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 😢

“full capacity but in the developed world beyond the UK, routine appointments, blood tests, etc, etc, including cancer treatment “

This should still be happening here, just the appointment may be by phone/video which is for the patients benefit because who wants to get on public transport right now to go to a hospital and then investigations if needed are still being done just maybe in a different way using “cold sites” and drive throughs or arranging for equipment to be delivered to patients homes - for example if you need a blood pressure check we will arrange for a automatic machine to be delivered to your home for you to check rather than bringing you in to the surgery to reduce the risk of the patient getting covid - it’s more work for us but safer for the patient

Some of our patients seem to prefer it like this, video consults are very popular as patients can access healthcare while at work and we are trying to see if we can afford to keep them after covid (the softwear is on a free trial for the duration of covid)

They are here too. I have said that the service isn’t running fully.

Hospitals that have covid wards can not manage routine appointments as they did it can’t be done here or abroad. Many clinics are still running but with social distancing in place for patients and staff that limits the amount of people that can be seen and that has a knock on effect on the services provided. All health care services that implement social distancing can’t fully function to a full capacity

Private hospitals (and many areas in Europe have two tier health care service) can pick and choose which patients they treat.

Case by case has to be looked at.

@AChickenCalledDaal would a video call be better for your dad? Then he could see their therapists face. There is also speech to text services that are starting to be used. Deaf patients are a real issue and the see through masks seem to fog up easily which makes them pretty worthless.

Speech and language is a hard area it’s high risk as working up close near peoples mouths is about as in socially distanced as you can get. I wonder if any SLT on here can advise about any innovative ideas?

Is there any particular help you think he needs? Parkinson’s is a horrible disease and by its nature progressive and you have my sympathies

When I started the thread, it was more about therapies as that is my area. Therapies aren't life saving in the traditional sense , they often pick people up after and get them back on their feet with rehab. It's more quality of life stuff in my area.

We can't 'properly' do our job virtually. We can have a stab at it. Which is fine in an emergency but not really forever.

My team have been fully displaced from our clinical space with the covid reshuffle and there is no space to find us a new home. We can't run clinics now even if we were allowed to but guidance is WFH anyway. So virtual is all we can do and the trust has said plan for 18 months.

My point was, everyone is ripping education to shreds when really, everything is different now, and it's all a bit shit.

@BovaryX - all that stuff is definitely still happening in my local NHS Trust because I have used or know people using those services, this thread is about when hospitals get back to capacity to perform ALL types of treatment.

From your example, in many cases it wouldn't actually be important to meet an endocrinologist in person at the hospital though, 90% of the work for many patients is in the blood test and talking, an occasional blood pressure check or physical thyroid check for some new patients / specific issues. Of all the services I think they should try to go online more, they could probably see patients more quickly that way too without the faff of going in and out, receptionists working by phone instead of in the hospital etc.

headachehenry I agree everything is different now and that isn’t likely to change soon. Also agree it’s shit for some it’s really really awful

@Bigfishylittlefishy, that must be really worrying. One of mine had eye problems, ten years of hospital visits, patches, drops, glasses, 2 surgeries. I was told the important window was to get things going before 7, we started at 2 and all finished at 12. Didn't need glasses again until he hit 40 and needed reading glasses. The only thing we were told he would never do was to be a pilot. He never wanted to be a pilot so that was a relief.

Obviously I don't know about your son's case but hopefully things will get sorted soon and he will be well within the window for getting it all sorted successfully.

I’ve got no complaints about the NHS. They had to shut non essential stuff down at the outset, they did it quickly and efficiently. Thousands of staff have continued to work selflessly in terrible circumstances. And, as the circumstances have allowed, they’ve continually adjusted and opened up as and when they’ve been able to do so.

We’ve had an A&E visit and a telephone consultant appointment during lockdown and I’ve been so impressed with everyone’s commitment.

No comparison to others.

@BovaryX can I ask where you live in the world ?

