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Secret Diary : Winter is Coming (and so are the patients)

I wonder how many of us in March thought we would be still in the depths of the pandemic as we moved into October?

It has been a rollercoaster six months, and the next six months over the winter are likely to be even more challenging. Up until September,  primary care had the support of patients, the NHS and the CCG and we were implementing new ways of working, many of them I must say were so long overdue. Our staff and GPs have been fantastic, and we have all pulled together and created a real excellent team spirit.


Is COVID fatigue setting in?

We had two fantastic socially distanced flu clinics in September with record numbers attending and have been using online consultations before any face to face consultations. We have never closed and refused anybody care, care has just been delivered in a different way. That was all fine but since early September, support seems to have changed - and not for the better.

There are several different articles reporting the same thing. Up until recently, we have had little staff illness but with the change of seasons and the increase in Covid cases, we are seeing far more absences. Obviously, any symptoms must be treated seriously, and so colds and sniffles may just be that, but they could also be Covid, and so we must err on the side of caution and insist on our staff isolating or getting tested. Whilst most are understanding, I have had a case of one staff member showing the Covid symptoms but refusing to get tested. So, in fairness to their work colleagues we said they must be off 10 working days. They could work from home, and in fact we set them up, but they were unhappy that we stopped them coming into work.

Saying they “know their body” and it is not Covid is not a reason to let them back before isolation is over.

Other articles, across the media report that surgeries are receiving more complaints in September 2020 than in the whole of 2019 and does say something - we are experiencing the same sort of increase in complaints and in the last 2 weeks we have been inundated. Most are utter nonsense, but it’s as though patients think we’re closed and on holiday. We have had patients wanting to know where all the doctors are and what are they doing as they are certainly not seeing patients.

Of course, this is not true - we have had face to face appointments and telephone/video consultations throughout this period. I think the anxiety level of most people has gone up and is fuelling this unrest. When MPs say it is ‘business as usual’ it sends the wrong message to patients – they think we should go back to pre-pandemic working.  MPs should be saying that it is “business as usual, only delivered in a different way”.

The public does not seem to realise that we are just as at risk as them and we must ensure staff safety and protection and that we have our own families to worry about and must take care. I have spent time this week arguing with a patient that needs a blood test and refuses to explain why she is exempt in wearing a mask. She claims it is none of our business and we cannot refuse her care. She is now claiming she is being discriminated against and is taking legal advice. We advised her to go to the hospital, but they have also refused to see her without a mask. We will probably have to see her but in the amber zone and fully kitted up in full protection.  Why anyone would not give the reasons why, is beyond me!!

 

Winter/Second Wave preparations

With the Covid rate going up, we have just started stress testing all our systems to see how we can best function and the least number of staff we need on site to ensure we can keep going. One of the biggest issues we all face is the IT.  The clinical system does not work as well at home and at times cannot be even accessed. This is very frustrating for those working from home and isolating. 

In my role I do not use the clinical system very much and can reasonably well work from home accessing most things like accounts, intranet, payroll etc. However, it still does not sit comfortably with me that I could work from home when others cannot, like receptionists who take a lot of abuse, and as a manager, I think I should be there and lead by example.

There has also been a change in approach by the NHS/CCG and that the most helpful extra funding to help the increase in running costs and overtime pay for covering people off sick or isolating has been almost withdrawn from August. I can accept that some surgeries may have been taking advantage, but I would hop, most to have not.  I can see that going forward we will all face more sickness and increase running costs to cover, and unless this is recognised by the NHS, it could create financial and operating difficulties for some practices.

Finally, I am convinced that some people are just not aware of how serious this pandemic is and the need to observe the restrictions in place. At a Cancer Coffee morning organised with social distancing for staff this week one of the nurses seriously asked, “where we are going for our Christmas party this year?”

Everyone just stopped and looked at her thinking she was joking, but when I said we are not having one, she seriously asked why?

In conclusion I know despite everything we will all rise to the challenge and we will get through this and move on. On a more personal note, one of the team has enrolled on the Oxford Study, agreeing over the next 12 months to have a series of Covid Tests and helping in their research and development of a vaccine.


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