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Letting staff know that ‘it’s OK not to be OK’ and that the NHS ‘has their back’ is the best way of ensuring that they will be able to care for our nation during this crisis and beyond, writes Professor Neil Greenberg The whole health and care workforce is due a well-earned rest at the same time the mammoth tasks of reopening services that are adapted to necessary infection prevention and control measures and responding to physical and mental needs that have been suppressed during lockdown need to be tackled.
GPs are being encouraged to recommend remote messaging services such as Docly to their patients to avoid face-to-face contact unless absolutely necessary, therefore reducing the risk of coronavirus transmission. Covid-19 presents an immediate and pressing challenge to the NHS. Many GP practices are straining to deliver services because of illness; due to two-week self-isolation because of exposure to suspected coronavirus cases; and because of the need for high-risk groups of healthcare professionals to social distance, meaning they cannot continue to work in the usual way. As the pandemic continues – creating pressure on both demand and supply across healthcare provision – the strain on NHS frontline services will continue to dramatically increase. There are positives to be gained from the situation, however. The move to online consultations in recent weeks has shown that fast and scalable solutions are available and can help to ease the strain on GP practices.
The supportive treatment and ventilatory assistance that coronavirus patients require is not in the surgeon’s repertoire. Internationally the trend has been for hospital specialties to become more sub-specialised over the years with many studies showing patient outcomes are significantly improved when surgical patients are managed in a shared care model. Demonstrated in Trauma and Orthopaedics where there has been a dramatic growth in the subspecialty of orthogeriatrics. Guidelines on the management of medical conditions memorised during formative years are unlikely to have remained best practice. As such, surgical colleagues are realising and must openly publicise their shortcomings as well as their skills.
Clinical negligence claims are often built upon a lack of adequate documentation of what was said and allegations that patients have not been properly counselled about risks and alternatives. Elizabeth Thomas explores what this means for the increasingly significant role of telemedicine and the steps which can go a long way in reducing the burden on patients and the public purse As a result of social distancing, technology is developing to assist those who can work from home and/or in isolation from others. Medicine is no different. Telemedicine was a well-known phenomenon prior to covid-19 and involves a telephone or video call between clinician and patient, or between clinicians. Any of these may raise practical or technological challenges which go beyond this article. Nonetheless, we expect that telemedicine will have an increasingly significant role to play in primary and secondary healthcare provision both in the current pandemic, the post-covid-19 epoch and in future pandemic planning (see NHSX). Guidance from the General Medical Council and the Royal College of Surgeons makes it clear that there is nothing wrong with telemedicine in appropriate cases. However, those cases will depend upon a number of factors, including the complexity of the disease and the clinician’s knowledge of the patient.

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