@headachehenry I can't speak for GPs, no idea what they will do about ear infections and the like. I needed to see GP this week so I can tell what is happening at my surgery.

I have a family history of cancer, genetic link, so some symptoms last week and getting concerned, sent online message to surgery outlining problem.

1. GP on triage phoned went through my message and said I'd need to be seen, in the meantime asked lots of questions as he said it would mean spending less time with doctor when I saw him. Given time to attend.
2. Arrived at surgery, door locked, receptionist put a mask and gloves on and came to the door and asked for details, couldn't find me on list, went off and checked came back and said I could come in.
3. Asked if I had been told to wear a mask, I said no, so given a roll of paper to make a make-do mask. Told to use handsanitizer.
4. Dr called me in, Dr wearing scrubs, an apron, gloves, mask and visor.
5. Few quick questions, told what will happen next.
6. As I left I could see into 2 other consulting rooms as doors open, two members of staff sitting writing, 2 receptionists and a nurse chatting at reception. I was the only patient in there in middle of surgery time.

So it was open, I got seen, obviously being very careful. I thought about my DD when school reopens and she is teaching classes of 15 all day, she is currently in half the week caring for keyworkers children with no social distancing, no PPE. I think the NHS are being considered more than teachers, they need looking after but so do teachers.

Your service may end up being domicilary OP.

Geriatrics OP clinics are being considered as home visits.

I think there is a huge difference depending on what area you live in. I’m an Nhs Podiatrist and all our ‘high risk’ clinics have been running as normal. We see more people at home now if they are shielding. We work closely with vascular and orthopaedic consultants and they are still doing their essential work.

@EffieIsATrinket possibly in the future. We're not allowed to do any home visits currently unless it prevents an admission but it might go that way once more track and tracing is out there.

@headachehenry do you mind me asking what sort of therapist you are? Physio and OT here are telephone and video triaging and then seeing f2f if needed. SLT not as it’s a lot harder to ensure distance.

I guess my issue with schooling and not my school who are fantastic is that at a national level the unions are calling for no reopening and on here some teachers are saying that all teachers are working flat out and that no improvements can be instigated. The NHS is saying nationally that essential stuff should be going ahead and that services now need to plan to reopen in the next few weeks and there isn’t any union push back on that I’ve seen, debate about how to do it yes but no blanket “not until it’s 100% safe”. I hope HCPs on here are also not saying all HCPs are working flat out. Many, maybe most are working really hard in horrid circumstances but if people find the rotten apples that aren’t they are fully allowed to complain. On the medical forums and groups I am on those who are not shielding that have tried to say they won’t return to work in the same conditons we are all working in have had there asses handed to them.

PPE is difficult. In GP land are wearing masks for all patient contact but as there the surgical Type not a respirator that is mainly to protect our patients from us, hence me asking earlier what patients might think if they were asked to wear a mask which would protect me. Personally I think that mask use in schools for children who are old enough to comply would be a good idea. Masks on the teachers would not protect the teachers however. My three year old is managing to comply with a mask for going into shops but I’m not sure if she could all day long in a classroom. A national debate about this however would be a lot more constructive than the hysterical “not until is 100% safe” threads because it’s not going to be a 100% safe for a long time.

Other than masks we obviously have an advantage over schools in that we have no shortage of sinks and that is something the dfe should look at as a priority imo, there are products for stand alone had wash basins that don’t require plumbing in. We (as in the doctors and nurses Not cleaning staff ) also wipe down our desks, keyboards, Telephones patient couches and door handles whenever we change rooms or see a patient with detergent wipes - it was a chore at first but is now second nature and dosent seem to add to the workload too much. This sort of action should be fairly easy to implement in classrooms, older children could do this themselves for there desks.

