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A winter ahead

I was asked to write a blog for the CCG and pondered hard about what to write. In the end I decided to write a frank piece for our public and staff of the huge challenges the health services face because of COVID19.

Compared to many other areas in the country, the Vale of York got through the first wave of COVID-19 relatively lightly. Even so, there were around 163 deaths in York, mostly in our vulnerable population. But the first wave has left a damaging effect on our health system that we are struggling hard to fix even now.

Many tests, procedures, chronic disease reviews, screening, health checks, and other non-urgent work have had to be delayed during the first wave. Understandably, we had to do this to prioritise our resources to deal with the surge of illness caused by COVID19. However, this has created a large backlog of work. We are not unique in this - this is the experience in  many places up and down the country.

It has been really challenging restoring health services back to pre-COVID levels. In general practice, we have had to put in a range of infection control measures to keep patients and staff safe. This means it takes much longer to see patients or carry out procedures. For example, a face-to-face consultation might take 10 minutes usually, but now takes twice as long as staff have to put on and take off protective equipment, as well as clean down the rooms between each patient. We have had to restrict activity at some clinics to provide a safe environment for some of our most vulnerable patients. No one wants a waiting room full of the elderly, pregnant women, young children, patients with cancer, mixed in with people who might have COVID19.   All of these restrictions have a knock-on effect in terms of reducing the number of appointments and slots.

On top of the usual work, extra work has been heaped on to our general practices. They have to provide extra help to care homes, catch up on routine immunisations, cancer screening and chronic disease reviews for patients, deliver more health checks for people with learning disabilities and severe mental health problems, deliver a bigger flu vaccine programme this year with more than 30,000 extra people to jab, and deal with deferred hospital referrals. This is on top of also having to prepare for a second wave of COVID19 that will turn into Mission Impossible if we have to lockdown practices.

So whilst general practice is open for patients, the reality is the demand for healthcare is large and outstrips what we can safely provide. Unsurprisingly, patients are frustrated when they can’t get appointments, or get to see the doctor, or when their tests and procedures are delayed.

The truth is there is no magic solution. We face a difficult winter ahead and there is no cavalry to come save the day. There are no extra doctors, nurses or clinics that we can create. What we have is what we have. There are only so many hours in the day. Many of our staff are working flat out. Whilst we have to make best use of our limited resources, we must also look after the staff we have – they are not superhuman and they are people too with lives and families to look after.

So we really need the help of our public. To understand the very real challenges we face, to use health services wisely, and to be patient – we are trying our best.  But more importantly, we need to keep COVID19 at bay. We all need to work together and stick to the plan: frequent handwashing, use face coverings, keep a safe distance, avoid crowds and confined spaces, and self-isolate when ill. If we do all of this we can keep infections down. This will help our health services keep going and gives us a chance to get on top of the mountain of work.

Together we can all do our bit to save lives and protect the vulnerable.

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Andrew Lee

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