However, a lot of people were encouraged to stay at home when very ill with covid and some died at home, while being told they were not ill enough to come to hospital (lips not blue enough etc)
By those working in the community care teams ? Like I mentioned before, we follow the same escalation criteria for the deteriorating patient as the acute sector and we didn't change any of the protocols, I know there was some discussion about some of the ambulance services doing so back in 2020, is that what you mean ? We have patients who are having a really good day if their oxygen saturation readings are 89% , so do not need to be escalated as that is their norm. If you had sats of 89% when they are usually 99%, I would probably have my special professionally worried face on and be suggesting you pack a bag of stuff to take with you to the hospital. It isn't about how ill someone is, it is about the difference in their health, so you can have a very ill person who pootles along at that level for a very long time with the odd little dip and you can have someone who is usually fine who has a sudden big dip, the latter is more worrying.
The biggest difference between community teams and the ambulance service is that we tend to have a previous relationship with our patients before they become actutely unwell, so we know their normal, we might see them every day or more than once a day, or a couple of times a week over a prolonged period of time, we know how they are emotionally, mentally, physically day to day and we notice changes, big or small. The same can be said for good care providers, who are the eyes and the ears for everyone above them in the healthcare heirarchy.
Sorry for the de-rail, if you want to ask anything else @herecomesthsun I am happy to answer by PM