The Government needs to do more on patient care disrupted by coronavirus

One of the biggest tragedies for non-Covid patients during the lockdown has been the monumental impact of emergency medical restructuring on routine diagnostic and treatment services. The UK government made sweeping reforms to how NHS staff and facilities were to be utilised from March 2020 based on predictions of unprecedented demand for ICU facilities. Fortunately those predictions proved to be over-estimated, and indeed many of the emergency Nightingale hospitals constructed were never even used, including the one built in North Bristol.

It is, of course, relatively easy to look back in hindsight and ask why such draconian measures were put in place at the expense of non-Covid patients, whose medical needs continued. It would be totally unfair to suggest that critical NHS services such as maternity care or existing oncology care were not maintained to very high standards, however there has been a significant cohort of patients whose care was significantly impacted and with severe repercussions.

It was reported in The Guardian that one cancer patient, Sherwin Hall, did not receive a planned MRI scan, and during the period of the delay his condition is considered to have significantly worsened. He told the newspaper that:

“I’m fighting for my life because I didn’t have a scan. I should have had the scan months earlier, but didn’t because normal NHS care was suspended because of the coronavirus. I started asking for one in early March but didn’t finally get one until last week… I’m angry, frustrated and disappointed. And I’m devastated that I might lose my life to cancer that could have been cured if they had done what they were supposed to do [more quickly].”

As we emerge from the acute phase of the pandemic in the UK, patients like Mr Hall are now rightly asking, “what about me”?

There are demands to know how NHS services will be able to cope with and catch up with their huge back log of work, not only in terms of cancelled routine surgeries, but more importantly the delays in undertaking routine oncology testing. It has been reported that the waiting list for appointments will reach 10 million by Christmas 2020.

So, can we do anything to rectify this situation with the lack of NHS staff and the stringent need for infection control in hospitals?

Cancer care

As further reported in The Guardian newspapers: Steven McIntosh, the director of policy, campaigns and influencing at Macmillan Cancer Support, said action was needed to enable cancer patients to get care:

“Coronavirus has created a ticking time bomb of undiagnosed and untreated cancer in the UK, which is leaving many people living with cancer feeling desperately anxious and alone….We need urgent action to address the uncertainty of delayed cancer services and prevent coronavirus resulting in a serious spike in cancer deaths. All UK governments must rapidly restore cancer care and deal with the backlog in treatment whilst keeping staff and patients safe during the pandemic,”.

For example, testing for cervical cancers via smear tests can still only be done by a nurse in GP practices; home testing kits are not presently routine practice. All routine cervical testing was therefore cancelled in March 2020 and the service has not yet resumed across the country, albeit some GP practices have now recommenced their programmes of testing.

The Royal College of Obstetricians and Gynaecologists confirms that testing is available for those women who are symptomatic, but what about those who aren’t? What about the women who fail to get tested for many months to come, but for whom an earlier test would have revealed an opportunity for a different outcome?

What now?

The patient representation charity AvMA said in their press release of 10 June 2020:

“Urgent action required to prevent avoidable deaths amongst non COVID-19 patients. AvMA today called for the Government to act urgently to open up NHS services for non-COVIS patients or risk avoidable harm to thousands. In his latest blog, AvMA Chief Executive Peter Walsh warned that many NHS Hospitals are running at 60% capacity or less, with Nightingale hospitals standing empty and the private sector capacity unused.”

There will not only be an issue of NHS resourcing but also the issue of how the psyche of the patient has changed; there is now for many an ingrained attitude of fear and resistance when it comes to seeking medical help, in particular towards entering a hospital environment. Patients will need to rediscover their trust in NHS services to provide them with the care they need whilst protecting themselves from the risk of contracting Covid-19.

I do not envy the management teams in NHS Trusts across the country who are battling to resume services for their patients, but who at the same time have a duty to protect both patients and staff from infection. It is the same dilemma faced by schools, who desperately want to provide for their pupils as before but cannot do so; many parents will acutely feel the impact on their children on missing out on their education, socialising with their peers and learning life skills.

There is not one sector of our public or private services or our communities which haven’t felt the impact of this pandemic. Now is really the time for our Government to “get a grip” and lead us out of this mess.