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.

[goldfishkiss]

@onlyreadingneverposting8 I wondered this myself, most cities have multiple hospitals and some are building extra covid19 facilities. I don't understand why they couldn't just turn some hospitals into covid ones and allow the others to keep operating as normal for those most in need, cancer patients and so on?

[fairgame84]

I work on a paeds ward. There are 2 paeds wards at our hospital, one is now designated for children with ?covid. My ward is for everything else that isn't covid.
We're have assessment beds and inpatient beds and normally see approx 20 assessment admissions each day. We're currently seeing approx 5. We would normally have at least 20 inpatients across the 2 wards, yesterday there were 6.
It's been like this since lockdown. Where are all the kids with appendicitis? The babies with temperatures? The kids with meningitis? The asthmatics?
It's a huge worry. Parents are reluctant to come because they don't want their child to catch covid but unless they have a cough or fever with no obvious source, they will come to our non-covid ward.
All others go in cubicles on the ?covid ward and then transferred to us if they test negative.
So far we have not had a child test positive.

[goldfishkiss]

@EachandEveryone It could be different as you say, I'm in Glasgow and there are problems with the system there so I am not sure it will be adopted throughout the UK. I can see the point of centralising all the expertise in one place to create a centre of excellence where all the staff are highly experienced but then there is an issue is something goes wrong i.e. the infections at the QEUH last year.

Also I think it will be a cold day in hell before the british public pay upfront to see a GP. I think its more likely to be done via taxation.

[TwistyHair]

@fairgame84 that is worrying. How many of your usual admissions end up being discharged with no intervention? As in, do lots of children come in who end up not needing hospital admission. Could that explain some of the drop?

[fairgame84]

All of our referrals come from midwives, gps and A&E.
Midwives are not seeing babies until day 5 so jaundice referrals have reduced. The majority of jaundice babies did not stay in anyway.
GPs are not seeing patients. That is where the bulk of our referrals come from. This time of year a lot would stay for a few hours for assessment and treatment and then go home. The problem is that the children are not getting the assessment or treatment because GPs won't see them. We aren't getting the tonsillitis, the abdo pains, the constipation, the vomiting, the fever with no obvious source. Maybe 4 or 5 of these each day would stay overnight.
A&E attendance is down, we might get 1 or 2 each day that need to stay over from A&E.
The kids that are coming are ill. They are coming too late. We've had 2 in HDU over the weekend that should have come in sooner. One asthmatic and one diabetic.
Yesterday we had one baby for phototherapy and 2 babies staying in for IV antibiotics. 1 older kid overnight with a head injury and the teenage diabetic. That is it. We haven't had an appendicitis for 2 weeks, we normally get 2 per week.
No broken limbs for theatre, we normally get 4 or 5 per week.
No foreign bodies up noses/in ears. 1 or 2 per week.
It's eerie.

[Jourdain11]

So sorry to everyone who's had a cancellation, delay, bad experience... it is so sad

I had my own experience with this over the last few weeks. (You can read my thread if you're incredibly bored www.mumsnet.com/Talk/coronavirus/3859180-How-selfish-would-this-be?pg=1&order= ) I had a random collection of very non-specific symptoms and couldn't get a f2f appointment. I ended up speaking to a doctor who I didn't know on the phone and he said it was probably anxiety-related. I had a feeling that there was possibly more to it and went to the UTC at my local hospital, although I was worried about time wasting. Anyway, except for the beginning, I've had the most amazing treatment from the NHS ever since. I just wanted to share this story because a) my experience in Urgent Care / A&E was really okay - incredibly quiet and any Corona-symptom patients were going to an entirely different part of the building. And b) Even though some treatments are being cancelled, it is not the case for everything.

So, my message to everyone is, that even if you don't think you will get anywhere, it is still worth trying.

[TwistyHair]

I see, so once you see them you know they’re properly ill. That’s such a worry. I know with my daughter who is 2, she had a temp for over a week just before lockdown started. She had a cold too and a bit of a cough. Anyway, in usual circs I would have phoned GP after maybe 5 days or a week. But I didn’t coz I was worried about wasting time or having to go in. She ended up being fine by about day 8/9. She’d seemed fairly happy in herself so I wasn’t too worried. But equally things can change so quickly with kids.

[Jourdain11]

@fairgame84 That is weird. I can get the reduction in broken bones - less activities, team sports, and so on. But I don't see why kids wouldn't be getting appendicitis and all the rest of it? I do think there's a big factor of people just being terrified to go to hospital.

[Misty9]

@Jourdain11 bloody hell I've just read your whole thread. You poor thing, what a whirlwind few weeks it's good you're getting treatment now albeit horrendous effects of it by what you write. You write beautifully, and it never sounds self pitying which you have every right to be! Have you thought of doing a blog? for the rest of your treatment

[LucheroTena]

The NHS has coped so far by basically moving many staff from its routine work (including cancer) to staff covid wards inc Nightingale, and increase ITU capacity. So the routine work is either cancelled or severely restricted.

