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 😢

I think the reason it's not as big on mn is on a parenting forum more people will be effected by the schools than health care.
I'm actually affected by both (and the NHS is what concerns me most). My op was cancelled (I'd waited 39 weeks already as of March - I have no idea when it will be, my health is certainly deteriorating). Ds's op has been cancelled, he was due some altering of medication which can't be started but meaning his health isn't optimal. SN assessment stopped, can't access cahms, school nurse rang basically said no help till back at school then it will be minimal. Also when I email for more medication/advice it's taking longer for reply due to reduced staf. Also when you ask for advice re covid they are so vague you feel more confused than before you asked. I don't blame individuals it's the management of the NHS that's the problem (& was prior to covid) - hence I'd been waiting 39 weeks because they cancelled all ops for 4 months over winter.

I am having to call patients daily and tell them that they need further investigations but I don’t know when or how long it will take to get it done. Wards are not busy but staff ( radiology/specialist nurses) are still on redeployment duties. Despite sending several emails, I have not heard anything practical about non COViD elective care.
Some of us want to initially start with first face to face and follow up with virtual clinics. Whereas some are being extremely difficult and send long emails why it should not be done for next 8 months even though attending their private patients weekly!

I think a lot of people will needlessly suffer and die unfortunately. A lot of the lives we save from covid will have just been swapped for a death caused by something else. It's devastating.

I've had physio over the phone. She did a very good job in the circumstances, but it's a long way from ideal (which the physio herself said!)

Dsis has lost her swallow - multiple LDs and autism . No one knows why . Can’t get assessed - so she’s told to eat mashed food indefinitely ... and only to eat and drink during the small windows of time she has carers present .

As a result she’s now smashed up half her flat and very, very distressed - how do you sort that? NHS said she’ll just have to wait - cancelled all her care and therapies and she’s lost every single day placement and activity she had . It’s just dreadful but seems totally unavoidable sadly

GP here says all healthcare dealt with via reception - you email them your problem, symptoms, photos etc and then they ask a doctor who tells the receptionist who then phones you back with advice . If they deem it necessary a doctor phones you or a nurse practitioner can ring instead . I think some stuff they also do on video chat, and other stuff they let you come to the surgery but only in exceptional circumstances .

@BovaryX

Pleased to see someone is highlighting the simmering scandal that is care homes.

OP,

Great you have raised this.

i can't fault the NHS, they have given my husband so much attention and left no stone unturned. He is under 5 specialists and we get regular appts over the phone and face to face when needed. He has has scans that were needed and now he is having surgery.
We are asked before every appt if he is happy to come into hospital due to higher risk or if he would prefer telephone consultation.
I have left messages to his consultants secretaries and have had call backs from his actual doctors directly to address any concern.
I feel like they have the time for us which was never the case before. And as bad as it is that all this is needed for my husband i feel we are extremely lucky he is being so well looked after during all this.

I'm an NHS therapist. We are doing video calls for out patients and it's not ideal at all but the best option for now. We have been told to plan for the next phase of how we will deliver our service as the nhs starts reopening services. There has been no blanket ' no patient contact'. The situation is evolving daily and our professional body are issuing advice frequently. We are having to fight to say why video calls are not suitable for all patients. It's cheaper and quicker so commissioners see an opportunity to save money/ space. It feels poor quality to me as a health care professional. Ok when no other option but not a long term solution.

I suggest any therapist or other HCP do a risk assessment to purely using video calls.

I work core NHS and and can tell you that hospitals have already started to reopen.

Also here is a news article that I have found from the day before we started to reopen:
www.newstatesman.com/2020/04/evening-briefing-nhs-services-reopen-whitty-warns-long-long-road-ahead

Our community service has continued largely unaltered, our therapists have been reassigned to positions in areas facilitating discharges and we have had to learn new skills to mitigate their move. They are always there for advice and support though.

18 months seems an awfully long time to be saying absolutely definitely no face to face treatment at all. Do you mind if I ask what area you work in ?

@frumpety

Are you asking what area I work in??

Our GP surgery has been shut for 7 weeks now. Apparently they are doing phone appts

@alphabetspagetti

The aim to have GP surgery's open fully within the next 2 months.

Pressed post too soon ...

Our GP surgery has been shut for 7 weeks now. Apparently they are doing phone appts but no one I have spoken to seems to have got anything other than a response to say that there's a global pandemic which has forced them to close and to use the online Covid checker if you are worried about symptoms or dial 999 in case of emergency.
What is annoying is that I know GPs in other local practices and they've all managed to stay open so I have no idea why ours has had to shut.

There is a 'Covexit' meeting this week for primary care locally.

In the past week I have personally assessed abdo pain, UTI, headache, blood pressure issue face to face in primary care/A&E. Examining ear infections doesn't generally add a lot to a good history so have been prescribing over the phone with advice will need seen if not settling after this - saw one ear infection as patient preference - that was okay. Rashes and red eyes by emailed photos. One such photo was forwarded to a consultant and the patient had a rare and benign diagnosis within the hour with planned follow up arranged. Honestly not sure what more we could be doing!

