For many, lockdown hasn’t been all bad

Nurses and doctors have surprised us with innovative ways they have developed to help us.  Telephone consultations have proven to be helpful to many, and of course lower pollution levels resulting from less traffic is a bonus.
Don’t  allow the good things that have happened during lockdown disappear. We all want to get back to scheduled operations, tests, screening, etc., but let’s ensure the benefits continue, and we don’t go back to the old ways.
For many, lockdown has meant contact with medical staff, rather than a faceless call centre.  Having initially been sceptical, I now find telephone consuItations are very effective;  I have had productive conversations with Consultants,  Nurses and Physios – long may they continue!
At the beginning
When lockdown started, many of us dreaded what would happen, with hospital appointments cancelled, this seemingly left us seemingly with no support.  Then suddenly, Consultants took things into their own hands, and started phoning us,  saying “you were due an appointment today, how are you?”  And we found telephone consultations had a lot going for them.
No longer at the mercy of the dragon receptionist, the consultants and ourselves relished the extra few minutes of relaxed chat, that made all the difference to the quality of consultations.  We had time to ask more than one snatched question, and doctors could pick up on a throw-away comment that gave a clue to what was happening.  All of a sudden we had ‘quality time’.
Where I needed a physical examination, or procedure, hospital transport was quicker (Ambulance staff told me they no longer dealt with time-wasting drunks, etc), waiting rooms were emptier and we were dealt with faster.
Is this the end of the hospital-slave relationship?
In future, many patients are likely to demand release from the hospital-slave relationship. Having experienced unhurried, focussed one-to-one telephone or Zoom consultations, we found this not only a welcome change but, in certain instances, it could be very productive.
When one Consultant said he needed a blood test, I explained that being disabled, I would have problems getting a lift to my doctor’s surgery,  So he arranged for the District Nurse to come to my home.  Brilliant service!  I would never have dared ask this of my GP’s receptionist!
As for the hassle of getting a GP appointment, with the three minute window at 0823hrs with the draconian option to get a grudging date 3 weeks hence … not any more.  It’s video first, which can often sort out the problem without wasting our time

The dreaded Hospital appointments that needed a day off work, paying a small fortune in the car-park and be kept hanging-about, disappearedNow, after an unhurried phone call with a Nurse or Consultant, if they think it necessary they arrange an appointment – and we find in a much quieter and less-crowded hospital.