If this goes on for months it will have a massive impact. There is no long term thinking evident from government or the NHS. I’ve noticed our current 3 pages of nursing vacancies on the hospital webpage has shrunk to half a page. This isn’t because we suddenly have lots of staff it’s because the recruiting managers are all clinical nurses who have been pulled to staff covid. So no one is focusing on recruitment. We need to majorly upscale the NHS to see us beyond this first emergency.

[girlofthenorth]

Totally agree with you @IheartNiles this is affecting our dept.
@Jourdain11 what a journey

[Baaaahhhhh]

I believe that the NHS has "bought" all the capacity from the private sector. I was speaking to BUPA the other day about some physio, and their response was that all their capacity had gone to fill emergency NHS requirements.

[Misty9]

This thread makes for more sobering reading www.mumsnet.com/Talk/coronavirus/a3868728-What-non-essential-medical-appointments-have-you-had-cancelled

[roses2]

I do wonder what all the staff that would normally carry out these routine appointments are doing now. Surely they can't all be working covid cases?

[Misty9]

A lot of them in my region are apparently not doing a lot. While waiting for the peak to hit.

[DPotter]

I think it's very dependent upon your area.
Our local hospital has a separate 'cold' entrance into a temporary A&E and there are 'non- covid' wards for anyone needing admission. Cancer treatment is on-going and outpatients appointments are being carried out by phone and in certain high need cases outpatients are still being seen.
In our area plans are being drawn up to provide urgent surgery (to begin with) in hospitals where they will be no covid patients.

I know ambulance response times have actually improved locally for both covid and non-covid call outs.
My other half had a screening outpatient phone call last week and has been given an appointment to attend the hospital next week.
we've heard from our dentist that emergency dental services will be available soon in a central location so that staff can have the full high level PPE.

It's bad but plans are being put in place to get back to some degree of normality.

[Kokeshi123]

The drop in air pollution levels might PARTIALLY account for a fall in heart attacks and strokes. I don't see where all the appendicitis etc. cases have gone to. Perhaps it's harder to spot things right now. Parents are harassed and busy trying to work and homeschool at the same time. Kids showing warning signs (crankiness, sleeping badly, poor appetite) are perhaps being attributed to stress, lack of outdoor time and their interrupted routine. There aren't other people around to bounce opinions off ("What do you think?" "Not sure, maybe get it checked out to be on the safe side..."). And there is so much unpleasantness around, online and in real life, towards anyone perceived as "breaking rules" in any way---I think people are afraid of getting nasty reactions if they ask online for opinions or turn up at a hospital with their child.

[BamboozledandBefuddled]

Some of the posts in the thread @Misty9 linked to are terrible. And it's really upsetting to see some people saying "I know it's not really important" because it bloody well IS!!

[Useruseruserusee]

Yes I worry about this too. I have a toddler with a complicated health condition, thankfully he was reviewed by his surgeon in Feb so we should be OK for a little while. I’m also fortunate enough to know the warning signs for him and to know when he needs to be admitted.

[BamboozledandBefuddled]

Just seen this on the BBC www.bbc.co.uk/news/health-52278825 Week ending 3rd of April there were over 16,000 deaths registered - 6,000 more than 'normal' for this time of year. Of those extra 6,000 only 3,475 mentioned Covid 19. The article then says 'It could be that cases of coronavirus are going undetected or other factors related to the lockdown and outbreak are having an impact, such as people not seeking treatment for other conditions or mental health deaths going up. 2,500 extra people dead in one week but not from the virus? What will that figure been in a couple of months?

[Kokeshi123]

I'm feeling concerned. I have just seen this on Twitter:

twitter.com/d_spiegel/status/1249986522692096003

Based on the latest data from the Office for National Statistics (which just came out), there appears to be a very sharp rise in non-CV19 deaths. That graph is alarming!

I am looking at the ONS data ( www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending3april2020#new-analysis ) on which that graph was based.

Total deaths are an 6,082 increase compared to the five-year average. It appears that only 3,475 of these were ascribed to CV19. Or am I reading that report wrongly? (It's late at night over here and I am feeling quite tired)

The New York Times reports the possibility of a similar phenomenon in the States.
www.nytimes.com/2020/04/06/well/live/coronavirus-doctors-hospitals-emergency-care-heart-attack-stroke.html

[Kokeshi123]

OMG, Bamboozled, you beat me to it! I think we were posting at the exact same time.

[BamboozledandBefuddled]

You're reading it right @Kokeshi123 The 'treatment' is going to kill more people than the disease at this rate.

[Misty9]

Which is exactly why I'm suspicious of the government's motivations for all this...

[dyscalculicgal96]

DD's speaking value appointment is cancelled.