Ok, so what about health and social care....?

[michaellocust]

Will there be specific guidance coming? (Obviously I know the answer to that!)

Just to summarise what's going on in my hospitals:

• masks at all times pretty much everywhere for everyone
• social distancing in all offices / clinical rooms - maximum numbers on the door
• twice weekly LFT for all staff. Strict PCR and isolate for symptoms. Risk ax if someone in the house has it.
• PCR testing of all patients every 3 days - lots of people coming up positive and being shipped to the covid ward and not receiving the care for the real thing they are in for.
• no visitors largely but if allowed in, have to present a negative LFT on the door
• PCR and self isolation before all procedures
• outbreaks EVERYWHERE closing wards, infecting staff and patients etc.

So far removed from members of the public now let alone after Thursday. I don't know why we're trying to contain something within a building that no one else will be doing anything about outside of it - it's like sand through fingers.

Who is actually going to say - yes, NHS workers, you too can also forget about covid....

I've been wondering that. Not nhs staff but a frequent flyer at our local hospital due to having dc with multiple health issues. Obviously nowhere near the awful things nhs staff have had to cope with but I would really like to be able to take turns with dh again when it comes to staying with dc in hospital so we can each get some sleep and spend time with the poorly one as well as the dc at home.

Boris has just said it'll be up to NHS trusts to decide what to do re testing for their staff which means they will have to pay for it out of their budgets (making the service even shitter) and won't relax restrictions as they will be lambs to the slaughter when it goes wrong.

Nothing for home carers either. So your 80y client may qualify for free tests (she never goes out) yet the 4 carers a day, her family and friends who often visit will have pay for a test before visit if want protect them

Prison service here- 2xLFT and 1xPCR a week each here as risk of mass transmission so high (prisons like a filthy cruise ship!). Will be interesting to see if the powers that be will continue to pay or if we will be able to stop?

Also wondering that. Surely it will just add to pressure on the NHS if vulnerable patients going in for treatment then catch Covid more easily because there are no mitigations. Or the effect if more staff are affected by sickness (this has been the case in many schools - staff are not absent through isolation but because they are genuinely too unwell to teach).

I've been saying this since last summer. The government are only concerned with their supporters, and they don't care. It's like NHS workers, and the often very unwell people in hospitals, are just not on their radar. As long as they've got their 'freedom'.

Inpatient mental health here, can’t see much changing🤷‍♀️

I think masks, isolation and testing will remain. We do PCR for all patients weekly, think that will continue.

Currently we ask all visitors to being their own LFT and do it before their visit, that won’t happen when they aren’t free or easy to get so that might have to change!

I suspect the hospitals will become even stricter now just trying to contain it. The testing / PPE etc will have to come from the trust budget rather than (I think) government covid budget so they will have to cut back elsewhere. Last thing we need is paying out for even more bank shifts when everyone is sick again etc.

I can see visitors never being let back in if none of them have to test or isolate - ward outbreaks are crippling us at the moment - what can they do 🤷‍♀️

Mind you, we have only found many of our ward outbreaks because we are routinely testing everyone. If we only tested for significant symptoms ie those which might require treatment for Covid, not just a cough or a temp we probably wouldn't find most of the outbreaks.

Hospitals still have to be safe for unwell patients and still have a legal obligation to protect staff from harm, so trusts need to keep restrictions in healthcare settings.

That is not conflicting with the Tories freedom farce, it is perfectly OK to have different rules in a place full of unwell/elderly and logically vulnerable people and the staff who care for them.

The difference between a hospital/care home and Sainsburys should be clear to even the most thick to see, so I hope trusts are brave enough to keep everyone safe.

By restrictions, I only mean testing and masks. Not anything too draconian.
Not all trusts have mandatory testing right now btw.

@sproutsandparsnips

Mind you, we have only found many of our ward outbreaks because we are routinely testing everyone. If we only tested for significant symptoms ie those which might require treatment for Covid, not just a cough or a temp we probably wouldn't find most of the outbreaks.

Agreed. If we stop looking, we'll stop finding it all the time and shutting care down for everyone in the process.

It feels a bit like we either need to keep all the restrictions and desperately try and contain it or accept that we won't / can't do that any more and stop looking at anything to do with covid unless people are sick.

@fudging

By restrictions, I only mean testing and masks. Not anything too draconian. Not all trusts have mandatory testing right now btw.