I guess this is the sort of stuff I expected to see being discussed about schools returning. Other ideas I have mentioned to our school are kids in their own clothes or PE kits because blazers can’t be washed at hot enough temps and kids only have one so it can’t be washed daily, instead of a physical homework diary and a f2f handover at drop off I get an email about her day and anything major as a phone call. Kids all have labeled water bottles rather than using cups, all the hard toys spend the night in buckets of Milton, so like a discussion about the small but incrementally useful things that schools could do to make the environment more safe.

just wish that I could have my B12 injection. its waay overdue

I’ve been working as an obstetric sonographer and it really is business as usual here, which I am quite proud of. No PPE apart from standard surgical mask, gloves and pinny.
I am concerned my vascular patients have disappeared. I normally scan patients Carotids on patients that have had a TIA as one of my specialties. But the work has gone. A TIA is a sort of mini stroke. Call it a warning sign, precursor to a larger stroke. I worry patients aren’t coming and will be having catastrophic strokes further down the line. People need to be encouraged to go to A&E but we can’t force them. The campaign of fear led by the media is largely to blame.

@OneOfTheHerd can the practice nurse at your GP's not do it ?

Notsafetogo

I agree. And anytime it is discussed teachers and school staff are made out to be whinging or lazy. Everyone deserves to be safe

And my family/friends dotted around the world are all have the same concerns we are having here even in Germany
Not me. I’m in Germany and my DS (6) has had 3 non-urgent face to face doctor’s appointments in the last 3 weeks, with associated tests, and has been diagnosed with a very minor condition. At no point was it suggested that we should put it off until the health system here is more able to cope, whatever that means. Meanwhile, a colleague of mine in the U.K. has a little boy who is really ill, with recurring infections of some kind, and she can’t get him seen in person, let alone get “permission” to take him to A&E, which is what she’d like to do. It’s a disgrace, and I hope these stories start getting traction, because people (including small children) are suffering and it’s definitely storing up problems for the future.

@dramadromadery no permission needed to go to a and e. Just turn up. I know you said your not in the uk but in case anyone thought they needed permission to go to A andE they don’t. Large public health campaign right nose enlarging people to go to A and E if they feel they need to. It won’t be the. A and E they know as staff in PPE, adults without additional needs probably won’t be allowed any one to come with them but kids can have one adult.

Nose enlarging wtf now encouraging

notthatdr that’s good to hear (although my colleague has been actively discouraged by 111). But I think the point is, she wants him to be properly seen by their GP, and for them to follow up to actually diagnose the problem, rather than keeping a small, sick boy in a holding pattern until.... when? He’s so sick that they have no choice but to admit him to hospital? And the other point is that the comparison with my experience here in Germany (and my boy isn’t even sick, in the traditional sense) is like night and day.

I am not sure why can she not take him to a&e it’s open and we have been encouraged to take ill children to a&e

Germany certainly has superior healthcare but my fiend is also having issues (as are others) that she is having to wait to be seen (which isn’t the norm). She also sees a specialist here (paid for privately) obviously that cant be done at the moment.

Germany also managed the crises far better less pressure on the health care critical wards. Can all the hospitals run a full service while implementing the guidelines I don’t see how that is possible by the sheer numbers of routine appointments that are within hospitals daily. The numbers of people going in and out, staff, patients, those supporting patients, children that are attending with a parent

I haven’t said that all appointments are being met they are not but clinics/hospitals that have covid wards and are implementing social distancing can not run on a full capacity service (unless running 24hrs even then hospitals here would be stretched)

Private or referrals to private do not see the same number of patients but even they shall be stretched due to having to follow very strict guidelines.

The services that are going back to normal are within the guidelines that we have not had to work to before so it’s a new normal. I can see staff having to work weekend and night shifts (or maybe he unions will have something to say about that)

Now starting to see deaths due to the NHS giving up on people without covid.

inews.co.uk/news/coronavirus-cancer-treatment-operation-chemotherapy-cancelled-2853819?utm_source=fb&utm_medium=fb&utm_campaign=jp_reshare&fbclid=IwAR3AMKEZg-myWDjbA9uyNooMq6wIVVCUsZkcnxIYVMQr4ubxhCU89xtz95E