When will covid end ? Please be nice and respectful to others

[DeanoL]

1 minute ago, fraybentos1 said:

Might as well just not exist at that point is it was months to get a phone appointment.

every year we are told the nhs is about to collapse.

What is "collapse"? Is waiting 3 weeks for an appointment not already "collapse" ?

It's not going to blink out of existence. Boris isn't going to come out and go "I've got to level with you, the NHS is massively over-subscribed so we're just going to stop it as of tomorrow".

The NHS won't collapse, it'll fall apart slowly. The quality of care will drop (hello telephone appointments instead of in-person ones). The time for appointments will increase (hello "I was told the earliest appointment is in three weeks time"). Waiting lists will go up. And all these will keep getting worse until, as you say, it may as well not exist.

The collapse of the NHS will be a whimper, not a bang.

Some people are living in a fantasy world where the reason they can't get an appointment is something that could be easily fixed if doctors just tried harder or the NHS just operated in a different way. 

And I agree, we can't be having restrictions on our lives just to protect the NHS from being overstretched. But you've got to understand, that means the NHS will be overstretched and what that means is it's possible you can't see a doctor when you want to. 

Honestly it's like Brexit all over again. "We want rid of freedom of movement" "Okay, done." "Wait, why can't I live in France 6 months a year any more".

"No lockdowns just to protect the NHS" "Okay, done" "Wait why can't I see a GP?"

[JoeyT]

What's the basis on which it's currently only 50yo's and above that are getting boosters? Is there strong evidence that the benefit of moving that to 30yo+ is of minimal advantage?

I have no idea where this stands from a vaccine stock POV but if the stock is there this makes more sense than hitting the restrictions button surely?

[JoeyT]

 

[pink_triangle]

I work in community health and think people are over simplifying things. Some of my patients can easily get a home visit from a GP while others struggle for a phone review. Some have great GPs and some have average ones. This was no different before Covid.

As a health care professional a move from face to face worries me as there is the potential to miss so much over the phone. The vast majority of patients want to be seen face to face and appreciate the service. What worries me is some (by no means a majority) health professionals are now using covid to continue with changes that benefit themselves reduced travel, saving on childcare when it's to the detriment of the patient. We sometimes now struggle to get staff in to do face to face or train students as it doesn't fit their new routine.

When the needs of the patients overlap with the want of the professional then that's great, telephone and video has its place. However the needs of the patient should always come first, accepting finances will effect what is possible.

 

[efcfanwirral]

1 hour ago, DeanoL said:

That's horrible mate - glad it worked out okay. There are definitely cases where the telephone consult thing doesn't work and fails patients, leading them needing to use more NHS resource than they would have otherwise. This definitely happens, and it's important to say that's one of the consequences of reducing quality of care in this way.

But overall, it's more efficient, because the savings outweigh the costs. Which is horrible when the "cost" is you or someone close to you but it's what we've been doing this entire pandemic in order to allow the NHS to cope (and what many here were advocating).

Oh absolutely a middle ground needs to be found, i just don't think they've quite got there yet. And obviously people having to wait weeks for appointments is unacceptable. We've been lucky in that we at least always get same day ones. 

Anything that might potentially need in person visual or touch diagnosis should be seen in person but there are plenty of things that don't need it- for example I got antibiotics for clear tonsillitis last year in a 5 minute phone call- I'd had it before, it looked and felt the same and I picked them up an hour later.

Balance would be nice, but I feel covid fear is going to take over in winter again and in person is going to reduce even more, lengthening the waiting lists 

Edited October 21, 2021 by efcfanwirral

[zahidf]

23 minutes ago, JoeyT said:

What's the basis on which it's currently only 50yo's and above that are getting boosters? Is there strong evidence that the benefit of moving that to 30yo+ is of minimal advantage?

I have no idea where this stands from a vaccine stock POV but if the stock is there this makes more sense than hitting the restrictions button surely?

It's just capacity to jab isn't it? Enough vaccines but they need people to jab them in. Better to prioritise with age

[BobWillis2]

24 minutes ago, JoeyT said:

What's the basis on which it's currently only 50yo's and above that are getting boosters? Is there strong evidence that the benefit of moving that to 30yo+ is of minimal advantage?

I have no idea where this stands from a vaccine stock POV but if the stock is there this makes more sense than hitting the restrictions button surely?

Because nobody can get a booster until 6 months after their second dose so opening it up to 30+ is going to change nothing yet as most won’t have had their second dose until June/July/August. 

[DeanoL]

19 minutes ago, pink_triangle said:

I work in community health and think people are over simplifying things. Some of my patients can easily get a home visit from a GP while others struggle for a phone review. Some have great GPs and some have average ones. This was no different before Covid.

As a health care professional a move from face to face worries me as there is the potential to miss so much over the phone.

