Let’s keep benefits from lockdown

During lockdowns, Nurses and Doctors developed innovative ways to help, and we found those actually doing the job were often better at running our healthcare

Telephone consultations have proven to be helpful to many, and it has been noticeable that cleanliness has improved.

Don’t  allow the good things that have happened during lockdown to 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 meant contact with medical staff, rather than a faceless call centre.  And I have enjoyed  productive telephone 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, seemingly left us with no support.  Then suddenly, Consultants, Physios and Nurses took things into their own hands, and started phoning us; we found telephone consultations had a lot going for them.
No longer at the mercy of the dragon receptionist, both sides seemed to 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 medical staff 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
Outpatients runs smoother

The dreaded Hospital Outpatients appointment 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 a much quieter,cleaner and uncrowded Outpatients.

Covid-19 has been a wake-up call – and infection control has improved massively.

London Taxis for transport
See the source image
Since lockdown, South Central Ambulance Service has borrowed London black cabs for some patient transport, as they have a screen between the driver and passengers.
Some cabs even have a helpful swivel seat which is fantastically comfortable to those with hip or knee problems: you stand on the pavement, sit down on the extended seat, which then turns and swivels you into the cab.  And you can stay seated on this for the whole ride.
Some cabs have a retractable ramp for wheelchairs that can also be used for walking up inside. This must save at least 10 mins of driver time, no longer having to hook and unhook the webbing to lift the chair inside by using the motor, then reverse the procedure at the destination – the driver just wheels the chair up a much lower incline and it takes a few seconds rather than several minutes.
And, Black cabs have hetter suspension than the converted van chassis, so let’s hope we get more.
District Nurses
French friends ‘use’ them constantly.  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 blood tests.  I wouldn’t mind paying; it is such a chore to ask a friend to give me a lift to the surgery, and taxis are £40 for the round trip.
Consultant referrals
When GPs referred us to consultants, call centres often ‘lost’ the referral, or issued an appointment 18 weeks hence (within the designated ‘time slot’) so by the time we saw the consultant we’d almost forgotten what was wrong to start with.
Treatment finished, the Consultant would tell us “if this returns come back and see me”. As the patient, you aren’t allowed to do this, but have to ask your GP to arrange another appointment, where you explain (yet again) you need to see the consultant for a recurrence, and the process starts again.  Now, it is now a five-minute phone call with your GP, securing you a place in the queue to see the consultant.
With things simpler, one wonders why the supposedly cash-strapped NHS, was allowed built up so many levels of bureacracy.  Empire building with our cash.
Infusions made easier
Having Osteoporosis, I now have to have a yearly infusion.  Moving to Oxfordshire from London, I expected to have this locally, but was told because of cost-cutting I couldn’t – and to go back to London.
My Oxfordshire GP referred 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 the transfusion done locally?  Of course.  So he arranged it!
My appointment was during lockdown, so a Nurse phoned to explain procedures.  On the day transport arrived on time for my 1200 appointment. Bang on time at the John Radcliffe Rheumatology Day Unit, I went straight in to a spotlessly clean room (believe me, when you have had to spend a month in hospital recovering from a Hospital Acquired Infection you notice this) with everything set up and waiting.
My deep veins usually mean painful prodding, and when I hear “just a scratch” I 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 inserted 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, then at the end explained that she had changed the infusion to saline water “to flush through any residue”.  I like that practical way of ensuring 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 easier during lockdown.  I can’t wait to go back next year!
I couldn’t have an appointment with Katy in the Royal Berkshire Physiotherapy Dept.  So she phoned me, found out what was giving me trouble, and emailed over a series of exercises.  These are easy to do, and seem to be working really well!
Then Jackie in the JR Physio department phoned me to ask how my arthritic hands were getting on.  Again, by phone Jackie gave me good practical advice, suggested  a Thermamit (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.
Who would have thought you could get ‘good’ physio from a phone call? !!
Gone are the clipboards
A friend swears a nurse approaching with a clipboard sends her doo-lally.  Now, services have been redesigned without a clipboard in sight.
It’s been lovely to talk directly to the nurse in charge, and find out they knew exactly what I 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 a 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, to be offered an appointment in three weeks.

If you are working, this is a more productive use of time, than the 0823 phone call……

Future-planners must take into account shifts 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.
Hancock must address this making provision for Granny-who-doesn’t-own- a-Smartphone – 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 in A & E.
Now, let’s hope the NHS gets tough;  if patients turn up drunk enough to cause problems, follow other countries and charge them, 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.
I am relishing the ‘new’ relationship with many consultants.  Overall it has made dealing with ‘co-morbidities’  less of a hassle since lockdown.