Thread by @CommonsHealth

🚨Tune in TODAY at 9am for our next Delivering Core Services evidence session. We're asking @RCollEM, @RCSnews, @TheBDA, @NVTweeting, @HealthwatchE, @NHSConfed and patients themselves about the impact of #coronavirus

Watch live:
📺: parliamentlive.tv/Event/Index/9d…
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Our first panel is starting now. We'll be hearing from @KatherineRCEM, @MickArmstrong61, @RCSnews, and Rob Martinez.

Watch live:
📺: bit.ly/2AtWw5n
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Rob Martinez describes living with lymphoedema and needing two knee replacements - Rob is suffering severe pain but having waited since October 2019, his surgery that was planned for April has now been cancelled

My GP practice was working better during this pandemic than before it, says Rob Martinez, but I haven't heard from my local hospital since my operation was cancelled. I've now been told there is zero chance of my operation occuring this year.

I have had to give up my job, I have pain walking and sleeping, and no medication has helped whatsoever, says Rob Martinez. My life feels on hold and it's extremely frustrating.

The communication from hospitals has been really lacking and I just want to know what is happening, says Rob Martinez. The hospitals should have been in contact with people and given some update, rather than remaining totally silent.

Rob thanks @VersusArthritis for their support over the past 12 months - if you're affected by the issues he has raised you can call their helpline on 0800 5200 520 (Monday – Friday, 9am – 8pm)

Derek Alderson @RCSnews says the big sadness is that Rob's story is not atypical - people waiting for joint replacements constitute one of the largest groups waiting unacceptably long times for their surgery - in April this year we saw 1 million fewer patients compared to 2019

The longer we are unable to restart scheduled services, the worse the situation is going to get says Derek Alderson @RCSnews - that's why we're calling to establish covid-light sites with minimal risk to patients

The Government needs to commit to maintaining such sites, including the arrangements with the private sector which have been taken during the pandemic, says Derek Alderson @RCSnews

@KatherineRCEM describes the changes needed in emergency departments: the old way meant ED could never say "we're full" - we need space in ED for our most at-risk patients or there will be great pain and enormous harm. She suggests a better contact point for urgent care before ED

@KatherineRCEM confirms that @RCEMpresident is calling for a "call before you walk" approach to emergency departments like in Scandinavian countries - but emphasises that 999 would remain and emergency depts would remain committed to being the safety net for patients

@MickArmstrong61 of @TheBDA describes how primary dental care has been "virtually non-existent" during the pandemic. Dentistry wasn't in a great place before the pandemic, he says - there were widening inequalities and rock-bottom morale and the pandemic has made it worse

The effect on oral health has been "catastrophic" says @MickArmstrong61 @TheBDA - 8 million courses of treatment have been cancelled nationally

@MickArmstrong61 @TheBDA - we need the correct PPE consistently and widely available, but the protocols in place severely limit our capacity to treat patients - in our practice we'd normally offer 150 appointments a day, it's now 10-15

Derek Alderson @RCSnews warns it will certainly be many months and may even be several years before we fully catch up - says it's "completely unrealistic" to believe we can go at full speed very quickly

We want people to have confidence that they can come to an emergency department with an emergency and be safe, says @KatherineRCEM, but we don't want people coming to ED where there are other places they could get their care

It's absolutely essential to regain public confidence that we are able to test our staff regularly says Derek Alderson @RCSnews - pragmatically this should be at least twice weekly

@KatherineRCEM agrees - we can't build confidence in patients if we can't be sure that we can protect everybody. We need to sure risks around staff-on-staff infection and asymptomatic carriers of Covid-19 are minimised

@KatherineRCEM Workforce is a real concern - we want to retain people, we want to make it possible to retain them in the system. We have a real worry about very experienced people for whom the aftermath (of the pandemic) might be too much.

@KatherineRCEM says integrated care is key to managing patient demand where patients could use a "beefed up" 111 call system. Technology is important to this, for example, we need to better track patients for example if they have followed the advice from 111

If you have departments that are big enough, a workforce that is big enough, and are not overwhelmed by patients, then you can provide really effective care says @KatherineRCEM

There must be no return to silo working, says @KatherineRCEM, and although training has suffered, we have managed to deliver a lot of teaching and training, embracing Zoom as a way of doing meetings. We can trust healthcare staff to do things from home.

The need to keep people safe has given us the opportunity to break down barriers. The demise of silo working has been one of the most positive things that has come out of this @KatherineRCEM

@KatherineRCEM: We need emergency cases to come back and we need to get the balance right. Some patients who really need to aren't coming. But we're seeing people presenting as intoxicated going back up - I want to see the person who is having a stroke or having a heart attack.