Trouble is, a lot of staff are done with working under March 2020 covid rules that show no sign of ever stopping regardless if people think they aren't too draconian. Half my team have left the NHS and we've not got a single applicant for the jobs.

People are fed up with working in hospitals now (me included tbh - if I knew normality was on the horizon and I could have proper conversations with my patients and remember them because I could see their faces, I'd be a lot happier)

Dunno - nothing on the emails yet. I won't look for a hospital-based job at the moment while things are still running as they are - I'll settle for the eternal fun of trying to put PPE on out of your car boot a fucking gale and not losing your apron down the street.

Is it something I can change? No.

Therefore is it something I'm prepared to sit and worry about? Also no.

So how will people living at or below the breadline be able to visit their loved ones or stay with their children if they have to pay for tests? Some people literally won't have the spare cash. And what if their toddler was admitted??

Care home immediate family here. Care home say nothing has changed in terms of entry requirements.

Boris charging £30 per pack of tests 🤦🏻‍♀️🤦🏻‍♀️🤦🏻‍♀️

I do see your point OP.

I think the patients need to be tested and the staff need to wear masks.

So infectious patients don't spread the infection to other patients or staff. Staff should be allowed to wear masks to protect themselves from infectious patients.

The year before Covid was ironically the worst autumn/winter imaginable for respiratory bugs caught from hospital and brought home. We were so ill (bed bound) 2-3 times each. That could easily have been avoided by wearing masks around the patients being treated with those respiratory bugs. Hopefully something that has been learnt from Covid will continue, and that is protecting healthcare staff with masks. There is no need for staff to catch every bug from every patient.

After all, that is what has always happened with norovirus. All the norovirus patients stay on the ward, no-one new is admitted until that ward is empty and then it is deep-cleaned. While norovirus is on that ward, there is no or limited visiting. The procedures have been in place for years already, just need extending to Covid.

@michaellocust

I suspect the hospitals will become even stricter now just trying to contain it. The testing / PPE etc will have to come from the trust budget rather than (I think) government covid budget so they will have to cut back elsewhere. Last thing we need is paying out for even more bank shifts when everyone is sick again etc.

I can see visitors never being let back in if none of them have to test or isolate - ward outbreaks are crippling us at the moment - what can they do 🤷‍♀️

I think it will go the other way to keep the elective work going to meet his targets. I also wonder how much the masks away from patients and social distancing between staff are making staff retention worse.

I'm very interested to know the answers to your questions. In particular what is to become of care homes?

Prison service here and we are doing mandatory daily LFTs and weekly PCRs. Still wearing masks and the regime is heavily restricted but it's looking like our regime will be relaxed over the next couple of months.

I’m finding this very confusing. As far as I can see the choice is:

Option 1:

Trusts abandon restrictions and end testing of staff. Patients may be eligible for free tests, but this is for early detection and not preventative. Increased prevalence in community may increase staff absence because of illness.

Option 2:

Trusts continue to test staff at their own expense. Increased prevalence in the community is likely to result in increased positive tests as well as absence because of illness. All costs of trying to control Covid through isolation must be met by hospital.

Is this correct?

Yes wondered about social care. Staff have been testing before each shift, full ppe. Does this all end? If private companies have to pay for testing and Ppe it would send many under surely. Such a bizarre situation.

If visitors need LFT what happens to poor people or those visiting patients in for longer stays. Maybe charities like MacMillan will be advertising on tv, please support our coffee morning or do a run so that people can visit sick relatives.

Even worse for those with just neighbours or friends. It may already a stretch visiting now, but if it is expensive just not the same priority as things for your own family. (Like what happened with bubbles when those without family were no one else’s priority compared to their aunt that lives alone. I’m not blaming these neighbours just a fact.)

Johnsons plan is to just declare Covid isn't a thing we need to worry about any more, in the hopes that saying it will make it so.

I'd expect that any attempts by hospitals etc to contain it by testing and masks will be met with shrugging shoulders and "the government can't be expected to fund decisions made by individual health trusts".

I wonder if we'll eventually see the cost of the tests rising slowly as a new source of government funding.

I also wonder with members of the public, like many on here on other threads who are happy now to forget about covid and get on with their lives (totally understandable) how they will feel putting masks back on for any health appointments, taking tests to come in for a procedure or visiting, still not being able to visit relatives, self isolating for procedures, endless testing as an inpatient etc - I feel like there may be some hostility as the government have said we don't really need any of those things anymore....