People need to know the NHS is still there for non-coronavirus illnesses and accidents too
“The challenge ahead is how routine NHS services can function in the ‘new normal’ of life with Covid-19”, writes Dr Philippa Whitford | PA Images
While the acute surge has flattened out, and the pressure on hospitals has stabilised, Covid-19 will be with us for some time. We need to adapt to the new normal, and ensure everyone who needs treatment gets it.
The coronavirus pandemic has come to dominate our lives as we remain in lockdown to protect our National Health Services across the UK. With the sight of Italy’s health care service being overwhelmed, the initial focus has been on hospital capacity, and particularly on the number of ventilators available. Hospitals have remodeled their emergency departments and wards to provide ‘red’ and ‘green’ zones and reduce the risk of cross contamination between patients. Specialists and GPs are carrying out most initial consultations by phone or video link, and are finding that many patients don’t need a face-to-face discussion but can be issued with a prescription or referred on for further investigations.
Such ways of working have been beneficial both for clinicians, who can quickly prioritise a patient’s next steps, and for the public, who face less traveling to hospital or waiting in clinics. Some of these innovative approaches are likely to be incorporated into normal practice after the epidemic is past.
While the acute surge has flattened out, and the pressure on hospitals has stabilised, Covid-19 will be with us for some time – the challenge now is providing support for patients in the community. Local health and social care systems are working hard to develop integrated community networks to support homecare staff and care homes, many of which have been ravaged by outbreaks. As the elderly and frail are most vulnerable to Covid-19, it is critical that care home staff have access to PPE and sufficient staffing as well as being able to access advice from their local GPs, infection control teams and specialists in geriatrics or palliative care.
However, while all this incredible re-organisation has been going on, it was recognised that the number of patients presenting at emergency departments for non-Covid emergency care, such as heart attacks or strokes, had decreased markedly and that referrals for cancer investigations were down by approximately two-thirds.
While, with less outside activity, some reduction in accidents or other non-Covid infectious conditions was to be expected, there has been real concern that the public think the NHS is only dealing with Covid-19 or that they are afraid to go to hospital in case they become infected.
It is critical that people realise NHS services are still there for those who are unwell. In an emergency, such as an accident or with an acute symptom such as chest pain, they should still go to A&E or dial 999 for an ambulance. GP surgeries are still open and functioning, albeit with initial discussions by phone or video link, and it is as important as ever not to ignore worrying symptoms.
The challenge ahead is how routine NHS services can function in the ‘new normal’ of life with Covid-19, particularly for conditions such as cancer or heart disease where additional lives could be lost if diagnosis and treatment is not expanded.
While some cancer services have been able to continue, high risk aerosol generating procedures, such as general anaesthetic for surgery or endoscopic investigations of the stomach or bowel, have been limited. Clinical teams are already considering video clinics and alternative investigations to minimise the riskiest procedures, but extensive testing of patients is crucial to getting health services fully functioning.
The UK abandoned trying to stop the spread of Covid-19, due to a lack of testing capacity. Now this is being expanded, it must be utilised as part of a test, trace and isolate strategy. Public health networks will need to be strengthened and funded to keep local outbreaks under control. This is critical to avoid a resurgence of Covid-19 when lockdown measures are finally eased.
Dr Philippa Whitford is SNP MP for Central Ayrshire and Westminster spokesperson on health and Europe.