London Taxis for transport
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Hospital transport arrived for my first hospital appointment under the ‘new’ regime, and I found South Central Ambulance Service had borrowed London black cabs for patient transport, as they have a screen between the driver and passengers.
Some cabs even have a helpful swivel seat, which turns so  the patient stands on the pavement, sits down on the extended seat, which then swivels them into the cab.  Some have a retractable ramp for wheelchairs that can also be used for walking up into a cab.
Black cabs have a smoother ride than the usual patient transport, so let’s hope we get more in the Thames Valley.
District Nurses
French friends ‘use’ them constantly; these could be very useful e.g. avoiding a long trip into hospital for a simple injection.  Until lockdown I didn’t know we had one. But if my Rheumatology Consultant could get the District Nurse to visit, I hope I can arrange this for future tests.  I wouldn’t mind paying; it is such a chore to ask a friend to give me a lift, and taxis are £40 for the round trip.
Consultant referrals
GP used to refer us to a consultant.  But call centres often ‘lost’ the referral, then gave us an appointment three months hence (always just within the designated ‘time slot’) before we actuall got to see the consultant.  (then having almost forgotten what was wrong to start with).
Once treatment finished, the Consultant would tell us “if this returns come back and see me”.
But you couldn’t.  As the patient, you weren’t allowed to do this, but had to go back and telephone your GP for another appointment, when you explained (yet again) you needed to see the consultant for a recurrence, and started the process again.  No longer!  The trek to the surgery, etc. is now a five-minute phone call with your GP whilst sitting at home, securing you a place in the queue to see the appropriate consultant.
Now that things are simpler, one wonders why the supposedly cash-strapped NHS, was allowed built up so many levels of bureacracy.  Somebody was Empire building with our cash.
Infusions made easier
Having Osteoporosis, I now have to have a yearly infusion.  When I came to Oxfordshire from London, I expected to have this done locally, but was told because of cost-cutting I couldn’t – and to go back to London.
My Oxfordshire GP was allowed to refer me back to King’s College and hospital transport spent 7 hours taking me there and back – so what did that cost the NHS?
Then I happened to be treated by a Spanish Professor working in the NHS at Oxford.  He asked why I went to London; would I like to have it done locally?  Of course.  So he arranged it!
My appointment was made during lockdown.  An efficient Nurse phoned to explain the procedures.  On the day transport arrived at 1130 for my 1200 appointment. I was bang on time at the John Radcliffe Rheumatology Day Unit   and went straight in to a spotlessly clean room (believe me, when you have had to spend a month in a London hospital recovering from a Hospital Acquired Infection you notice this) with everything was set up and waiting.
Having deep-seated veins, I am used to painful prodding, and know when I hear the dreaded words “just a scratch” to brace myself.  The male nurse (one bad thing about life now is you don’t see name badges under PPE equipment) was slotting the infusion into the stand before I realised he had actually put the needle and all the accompanying ‘stuff’ into my arm, and I hadn’t felt a thing.  All I know is he was from Barcelona – thank you!
The efficient female nurse had my notes all ready, confirmed that I was allergic to penincillin, and I didn’t have to repeat the rigmarole.  Then at the end explained that she had changed to infusion to saline water “to flush through any residue of the infusion”.  Now I like that practical way of ensuring nothing is lost and one gets value for money.
Just as the last drop went in, I was told my transport was waiting to take me home.  None of the expected 1 – 3 hour wait which used to happen.  Two days later the notes from my appointment came through my letter box.
All in all, this was so much, much easier during lockdown.  I can’t wait to go back next year!
And whilst we are discussing the JR, their Physio department phoned me to ask how my arthritic hands were getting on.  Over the phone Jackie gave me good practical advice, recommended a Thermamit which at £19 is much cheaper than wax baths, but will probably give wonderful soothing warmth (as long as you have a micro-wave), and made an appointment for me – in the future, but something to look forward to.  Her phone call was lovely ‘buck up’ call.
Gone are the clipboards
I have a friend who swears a nurse approaching with a clipboard sends her doo-lally.  Now, services have been redesigned and provide miraculous, fast and safe care without a clipboard in sight.
It’s been lovely to talk directly to the nurse in charge, and find out he/she knew exactly what we needed, but hospital admin hadn’t allowed them to use their expertise to put this in place.  Now, with Admin bunkered down away from the front line and unable to interfere, staff have been able set up patient-friendly services.
Let’s make sure this continues after lockdown.

Private doctors

Some of us will have dipped our toes into the private stream, following Health Minister Matt Hancock’s example. If our time is valuable, it has been well worth the money for the convenience to go online and talk to a well-qualified doctor, who actually listened to what we had to say, without a prescription pad in sight. They came up with sensible suggestions as to the way forward, without taking up a large slice of our working day.

It seems as if, post-lockdown, many of us will have an NHS GP for day-to-day medical problems, and a private doctor on speed-dial for when we have an emergency and want advice on treatment without delay.  Gone will be phoning my GPs surgery with a real emergency, only to be told “the doctor can see you in three weeks”.

For those of us in work, this is a much more productive use of our time, than the 0823 phone call……

Future-planners must take into account the shift in demand.  Populations have acquired new digital habits and will expect the NHS to respond.  We’ve got used to having time to put our case, and I for one don’t want to go back to the old days of rushed ‘ten minute’ appointments.
Hopefully provision will be made for Granny-who-doesn’t-own- a-Smartphone.  Hancock and his underlings must address this – it shouldn’t be too difficult.
Anyone who has been in A & E at a weekend will understand why Ambulance crews tell me they welcome lockdown = no drunks.
As a patient, I have been a horrified witness whilst drunks assaulted staff.
Now, let’s hope the NHS gets tough, and if patients turn are drunk enough to cause problems, we follow other countries and charge them, This should be easy enough;  they obviously carry a credit card to pay for the drinks they consume.
One policewoman told me it costs a minimum of £400 to treat a drunk – imagine what that does to NHS budgets. Let’s hope that post-lockdown anyone over the limit is made to pay for treatment;  they do this abroad, so why not here?
All in all – I am relishing the ‘new’ relationship I have with many of my consultants.  Overall it has made dealing with all my ‘co-morbidities’  less of a hassle since lockdown.
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