So much chat about schools, why is no one looking at the NHS?

[headachehenry]

So much ripping apart of the plans to get schools back with different measures, what education will look like from now on, etc - understandable. I'm really surprised that no one is asking questions about the NHS in a covid world.

I'm in therapies in a role where I need to touch and examine patients in order to assess, diagnose and treat patients. We've been told that we won't be allowed to offer face to face for 18 months and can only treat people over the phone or in virtual appointments - conditions can not get diagnosed this way. Colleagues are having to talk parents through doing procedures on themselves online, talk relatives through doing complex rehab over the phone, procedures we use for diagnostics are suspended long term, therapy assessments on small children being carried out remotely (challenging when they won't stay on camera). Many staff members told to plan to work from home (in unsuitable environments with lack of confidentiality with family members) indefinitely.

The NHS is not all about inpatient care (which remains) or elective surgery (which is all you ever hear about) - I'm really surprised that people aren't on here ripping NHS services to shreds. I'm embarrassed that it's clap night again because I feel ashamed at the service I'm able to offer from now on (I know it's not my fault, it's the covid NHS) and wish people would shout about it 😢

OP “ We're dealing with an unprecedented situation that is only going to get better with social distancing ”

Do you believe that?

*“ I'm in therapies in a role where I need to touch and examine patients in order to assess, diagnose and treat patients. We've been told that we won't be allowed to offer face to face for 18 months”

That’s shocking. I was very pro NHS before....*

Actually, I should have added that we can do face to face is it's extremely urgent, life threatening and will prevent admission...but that's not really the work I do, so we have to stick to virtual. It's no less important to my patients though.

@LilacTree1 well, no...I worded it wrong really. Hospitals are very very busy, crowded and high risk places. We have to reduce contact as much as we possibly can and that means moving away from face to face contact. It's shit though.

Wow, 18 months! That’s a looong time...

Who could possibly have thought transferring the most vulnerable demographic from hospital into care homes in March without testing them for Covid was a defensible idea?

^according to the latest Office for National Statistics (ONS) data, deaths in care homes made up 40.4 per cent of overall coronavirus fatalities across England and Wales in the week to May 1.
In total, there were 8,312 coronavirus-related deaths in care homes in England and Wales – but care providers have warned that the true figure is far higher. In response, the EHRC announced on Thursday that it is considering investigating the legality of discharging possibly infected patients from hospitals into care homes^

OP “ We have to reduce contact as much as we possibly can and that means moving away from face to face contact.”

But surely in cases where face to face is needed, it should be done? Or are the NHS now planning that no one will ever see a medical professional without full PPE?

Bovary - yes I dint think they tested discharge patients till 15th April or something?

www.telegraph.co.uk/news/2020/05/14/equalities-watchdog-considers-whether-sending-patients-hospitals/

@LilacTree1 lots of people will access face to face healthcare. Most of it is the typical stuff the media reports about...cancer screening and care, emergency treatment, elective surgery etc but lots of things that aren't life threatening are being reduced and moved to virtual clinics.

I'm really surprised that your organisation is saying 18 months. I work in mental health..currently working remotely but theres no way I expect that to continue for that long, a couple of months if that. My partner works in a childrens hospital and his service are now working to reinstate routine face to face appointments.

This policy is unfathomable. Those responsible for this should be held to account. The decisions made and the consequences of those decisions; from removing vulnerable patients from hospital to cancelling millions of operations? They need critical analysis.

in two damning policy documents published on 19 March and 2 April, officials told NHS hospitals to transfer any patients who no longer required hospital level treatment, and set out a blueprint for care homes to accept patients with Covid-19 or who had not even been tested.Analysis by the Telegraph suggests that the rate of coronavirus deaths accelerated more than twice as fast in care homes than in hospitals in the week beginning 7 April - two and a half weeks after the first policy document was published. The number of Covid-19 deaths in care homes was estimated by Care England to have reached 7,500 a week ago, the Government is under pressure to start publishing a daily tally of coronavirus-related deaths in care homes

www.telegraph.co.uk/news/2020/04/24/care-homes-ordered-take-patients-suspected-coronavirus-nhs-hospitals/

OP

I know you’re tired, sorry

But you said you needed to see patients face to face and you don’t expect to do so for 18 months.

