BY THE time you read this we will have had a very important select committee session on the challenges facing the NHS as it tries to resume ‘normal’ service.
To remind you of some of the issues: cancer referrals are down 72 per cent and mental-health referrals for young people down between 30 per cent and 40 per cent since the start of the crisis.
Some of these are problems that will sort themselves out – but many are not.
In both cancer and mental health, there is much evidence that early detection of problems greatly increases the chance of a full recovery.
In many cases the issue is not that services are unavailable – it is that people are not coming forward.
Louise Stead, chief executive of the Royal Surrey, told me that last week 30 potential cancer patients failed to show up for vital investigations.
People whose bodies are fighting cancer are understandably worried about the risk of catching Covid when their immune systems are suppressed. So how do we make it safe for people to come forward for the treatment they may urgently need?
The NHS has already made important changes, for example introducing social distancing for people coming in for chemotherapy or radiotherapy appointments.
But one essential change we will need to move to is weekly testing of all front-line NHS staff.
About half of all transmission happens when people are asymptomatic and a Cambridge University study at Addenbrooke’s Hospital found three per cent of staff were carrying the virus without knowing it.
Testing a million front-line NHS staff every week would alone need more than 140,000 tests a day so it has never been more critical to ramp up our testing capacity.
There are other changes we will also need to consider. A&E attendance for March was 29 per cent lower than a year ago.
But do we want people to go back to A&Es in the same numbers as before if it risks spreading the infection in a crowded waiting room?
We will need to look at innovative ways to control the flow of patients into emergency departments to keep them safe.
The aim in all of this will be to offer patients ‘clean services’ where they can be confident a visit to hospital will not lead to an unintended infection.
At the same time we have learned many new things that will permanently change practice even when the virus is finally behind us.
Every day the NHS is now carrying out 6,000 video appointments – prior to the crisis it was just 200. This is a brilliant innovation, meaning frail patients are not having to travel – and doctors who might have left the service can now work from home.
But none of these changes will have the impact we need if one final change is not fully grasped by the nettle: to understand and deal with the extreme mental pressure that front-line staff in hospitals and care homes have been experiencing over the past few months.
That needs to be addressed not just with practical measures such as adequate PPE, but also with enhanced mental-health support for those suffering from the Covid version of PTSD.
We owe our brave front line staff no less.