The hospital I work in is so quiet

[QuietHospital]

London hospital.
Half empty. Some wards have less than a handful of patients, some wards are closed. Most staff have been moved to wards so are falling over selves. While their regular work goes undone.
A&E very quiet. I’ve sent patients there who are seen immediately. The heart attacks, strokes and appendicitis cases are presenting too late. People with covid are waiting too long to present. If you get breathless then for goodness sake come in. I’m so cross at the initial advice to stay home until struggling.
Had a look through covid ward lists and vast majority patients are aged over 70. Hardly any patients under 60, those who are have underlying health problems for the most part. Lots more men than women affected.
It’s just a snapshot but echoed by colleagues in other hospitals.
I think we can / should start to move back to normal life soon for the well young people among us. I fear for the short and longer term economic hit. It’s crazy to have all these young well people furloughed or made redundant.

Same here in a north west hospital. On green alert (usually on Red or Black at this time of year). Staff wandering around with nothing to do. I work in dermatology and the amount of skin cancer patients that may have been put on hold is worrying me.

@BubblesBuddy the phrase being used by the Government at the moment is Protect the NHS , it is on all the Gov websites.

Re: regionalist. Yes. Sad that NHS 10 year plan not yet implemented. This puts power into regional authority hands for local healthcare planning and purchase. More like the German model. Lots of negative press over this too, with contracting out to private companies. However, the German model seems to work well, so why are we so resistant. Perhaps this experience will help effect change.

I think people expect things to move too fast. Routine services had to be stopped to accommodate the surge.

They will now be reconfiguring staffing etc to transition back to normal but it will be a gradual process. It was only the presumed peak last weekend.

Pomegranate do you mean 111 triage? I’m Posting quickly.

But from what I have read I would like to see further investigation on whether it is at the right level. There’s been a few sensible posts on other threads re early signs it is being looked into more. Hopefully then we will get better data. It worries me but more from look into it than this is the case perspective.

For those who want to continue with the lockdown, when would you start to relax and how? The evidence is that the NHS is not overwhelmed and that the side-effects of the lockdown on deaths from other causes are starting to mount. If the NHS has spare capacity, should we not start to use it?

Not everywhere is like London and on the downward curve. This was always going to happen because London was ahead of everywhere else.

The hospital on the 10 o'clock news in Wishaw has quadrupled their ICU capacity and is full to the brim. Other Lanarkshire hospitals are the same, Glasgow too.

I think until at least the top 6/7 cities population wise (as they seem to be the hardest hit areas) are all on the the downturn lockdown needs to stay otherwise the problem will just spread around

Now we’ve ridden this first wave we need to1. Encourage and facilitate people with concerning symptoms to get seen early.2. Set up covid negative and covid positive hospitals and get the testing turnaround right to facilitate this.3. Start up normal NHS business.
4 Get the young and healthy population back to work so we can end the hysteria and start paying for all this.5. Test and trace in the community. Stop the outbreaks in their tracks*

OP - I have only read to page 10 so this may have been covered already. Apologies if so.

It is frustrating to read that so many health care professionals seem to be standing around doing nothing or very little. On the other hand, if it means the system has, broadly, coped then I think that is positive although I accept there will be damage in terms of longer term outcomes for patients with other conditions (and that could affect any one of us at any time).

So my question is, what would have happened if there had been no lockdown? Or a partial lockdown? Would you still be saying the same thing?

And you have said five things need to happen, above. Surely the priority should be the test and trace strategy to keep the NHS from being over whelmed with a second or further waves in the future?

How do you feel about winter and seasonal flu this year? What will be the impact of COVID on your usual experiences?

It feels to me that one way or another, the lockdown has acheived what it set out to achieve and that is a good thing overall. I was fearful of us being overwhelmed, of deaths into the thousands daily, possible civil unrest, food shortages etc. If we have got through this and are able to perfect test and trace, surely that is a good thing?

Btw my trust is looking into resuming some elective admissions. I really do feel we are managing this crisis in quite a controlled way. Obviously there is a lot of work and planning happening which isn’t evident.
We’re really not resting on our laurels. Although I would say, some areas need some quiet time to process what they have seen. We’ve particularly struggled having very ill colleagues, people dying/have died simply because they were looking after people. We’re fining that really difficult 😢

Are doctor surgeries the same? (Sorry haven’t read the whole thread), I’m waiting a call back after a online consultation.

I can’t understand people not going in if they are unwell, I have appendicitis last summer and I don’t think I could have not gone in. People need to use common sense and get treatment if needed.

@Bringringbring12

If you will “probably die if you get it” isn’t there an enormous array of infectious illnesses that would also mean you would “probably die”?

Your empathy has overwhelmed me.

Perhaps you haven't heard of antibiotics? They've kept me alive a few times. They don't work with Covid.

To be fair, Germany also spends about half as much again per person on healthcare as the UK.

Increasing the number of profit-seeking companies taking money from the healthcare budget, while keeping that budget the same, is unlikely to magically cause better outcomes.

