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Addressing health and care challenges during winter – a blog

In a blog article the outgoing Executive Director of Primary Care and Population Health at NHS Vale of York CCG, Dr Andrew Lee gave an open account of the huge challenges the health services face because of COVID-19.

Dr Lee who is moving on to fight the pandemic in a new role as a Consultant in Public Health with Public Health England said: “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.”

Not only is non-urgent work being delayed, the way general practice operates has had to undergo a number of different changes to ensure they are providing safe care to our community.

Dr Lee added: “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 onto our general practices and Dr Lee explains why.

“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.”

GP practices will not be affected by the new national lockdown restrictions coming into place from Thursday 5 November and will remain open for those patients who need them. However if a breakout of COVID19 occurs within a surgery, it will need to close for decontamination.

Dr Lee explains that there is “no magic solution” to help with the frustration of patients as a result of not being able to access appointments or having to wait for tests and procedures.

Dr Lee said “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 to keep going and gives us a chance to get on top of the mountain of work.”

To read the blog ‘Dr Andrew Lee – A winter ahead’ in full please visit the NHS Vale of York CCG website:

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