to do that now so why isn't it being done?!
Personally, I've had an important clinic appointment cancelled. And my eldest ds (17) has now had 2 gastro appointments cancelled - this was also important as he was diagnosed in Jan (via emergency admission to hospital) with ulcerative colitis of his entire bowel. He has only just weaned off the steroids and that appointment would actually have been his first with the consultant (team). He feels a bit left in the dark with how/when to seek treatment, what he's looking for as to whether he needs to go back on steroids etc He's had bad acne develop as a side affect of (we think) the steroids (has Never had any acne before - just the odd spot) and this now needs treatment too.

@user1497207191 that is beyond awful, I'm so sorry it won't be the priority for you understandably but please report this to the media somehow. That BMA document I linked to says that these decisions need to be made based on fair assessment of likely prognosis, and conveyed in a compassionate way. It sounds like both of these have not happened for your partner and the NHS has failed you dreadfully.

At the hospital I work at I am still able to work in my service where we are now phone counselling / video link . There is a drop in patients presenting for this particular thing which is really concerning and means for those people who would normally present there will be ramifications later on . It has picked up slightly though , possibly people are worried to come to have the test, or worried about putting pressure in the NHS but we are still here ! One of the AE consultants has put a shout out in local media to reassure and ask people to present as they normally would . Our hospital is very organised with Covid Areas and non Covid areas .

@aladyofinderterminateage call your neighbours GP again, if the neighbour has a blood pressure cuff at home or you can get hold of one, there is no need for the GP to see at surgery , they can speak to neighbour and prescribe something over the phone. You might need to be more persistent .

I think the NHS is never going to be the same after this. Outside auditors and top dogs will be brought in to change the whole set up. Paediatrics will be Centralised into one super hospital connected to a massive adult hospital and everything will come from there. Community the lot. They do something similar in Glasgow. I think they will spring up all over the UK. And possibly some kind of further tax will be introduced to pay for it all. Or we will have to start paying to see the GP like in other countries. It will be a massive overhaul I think and staff will feel it sadly.