So it does sound pretty dire. I realise of I have a heart attack I’m unlikely to have a virtual conversation but what about about if - random example - I get an ear infection? Am I going to be told “not acceptable to see a GP” for that?

And physio over a video call sounds pretty nuts.

Mental health community here - we've started planning our return to BAU whilst incorporating some working practices gained through Covid. We would probably been resistant to more use of technology but it's actually been well received amongst a large cohort of our patients.

We are very worried about some of our patients who don't have skills in self advocacy though and are keen to get back out to being more assertive in some areas.

The whole situation is a joke for non covid patients. In my job, I am in hospitals most days (Im not NHS). Yesterday, what would be outpatients waiting room had a barrier round it with around 20 porters all sitting with their feet up laughing and joking ( no social distancing or ppe). I needed a blood test last week - went to phlebotomy clinic - 6 phlebotomists again, twiddling their thumbs. Jumped apart from their little chat when I came in (again no social distancing).
There are so many members of NHS staff with absolutely nothing to do.
I’ve been referred for some more urgent bloods and now can’t get an appt as everything has changed since last week and the clinic is no longer accepting walk ins. They’ll phone me whenever they can take me.
I know it isn’t the staff’s fault, but I won’t be out there clapping when I’m still trying to do my even busier job every day, combined with a potential illness I can’t get a diagnosis for :(

Crazy, I feel for you

I must admit, I don’t blame nhs staff for not social distancing

It’s bloody hard to maintain.

In my hospital and my husbands we've started planning to restart some elective and urgent work/procedures/ops as of next week.
Staff involved will be tested on a weekly basis and all patients coming in for elective procedures will be tested prior to admission.
In my hospital we have continued to offer urgent clinic appointments, blood tests, X-rays etc throughout all of this as well as doing all routine appointments by telephone where possible.
I'm very surprised that your hospital is saying 18 months op.

Haven’t the nhs effectively taken over private hospitals too? It’s such a disaster.

18 months? What's the rationale for that time period?

.

My husband has had his physiotherapy assessment cancelled indefinitely. Now that might not sound very urgent but he has a congenital hip problem that will need surgery and the physio would help with pain management and keep him mobile for longer. He is in constant pain and starting to suffer from depression. Can't even get past the receptionist to talk to a doctor about it He's only 59.

It's supposed to be the National Health Service not the Covid Health Service.
Enough is enough.

@LilacTree1 I know. It's crazy. I can't speak for GPs, no idea what they will do about ear infections and the like.

I can do my job virtually but it won't be done properly. I need to physically examine people to get the full picture up but I can make a best guess virtually if that makes sense.

I thought 18 months was a bit extreme but that's what we've been told. I guess it may change. They are probably trying to manage expectations. We have very poor infrastructure so we don't have room for covid and non covid.

I know op, It is bad isn't it. I won't be getting some of my maternity appointments that the nhs usually day are important for mother and baby's health. Either they're not important or they are - which is it.

To be clear, I absolutely don't blame staff for this at all and it's a very difficult situation but I think medical appointments are pretty necessary and should be going ahead instead of people being encouraged to go back to work or told they can meet someone in a park etc.

@EllaPaella it's not 18 months for everything. Lots of work looking into electives and procedures. I work in therapies though and that's what I'm more talking about. Most of us don't have offices or clinic space anymore as we were kicked out of the rehab hospitals for example. We're working from home remotely and there's no room to have us back until covid moves out!

Really 18 months?

Our hospital is looking to start elective procedures again soon some have already begun depending on severity. Everything we do is face to face and hands on and we are looking at ways to safely restart routine clinics again currently, so we can start soon.

All our TWWs were called initially and then bought in if it was anything concerning or if the patient wanted to be seen, bearing in mind a lot of TWW patients we get referred are fairly obviously not cancer after a short consultation so sometimes face to face was not needed. But no TWW patient has been denied a face to face consultation

The problems we have is a lot of our hospital has very small waiting rooms, and our clinics get really busy. We have had to massively change our infection control procedures and this takes a lot more time and actually space. So we need to rethink how we do it, and rearrange our outpatient facilities to accomodate different clinics. For example we would normally have multiple clinica running for the same waiting room, this is obviously not possible with social distancing