I'm so sick of having to explain this, and it's entirely the NHS fault for not communicating it properly and letting people understand what's going on! No wonder everyone's concerned, fed up or scared. Basically, not every dept or trust has done the same thing. However the reasoning is all fairly similar.
We had to stop routine care as the sickness rate was so high (I had 40 medics off on one day sick with covid or isolating awaiting results) and the expected admissions were so high that in order to safely staff the wards where patients were recovering/dying from covid/other stuff clinics had to be stopped, there was just no way to safely cover wards AND continue to deliver the same level of surgery outpatient care. Secondly bringing patients to clinic or for surgery would massively increase exposure and risk of infection for both patient and staff. 3rdly: no one had a bloody clue what to do and where quite honestly making it up as we went along as we had little direction.
Not every trust stopped everything. Not every department stopped everything. Classic NHS - no consistency in approach. In my trust, all patients on any list (in some cases over 800 patients) had their notes, results, referrals and last letters reviewed and put in a priority order. The urgent patients (cancer, life and limb) have continued to be "seen" not necessarily face to face, some via video and some via telephone. Not ideal, but better than nothing. Reducing face to face contact has been a big aim of the NHS for years covid or not, so it was going this way anyway as you can see more patients and disrupts patients less as the clinic can be done from home/work etc. Covid just sped this process up, massively. It's a bloody miracle it was achieved actually when you bare in mind the need for buying and getting the hard ware, the soft ware, setting up, getting consultants to accept the change, training them and THEN getting the patients on board, all in the midst of a pandemic. Like I say, not ideal for some but better than nothing for most.
This list I mentioned is being monitored carefully by managers to make sure people aren't slipping through the net. It's called risk stratification, consultants review the aforementioned detail and determine when the patient needs to be seen before coming to clinical harm, the clinical rationale for this reason and how the patient should be seen (f2f/telephone) eg: asymptomatic bradycardia in a 50 year old who recently had bloods done might be deemed safe to see in 6 months time, whereas a 70 year old with complex comobidities, sudden onset of shortness of breath etc will need to be seen within 4 weeks, therefore the 70 year old is prioritised over the 50 year old despite the 50 year old already waiting 6 months (note: I'm not a doctor/medical in anyway and have plucked 2 conditions out of thin air not having a clue whether one is worse than the other, so don't panic if you have either of these symptoms - just using 2 different conditions as an example). It's shit but necessary. After the patient is seen a review is then conducted to determine if any harm has been caused by the delay, if so this is the. Reviewed by senior clinicians who can put actions in for bed practise in the future.
I am aware not all trusts are doing this - why? I can only speculate it's purely down to staffing and how badly effected their hospital was. Or how poorly ran it is. Post code lottery I suppose. (By the way, my trust got requires improvement in the CQC report so isn't like some amazing teaching hospital)
In terms of how long will it take to recover these lists? A year I reckon as we're not allowed to pay the doctors extras to do evening clinics/Saturdays, number of clinics held in our patients for f2f have to be limited for social distancing. Patients cancel on the day as they're poorly or sick wasting slots and then need to be fitting in, doctors get sick on the day and there's no one to cross cover their clinic so the entire clinic gets cancelled. The latter re sickness is standard problems though.
For the last 3-4 weeks all hospitals have been told to work on a plan for "business with covid" ie get back to as close as possible for normal business whilst considering social distancing/PPE and the increased ward rounds.
Most of my specialties have a consultant ward round twice or three times a week in normal circumstances. At the height of the pandemic there was at least 1 a day, if not two to manage the poorly patients and discharge as fast as possible to free up beds. There was therefore no time for clinics to be held. Quite often registrars hold clinics, but all of these were cancelled as they were needed to support on call etc.
It's been shit for everyone, the patients who have been left "abandoned" especially - a lot of worry could have been eased by communicating the hospital plans and reasons why, but it hasn't been which I feel is a big let down for patients too.
We tried to get Locum doctors to come and work for us, most refused to work in covid areas and the ones that would engage wanted 2-3 x the normal hourly rate (up to £300 an hour in one instance) we just didn't have the money to do so!
I'm really really sorry to those who have suffered because of this, but please note it's not your local NHS docs nurses or managers making these decisions. And edict was delivered from NHSE saying " all none essential work must stop" this was sent out mid March and said only til the end of April. Then about the 24th April a second one came out saying cancel everything until end of May, then a couple of weeks ago the same for June giving us little notice or time to plan for each months worth of patients - most trusts (from reading your sad posts on here) seem to have taken it literally - maybe they had to because of sickness/influx of patients I don't know, but there was an element of common sense to be applied which is what my trust did. Nothing perfect, patients still having to wait longer than anyone will like but not sure what the alternative was?
Things are getting closer to normal now, but like you say, the implications of this ceasing of services in many areas may be catastrophic and we won't know the true extent for years.
My unsolicited advice - if you are unsure what's going on in your trust you can call PALS and ask to speak to the relevant manager for your area, you could request a Freedom of Information Request for the trust business continuity plans for your area. If you have any worsening symptoms call the secretary, email if you can get an address and make it known so the consultant can review and determine how to progress.
Hope that helps somewhat understand some of the rationale; and hope sincerely you all get seen soon and get the treatment you need as safely as possible!
and cannot change them as there's only one in the area and they can't move. Mine is a fob off merchant so I have to go private. I needed fexofenadine, all the other OTC anti-allergy meds have not worked for me and I'm quite ill with them (this is the worst I've ever been). Really backwards and restrictive prescribing restrictions in the UK as well (not the GPs fault).