"Figure 1: UK health spending per person was around the median for OECD member states"
"Healthcare spending per person in OECD countries in 2017"

• In 2017, the UK spent £2,989 per person on healthcare, which was around the median for members of the Organisation for Economic Co-operation and Development: OECD (£2,913 per person).

• However, of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).

• As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017, while healthcare spending as a percentage of GDP rose for four of the remaining six G7 countries.
www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29#healthcare-spending-compared-with-health-outcomes

@PerkingFaintly

Totally agree and spending falling only slightly for the U.K. probably means a big cut in real terms if you have an expanding older population (not hating on elderly people, just that resources tend to be spent most at beginning and end of life).

'Everyone is really, really worried about the patients out there who are not presenting for heart attacks, strokes, cancer etc'

But if having a heart attack or a stroke it isn't something people can decide if they attend hospital for, surely it's a 999 situation where they would be admitted?

Regarding cancer, GPs have remained accessible for all advice and 2 week urgent referrals have continued, 111 is available 24/7 too.

I think there'll be more minor illnesses missed and managed at home but some do treat A&E like a GP anyway so that maybe isn't a bad thing.

Great post OP. I can not believe this is not being reported, I'm exasperated with it.

I work in a trust in the North. Massively under capacity. We're sat around doing nothing. No PPE issues.

Latest study is that 150,000 will die from the impact of lockdown. Includes DV, suicide, cancellation of treatments, cancellations of screenings, not attending a&e in a timely manner.Far more than will die of CV.

People are terrified of going to a&e due to CV. My local one is empty. Have a friend with a child with complex medical needs and she's trying to treat her at home despite being encouraged to take her in. She thinks going in automatically means she'll catch CV and it therefore taking her chances at home.
She's risking her life.

This could potentially wreck the NHS. The waiting lists are rocketing . They have cancelled all leave at my trust which will have to be taken at some point. So even when we get back to "non-essential" work there's not going to be the staffing available to run things properly for a while.

I have colleagues lapping up the attention and freebies, making out on SM they are heros for being NHS frontline workers working all hours when that's just not the case. It's shocking behaviour and just adds to people's anxieties.

Latest study is that 150,000 will die from the impact of lockdown

Can you link?

To clarify my original point about London being used as the model was related to how local health services are mandated to act. I do see why the whole countty had to lockdown together. I do worry our regional peak will come later than London and lockdown might end too early if numbers are dropping in London. I also feel social distancing is far easier where I live, and worry well face unnecessary restrictions on life for too long in quiet regions, whilst we wait for it to be safe in busy London. Again, I see why decisions have to be made nationally but perhaps we could be less London centric for once.

With heart attacks it's the timeliness that is the issue. People would usually ring much earlier or go direct to a&e more promptly but are avoiding doing so. As a result there has been an increase in paramedics attending and the patient already being dead. Data last week was an increase of 80 per day in London alone.

l wondered about this. My blood results have been 'odd' on and off for about 18 months now, so l was referred to haematology a month ago.
Hospital letter arrived, l was given the choice of 4 hospitals, 2 local, 2 a bit further afield. Went online to book an appointment - all clinics are closed.
l had the option to request contact back when appointments became available. l've heard nothing, so l assume the clinics are still all closed.
l'm just keeping everything crossed that it's nothing serious.

It is difficult times. May be some NHS staff will even have to be made redundant or put on furlough - it is so hard to get all this right.

yet people finding it hard to breath are still apparently finding getting an ambulance is the bottle neck. Someone on MN';s 9 year old son apparently called for one when she who has covid 19 could not breath and they would not come out. That is not a doctor but the 999 people who answer the emergency phone. Another London lady 2 weeks ago got one out eventually, mother of 3, but they refused to take her in. Next day her husband found her dead on the floor.

If hospitals have capacities we do need to ensure we get people who need help with oxygen in there before they are almost dead.

Heart attacks are different from cardiac arrests. Lots of people don’t understand this. You can have symptoms of a heart attack for days or even weeks before you suffer a large one, many people mistakenly think they have indigestion and take Gaviscon etc for days until it gets to a point they think they need hospital treatment. Many of those people now simply won’t go at all and will die at home.

I heard similar from doctor relative, eg AAU more than half empty when normally full/people waiting to get on it.

@Tangledyarn genuine question. If you didn't got to hospital how do you know you had it?

Following thread with interest

Not what my surgeon BIL is reporting or my A&E nurse SIL (opposite ends of England). They're saying it's manic.

I would just be presenting myself to A&E if I needed to and they agree.

"Not sure why we are picking up in the NW 3 weeks into lockdown?" Because nobody can behave themselves. All out and about all over the bloody place.

My local hospital has mostly six bedded bays with only a few side rooms in each ward. I would not want to be sharing a bathroom with another five people at this time unless it was absolutely unavoidable. The tests for Covid are not 100% accurate and people who have initially tested negative go on to become positive. I think it’s incredibly difficult to be sure that any area will remain Covid free.

I’m assuming that some of the people on this thread don’t know anyone who has died of Covid. I know of three people, one of whom caught it in hospital whilst in for something else, and I know someone else who is ventilated and fighting for his life. This thread trivialises that and makes it seem like it’s all been a big overreaction- try telling that to the families of the people who’ve died.