How complicit has NHS Leadership been in Johnson’s pandemic calamities? And have lessons been learned?
There is a long list of failures:
▪️Ageist policies
▪️Blanket Do Not Resuscitate orders
▪️Inadequate PPE
▪️Ethnic disparities on the frontline
▪️No Triage
▪️No clinical follow-up
▪️The ‘Stay Home’ messaging
▪️Ineffectual Contact and Trace
▪️Circumventing primary care
▪️Rationing of access to healthcare via ‘111’.
▪️Oxygen rationing
▪️Shrinking the NHS during a pandemic
And these failures, while still remediable, continue to place HCWs in unsafe and traumatic working conditions, and are still leading to unsafe care provision for the British public.
Perhaps the first step is to accept how far off track we have fallen. How ill-informed government policy dictated clinical standards and healthcare priorities. It’s still happening…Sajid dictating clinical priorities to GPs and Johnson ignoring infection control policies.
Why have national leaders not stood up more against such clearly harmful policies? Where is the outrage, the whistleblowers, the resignations? Or is there too much fear of a tyrannical government beset on deconstructing the mechanisms of accountability?
Whatever the reason, the claim that ‘no-one was denied care’ seems utterly ludicrous now. All it showed is how disconnected leadership is from what is actually happening on the frontline and to the people they serve. But just as Hancock has, Sajid and Johnson will move on…
..as too is the populist sentiment. And what will be left, except a huge moral debt. The public and NHS staff will be asking the question: who is due? Who abandoned us when we needed actual LEADERSHIP the most?
Time is running out. The health service must uphold its own standards. For it will be those standards on which we are judged, not how well we followed past political leaders. Ministers are accountable to the voters, but we must answer to a less fickle and more robust framework.
The NHS is currently under the worst pressures in its history. For months we have worked way beyond safe occupancy levels and now beyond dangerous levels. Failing to strengthen the NHS frontline during a pandemic will be indefensible, albeit the responsibility for such failure...
will sit across many shoulders. Asking a weakened healthcare staff to fight a pandemic currently killing three times that of pneumonia with LESS bed capacity will, under any examination, look utterly and wilfully negligent.
There is still time to take the fight to COVID-19.
END
• • •
Missing some Tweet in this thread? You can try to
force a refresh
Where problems with care seem national, those of us actually delivering care can feel quite helpless to change it. Take the government’s pandemic policy...
We on the frontline are also victims, collateral damage, of ill-conceived healthcare policies.
But the GMC guidelines, while adding yet another responsibility on our shoulders, also provides the encouragement and compulsion to speak out.
“If you have reason to believe that patients are, or may be, at risk of death or serious harm for any reason, you should report your concern.. Do not delay doing so because you yourself are not in a position to put the matter right”
Firstly, you should use the same judgement as you did before the pandemic. Who would you normally contact if you are concerned about specific symptoms?
You may think you are saving healthcare resources, but waiting until you are worse neither helps you or the health service.
Secondly, if you test positive for COVID-19 and are either over 65 yrs old or have a condition that makes you clinically vulnerable you should contact your primary care provider (GP practice) to let them know you have Covid and request 'remote home monitoring'.
The NHS needs REFORMED.
Indeed, the NHS needs serious overhaul.
It is no longer providing world-class universal care [IMO].
It seems to not even be providing ‘value-for-money’ anymore.
But it is our money and our health, so we must have a say…
🧵1/n
RT pls.
The NHS once provided the most cost-effective healthcare of all developed nations. Indeed despite consistently spending the LOWEST percentage of GDP (national income) of similar nations (graph), up until the last couple of decades it still provided world-class outcomes.
In the 70s the UK had one of the lowest infant-mortality rates in the world. But by 2010 it looked like this (source BBC):
I fear we have not learned how to respond to a pandemic. Both clinical and public health responses in many nations have been chaotic, inconsistent and had disappointing results. So what would a decent response look like? Pls add your own… #Covid19
1. Early “circuit-breaker”.
Debate remains as to the justification for lockdowns. The argument being that lockdowns cause more damage to non-Covid problems than the lives saved from the virus. I think that depends on a few things:
a) Healthcare capacity
A new pathogen will lead to extra strain on health services. Unless the health systems in place had capacity prior to the pandemic, then the additional burden will impact all diseases. The UK is a good example of this. All cause mortality = +1400 per week.
I hear this question often: why didn’t all countries just lockdown for a month and extinguish COVID-19?
The principle is sound - a global response. Our leaders didn't try, it seems, due to the fear of economic instability.
Is it time then, for a new economic model?
1/6
Essential services adapted. Food networks were secured. People worked - often successfully - from home. Healthcare services utilised emerging technologies to maintain care. But, apart from printing more money, where were the intelligent economic solutions?
2/6
And it is not just about the Fat Cats needing the workers to get back to making them rich. Billions rely on daily earnings to survive. The rickshaw driver in India can’t afford the month off, nor can the piecemeal factory worker in England.
3/6
▪️How to tell if a Covid-19 patient is deteriorating at home?
A cross-discipline team reviews the signs and symptoms to watch for.
(1/10)
Share pls.
2/10
The majority of Covid-19 resolves without event. Typical symptoms are similar to the cold or flu and tend to start improving after two or three days.
3/10
The public should exercise the same judgement for who and when to contact if concerned as they did prior to the pandemic.
[The British Thoracic Society CAP guidelines remain unchanged.]