@MickArmstrong61 says private dental practices and NHS practices are on the brink, only 8% of practices think they're financially viable

@MickArmstrong61 @TheBDA: There is a serious concern that dentists won't be paid enough to keep going. It is financially nonviable to keep doing dentistry in small numbers - we need long term investment.

@MickArmstrong61 @TheBDA: The Department of Health understands very well where we're coming from, it's the Treasury which seems to be the problem. We remain the Cinderella service of the NHS and it has to change.

We got one working day's notice before we were told to open says @MickArmstrong61 @TheBDA. There was a plan for dentistry ready to go for a week before it was released, but it appears the political will and 'the system' yet again got in the way

The profession is ready and willing and very able to deliver says @MickArmstrong61 @TheBDA but we need a plan, we need clear lines of communication - and influence. If we need something and ask for it we expect to be heard

Pre-COVID you could protect a patient and it cost two or three pounds. Now it costs over forty pounds per patient. So dentists have huge expenses but very little income @MickArmstrong61 @TheBDA

Our second panel on core NHS and care services during the pandemic is starting now - we'll hear from @dalonic, @CharlotteAugst, Sir Robert Francis @HealthwatchE, and @LaylaMcCay @NHSConfed

📺: bit.ly/2AtWw5n
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@dalonic: I started the lockdown in a clinical trial. I was told I needed chemotherapy but for most of the lockdown I have been sitting here, knowing my tumours were growing, with no word from the hospital about when treatment might start

@dalonic: I'm a single mum with teenagers at home. My priority is to stay alive. I can't tell you how difficult that limbo period has been - but it has been resolved now

@CharlotteAugst says this is typical of people trying to access health services during the pandemic - in cancer there are 12,000 fewer patients receiving surgery, 6,000 fewer receiving chemotherapy, and 2,800 fewer receiving radiotherapy

People who need treatment are not being involved enough in decisions about what is happening next, says Sir Robert Francis @HealthwatchE . There is not enough explanation being provided to them and patients are not being considered holistically.

Patient safety appears to have been taking a back seat, not in relation to the pandemic itself, but in an understandable rush to change things around, patient safety hasn't been properly considered, says Sir Robert Francis @HealthwatchE

The CQC inspection system has been very effective at putting quality and safety at the heart of the NHS, says Sir Robert Francis @HealthwatchE, and I would be concerned if inspections did not resume

Our members are telling us that pre-Covid-19, most people were working around 90% or more of capacity, and they are now expecting to be working at 60% says @LaylaMcCay @NHSConfed

On communication with patients, @CharlotteAugst thinks poor communication is the common thread through the patient stories we've heard - but this is not new in the NHS

The approach taken to talking to patients and public is very unsophisticated says @CharlotteAugst What happens in hospitals is only a small part of how we will weather this storm going into winter - patients and public are the most important actors and need tailored communication

People need to know why appointments are being cancelled and what is being done for them says Sir Robert Francis @HealthwatchE - this is not just an administrative matter, people need to be treated as individuals

You have people who are socially isolated or don't have internet access, and we have to cater for those whilst continuing to reduce the need for face-to-face appointments where we can says Sir Robert Francis @HealthwatchE on remote consultations

1.9m households don't have access to the internet, 25m people are on expensive pay-as-you-go tariffs says @CharlotteAugst - you need money and confidence to make telemedicine work. We need to tailor our technology responses to pick up people with the biggest needs

We have heard that trusts and CCGs are doing things in a few weeks that would otherwise have taken years to accomplish, says @LaylaMcCay @NHSConfed. Having now tried out digital and seeing that it works, it's really moved things forward.

We don't just want to return to the old ways of working - there's an opportunity to think about how we plan, how we commission, how we deliver care in new, more effective and more productive ways @LaylaMcCay @NHSConfed

What have we learnt from Covid? How are we now going to change the conversation? How can we improve the way that the NHS works? - Key questions being considered by @NHSConfed from workforce to mental health to regulation

@CharlotteAugst says that difficulties caused for people by shielding are massive and have been exacerbated by the lack of clarity and communication of decision making

I am supposed to be shielding, but the advice is totally impossible to follow and is utterly meaningless, causing an enormous amount of distress says @dalonic

Our session on core NHS and care services during the pandemic has now finished.

Thank you to our first panel - Rob Martinez, @KatherineRCEM, Derek Alderson @RCSnews and @MickArmstrong61 who described the impact of #coronavirus on surgery, emergency departments and dentists

Thank you as well to @dalonic, @CharlotteAugst, Sir Robert Francis @HealthwatchE and @LaylaMcCay who spoke to the Committee about the impact of #coronavirus on people living with cancer, on mental health services and the way the NHS as a whole works

Finally, thank you to @VersusArthritis and @macmillancancer for helping us to highlight the voices of people most affected by the pandemic

📺Watch the session back here: bit.ly/2AtWw5n
Review our live tweets 👆🏿
And look out for the transcript 📰