I think a combined system would work best but it's a big move away from local GPs. You have a GP call centre that's national, through which all initial appointments are done. You develop an app so these can be video calls where the patient is comfortable with that. Then if you need examination you're passed on to your local GP to be seen, preferably the same day. But if you don't it's done over the phone. 

One of the worst things we did was scrapping NHS Direct, when you could actually talk to a qualified nurse 24-hours a day. That would have been ideal but instead now we've got the useless 111 service.

[BobWillis2]

8 minutes ago, DeanoL said:

I think a combined system would work best but it's a big move away from local GPs. You have a GP call centre that's national, through which all initial appointments are done. You develop an app so these can be video calls where the patient is comfortable with that. Then if you need examination you're passed on to your local GP to be seen, preferably the same day. But if you don't it's done over the phone. 

One of the worst things we did was scrapping NHS Direct, when you could actually talk to a qualified nurse 24-hours a day. That would have been ideal but instead now we've got the useless 111 service.

There definitely needs to be an overhaul to the GP system. 
If we could bypass the militant receptionists and take it to a national system that works I’m all for it. 
There’s been many occasions in the past where I’ve sat waiting for over half an hour at the doctors surgery and only been in the doctors room for a minute or two and a telephone appointment would have been far more convenient for everyone, and on the flip side getting a face to face appointment at my doctors surgery has been next to impossible since March 2020 and now I can’t even get past the receptionist to speak to a doctor on the phone. 

[Crazyfool01]

32 minutes ago, zahidf said:

It's just capacity to jab isn't it? Enough vaccines but they need people to jab them in. Better to prioritise with age

Yep my sister runs a vaccine centre … no shortage of vaccine … just a shortage of people available to jab and administer all of it … along with the volunteers who were available because of furlough previously … some clinics have unfortunately been cancelled … along with some covid related sickness 

[DeanoL]

1 minute ago, Barry Fish said:

GPs stop taking face to face appointments because they was scared of getting covid when we didn't have a vaccine.  Don't re-write history...  

That's true (I mean, not "scared" but it was to prevent spread) and at that point it was "fine" as demand was down anyway. But demand is up now because of the backlog and lack of GPs. And many GP surgeries had already been moving to phone-first consultations pre-COVID (my partner's at her old place had already) to boost capacity. So it's a mix of both.

I dunno man. I've found today quite frustrating. There's people on here I've spent 18 months disagreeing with on COVID. People saying we overreacted, saying people die anyway, saying it's almost entirely old people, or those with pre-existing conditions, or those unvaccinated that are dieing from COVID. That wasn't our experience, and I was never happy with the position of saying "it's just bad luck for them, people die, that's life". But I got their point. I respected their point. People die, your number comes up, shit happens, can't save everyone. It's a pretty ruthless viewpoint but I get it. We can't all put our lives on hold to save everyone. Sure.

And now many of those self-same people are complaining they can't get doctor's appointments for themselves or their family. And suddenly that's a big deal. 

We had family and friends pass from COVID, in one case someone our age (late 30s) with no pre-existing conditions. And in the case of my partner's father, it was at least partly down to NHS overcrowding. He didn't have COVID when he went in to get the emergency operation. And that's part of what's informed my personal view on this whole thing. 

It's so much harder to say "ah well, people die, the overall numbers are low" when it's your own family and friends that can't get the care they need. 

[JoeyT]

16 minutes ago, crazyfool1 said:

Yep my sister runs a vaccine centre … no shortage of vaccine … just a shortage of people available to jab and administer all of it … along with the volunteers who were available because of furlough previously … some clinics have unfortunately been cancelled … along with some covid related sickness 

Let's hope we can sort out that issue then because of the below... It's a long thread but worth a read.

 

[fraybentos1]

Great news that the boosters seem amazing. Every over 50 with one of them this winter will help a lot!

[mcshed]

12 minutes ago, Barry Fish said:

People arguing there is no issue with GPs....

I don't think anyone is saying there isn't an issue with GP access in this country what people are arguing is that phone appointments aren't the cause so removing them isn't the solution.

[zahidf]

I don't think anyone on here is arguing for the return of restrictions?

Its fine to discuss what to do with the NHS issues. As with most things, a mix of more appointments and face to face is probably fine for the GPs. But its a localised thing anyway, i dont think good GPs are suddenly rubbish or vice versa

 

[DeanoL]

3 minutes ago, Barry Fish said:

Its about being realistic what you can do and being balanced with that- its nothing to do with how much you have been impacted - or being comfortable with millions being dead.  What a lot of nonsense.

 

Then take that same attitude and apply it to GPs. There's not enough appointments to go around. You've got to be realistic that you and your family won't always get one. Until we can fix the issue. And "stopping telephone appointments" isn't the magic bullet you seem to think it is. Nor is "tell them to stop being lazy". 