At present I think the main risk in the NHS is to frontline HCPs but hopefully immunity has now built within this group. Those in the 'second line' ie clinics and therapy will hopefully have some immunity from encountering the virus in day to day life as we come out of lockdown. The risk to patients as we open up is as likely to be from the waiting room as the staff imo. Especially if they have been shielding or staying in a lot or are just generally vulnerable. SD waiting rooms are going to restrict things a lot. And the question over PPE remains - even if staff have a positive antibody test could they spread the virus on their clothes from one patient to the next??

I'm sure the backlash is building though OP - fear not! There are already signs of it.

I’m with you OP.

In a family of 6 - 5 of us are waiting for appointments.

DD2 has been complaining of headaches and struggling to see the board or the computer screen clearly since February. She had an optician’s appointment end of March (first one we could get) and now nothing. She’s at that critical age in eye development that if it’s left too long it could have long term impact on her eyesight. Nothing we can do.

DD1 got her brace on in January and was due to have it adjusted in March (and then May, and then July). Nothing. It’s unlikely to have a long term effect on her teeth, but it will mean her orthodontic treatment will last longer, potentially be more complicated and ultimately cost the NHS more. Nothing we can do.

DS has been waiting for a podiatry appointment since we moved last summer. He has hypermobility and non-existent arches. He’s also a runner so needs regular appointments to ensure his insoles are working. (was previously being seen in old area but had to be re-referred due to moving) He finally got one for March 20th and it was cancelled. No idea when he’ll be seen now. Nothing we can do.

I had surgery last summer. We then moved shortly after so my post-surgery check up was referred to hospital where I live now. Was supposed to be October/November time. Still hadn’t got an appointment by the time lockdown started. No idea when I’ll be seen now. Problem which surgery was meant to fix has returned. Not life threatening - but I’m in pain daily and it affects my daily life. Nothing I can do.

DH is supposed to be seen and scanned every 3 months for a post cancer check up. His last appointment was 20th March and of course it was cancelled. He had a phone consultation in April, but as you can’t scan over the phone it was pointless. He’s got a new appointment for end of July. We are just praying that appointment goes ahead. He’s seen regularly for a reason - to stretch his 3 month gap to 6 months is bloody scary. Nothing we can do.

@timrigginshasmyheart

In the hospital i work in cancer treatment is still going ahead as planned and is supposed to in every other hospital.

If shes at that critical age in eye development, you need to call them and they will get you an appointment.

I'm sure the backlash is building though OP - fear not! There are already signs of it

What a peculiar comment. Two million operations have been cancelled. A&E attendance halved. Stroke and heart attack patients? Where have they gone? The guidance in place for one month in London from March 10th to April 12th meant even suspected Covid patients struggling to breathe were not admitted to hospital. Karl Sikora, the prominent oncologist, warns that 60,000 may die as a consequence of cancelled and delayed cancer treatment and diagnoses. In March, elderly patients in the most vulnerable demographic were decanted into care homes. Without being tested for Covid.The upshot of that was predictable and lethal. Meanwhile, an atmosphere of hysterical adulation has been promoted, with nonsensical talk of 'angels' and rainbows. How many people have and will die because of cancelled treatments, postponed operations and the huge backlog being created. This is not happening in other countries with functioning health care systems. Appointments with doctors continue. The attitude to the NHS is not only dysfunctional. It's unfathomable.

Please, please if something happens which you would usually go to A&E for, please still go.
You will be kept separate to Covid patients. Hospitals have a covid side and a non covid side.
I work for the NHS so I know this very well and it is scary to see A&E attendance dropping.

In the hospital i work in cancer treatment is still going ahead as planned and is supposed to in every other hospital
Tiatotherescue

If so, why is Karl Sikora sounding serious alarm bells?

^in a usual April, we would normally see around 30,000 people diagnosed with cancer. I would be surprised if that number reaches 5,000 this month.
Coronavirus will steal the headlines, but cancer kills 450 people a day in the UK - there is no peak and the numbers aren’t coming down. Unless we act urgently, that number will rise. A group of oncologists, including myself, estimate that 60,000 cancer patients could die because of a lack of treatment or diagnosis.It’s absolutely right to stop the treatment for some cancers in the face of coronavirus. The immunosuppressive effects of the treatment would put the patient at risk as their immune system is significantly weakened. But for others, a delay of more than a month would have a negative impact on the future prognosis^

@Tiatotherescue it’s not cancer treatment - it’s a post cancer check up to check for recurrence. I think that’s why it’s been bumped. Not serious enough apparently.

@bovaryx

I am only saying what it is like in the hospital I work in.
I can't be responsible for what other hospitals are doing.

@TimRigginsHasMyHeart

No, it should still be going ahead, post cancer check ups in our hospital are.

Well there you go - it’s not happening here, and we can only hope it happens in July by which point it’ll be more than 7 months since his last appointment and scan. (Was last seen in December)