[DeanoL]

1 minute ago, zahidf said:

I don't think anyone on here is arguing for the return of restrictions?

Its fine to discuss what to do with the NHS issues. As with most things, a mix of more appointments and face to face is probably fine for the GPs. But its a localised thing anyway, i dont think good GPs are suddenly rubbish or vice versa

I'm not arguing for them, but surely we all have to admit, restrictions would reduce the load on the NHS. They're probably the only actual short-term fix for the current stress on the system. You can put COVID aside, just generally less interactions means less things people can do that end them up in hospital. A better structure and a push on recruitment and training for more GPs is needed, but that will take years. If you want to ensure everyone has access to a GP appointment when they need it, then locking us in our homes would work. I don't know what other measure you could implement tomorrow that would fix it in the short term?

But again, I'm not arguing for it, I think that's overkill. But that does mean the current issues will continue and that means we can't all get the care we need when we need it. 

[DeanoL]

1 minute ago, Barry Fish said:

You honestly don't know what you are talking about.

If you listened and believe what you was told this might help I guess.  Not me personally but maybe the countless articles out there.  GPs are doing less hours, are less available.  The way they get paid, the NHS contract and so on allows them to do this.

There is no point me telling you this though as I you don't want to listen.  The only people who is saying any different is the GP unions who couldn't give a monkey about patietns and only making their members richers (to be fair - that is their job)

Okay so how do you propose to fix that? Yeah GPs might be working fewer hours, maybe they're burned out after dealing with a pandemic for 18 months? We could change the contract, but then some would leave. Would that actually boost overall hours?

It doesn't matter *why* the system is over-stressed. Be it "lazy" GPs or chronic underfunding for decades, it *is* overstressed. You can't just give GPs a stern talking to and they suddenly come back in more often again. 

[DeanoL]

4 minutes ago, Barry Fish said:

Most accidents happen in the home - another wrong point of view for you Dean.

Most flu transmission doesn't!

3 minutes ago, Barry Fish said:

Isn't it the same argument that you can't tax people because they will leave ?

Its partly bullshit.  Yeah some might leave but most won't and so on...

 

There is no short term answers to any of this.  The start of fixing a problem though is admitting you have it.  You need to get to stage one and then maybe we can talk....

We have a problem: a shortage of GPs. We both agree on that. Do GP working hours factor into that? Yes. Does Brexit? Yes. And plenty of other things beside. It's not just "lazy GPs" just like it's not just Brexit or telephone consultations or anything else.

And yeah, there's no overnight fix (short of locking us all up) and that's a problem because you can get very ill overnight. 

10 minutes ago, Barry Fish said:

I always think the issues of GPs is always a troubled one for the average socialist.

I mean they are largely awful people to be honest.  They are some of the biggest earners within the NHS - don't often get their hands dirty - do the least amount of hours - I mean they really cream it off the public purse to be honest.  Have a look at the NHS GP contract - makes PPI look good.  They are also mostly always massive Tories as well...

Sounds like a troublesome issue for the average capitalist too - if it's such a cushy job how come there's a shortage? Where is the market?

[pink_triangle]

To be honest if a lot of people went to the pharmacy for first line advice it would free up a lot of space for those who really need the GP.

[steviewevie]

Moscow gone into lockdown.

[steviewevie]

Doctors are just lazy, obviously.

[fraybentos1]

18 minutes ago, DeanoL said:

Okay so how do you propose to fix that? Yeah GPs might be working fewer hours, maybe they're burned out after dealing with a pandemic for 18 months? We could change the contract, but then some would leave. Would that actually boost overall hours?

It doesn't matter *why* the system is over-stressed. Be it "lazy" GPs or chronic underfunding for decades, it *is* overstressed. You can't just give GPs a stern talking to and they suddenly come back in more often again. 

Is it possible for GPs to work fewer hours? Monday Friday 9-5 is a pretty cushy amount. I wouldn’t be complaining if I were them.

[JoeyT]

16 minutes ago, steviewevie said:

Moscow gone into lockdown.

A damning advertisement of the Sputnik vaccine? Poor vaccination take up? Or both?

[Crazyfool01]

21 minutes ago, Barry Fish said:

Crazy wants face masks back.  So not true.

facemasks arent restricting me in anything I do .... my life is the same as pre covid pretty much ....... I dont call that a restriction to me and my life ...... 

so in response to the silver bullet thing ..... Im quite happy to concede they arent an answer and that some are pretty ineffective especially when worn as a token gesture without covering the nose ..... But they are better than nothing .... on some of them thats marginal on  the n95 ones its not which should have been rolled out to at least the vulnerable ( far cheaper than a hospital admission )  .....  My happiness to wear one stems from the fact I dont want further restrictions  to my life ..... ill happily wear one indefinitely in shops and on transport if it means I can meet my mates and family ... hopefully we see drops over half term and none of this is needed ...