{"id":732,"date":"2021-01-23T23:32:16","date_gmt":"2021-01-23T23:32:16","guid":{"rendered":"https:\/\/dauk.org\/dauks-dr-vinesh-patel-in-healthcare-leader-news-there-is-a-breaking-point-that-us-as-human-beings-will-reach-as-well\/"},"modified":"2021-01-23T23:32:16","modified_gmt":"2021-01-23T23:32:16","slug":"dauks-dr-vinesh-patel-in-healthcare-leader-news-there-is-a-breaking-point-that-us-as-human-beings-will-reach-as-well","status":"publish","type":"post","link":"https:\/\/dauk.org\/dauks-dr-vinesh-patel-in-healthcare-leader-news-there-is-a-breaking-point-that-us-as-human-beings-will-reach-as-well\/","title":{"rendered":"DAUK’s Dr Vinesh Patel in Healthcare leader news: \u2018There is a breaking point that us as human beings will reach as well\u2019"},"content":{"rendered":"\n
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Answering the call to do more shifts at his local Covid vaccine hub is something GP partner Vinesh Patel says provides \u2018a bit of a morale boost\u2019 \u2013 but there\u2019s also no escaping the extra pressure the programme is placing on an already overstretched workforce.<\/p>\n\n\n\n

Last week, his practice in Sutton had to release more staff time to double the number of sessions both their clinicians and administrative staff were undertaking at the vaccination hub \u2013 after the site was notified at short notice that it would be receiving double the vaccines.<\/p>\n\n\n\n

Dr Patel \u2013 was who speaking to Healthcare Leader<\/em> on behalf of the Doctor\u2019s Association UK \u2013 says \u2018people forget\u2019 GPs are not being told they can reduce two or four clinical sessions at their surgery to do this \u2013 it is \u2018on top of all the extra work we\u2019ve been asked to do\u2019.<\/p>\n\n\n\n

The Covid vaccination programme is rolling out alongside a raft of existing pressures. Staff are dealing with normal routine work and the \u2018emergency normal day-to-day stuff\u2019 seen in winter, says Dr Patel, as well as managing patients who have had elective and routine work delayed in hospital \u2013 and continuing this season\u2019s expanded flu programme.<\/p>\n\n\n\n

The request to provide more staff and time to the vaccination effort has also coincided with an email callout asking GPs to volunteer at the Nightingale Hospital, he adds.<\/p>\n\n\n\n

\u2018Within all of that we have staff who are isolating \u2013 either because members of their family have got symptoms or who have been told to isolate, or they themselves have.<\/p>\n\n\n\n

\u2018We are down to the bare minimum at the moment.\u2019<\/p>\n\n\n\n

GP workload<\/strong><\/p>\n\n\n\n

NHS England has recently set out a range of measures <\/a>in a bid to address GP workload \u2013 including the suspension of local enhanced services. The same letter also detailed the \u2018biggest priorities\u2019 \u2013 alongside the Covid vaccination programme \u2013 for general practice, which included that it remains \u2018fully and safely open\u2019 and maintains appointments.<\/p>\n\n\n\n

The waiting time for routine appointments at Dr Patel\u2019s practice is still less than a week, but he says they have made an \u2018active decision\u2019 to reduce the number offered.<\/p>\n\n\n\n

\u2018I could have a full clinic booked because I expected to be in, and then suddenly be isolating and call in that morning \u2013 and that puts the pressure on the team,\u2019 he says.<\/p>\n\n\n\n

\u2018We\u2019re trying to manage that by reducing the number of routines so that if those incidences do occur, the pressure on the team that is available isn\u2019t so much.\u2019<\/p>\n\n\n\n

This pushes the waiting time up, Dr Patel says, but it\u2019s the \u2018only way\u2019 they can fill the timetable at the vaccine clinic \u2013 recognising that staff \u2018are already strained and mentally and physically drained\u2019 and that those last-minute changes make it harder to cope.<\/p>\n\n\n\n

It is, he adds, \u2018probably a story that is being replicated across the country\u2019.<\/p>\n\n\n\n

\u2018More pressure and more complaints\u2019<\/strong><\/p>\n\n\n\n

Another key \u2013 but not new \u2013 challenge is managing patient expectations. Practices have come under fire for being \u2018closed\u2019 during the pandemic, when this is not the case, and a recent study warned of an \u2018urgent need\u2019 to restore public trust in remote consultations.<\/p>\n\n\n\n

Dr Patel describes it as \u2018constant battle\u2019 to explain that practices are not closed, but says that the public needs to understand \u2018the complexities that we can\u2019t carry on the way we are\u2019.<\/p>\n\n\n\n

It is made worse, he adds, by the fact \u2018the central output from NHS England and again within CCGs\u2019 has been that practices need \u2018to carry on business as usual\u2019 \u2013 and by a lack of public announcements that provide a clear message about the pressures in primary care.<\/p>\n\n\n\n

\u2018It would be great if we had more public announcements saying that \u2018we know some elective work is being delayed and passed over to primary care\u2019 \u2013 but that\u2019s not something the Government want to advertise because it doesn\u2019t reflect well on them.<\/p>\n\n\n\n

\u2018But that is the reality and without that understanding, what they fail to do is actually creating more work, more pressure and more complaints.\u2019<\/p>\n\n\n\n

When asked how it feels to face complaints and abuse from patients at an already pressurised time, Dr Patel says it is \u2018painful\u2019, demoralising\u2019 and \u2018does get you down\u2019, adding that an upcoming DAUK survey is due to reveal a stark rise in incidents.<\/p>\n\n\n\n

\u2018We know that the ones who complain or who are unreasonable aren\u2019t every single patient but the abuse that we get\u2026we\u2019re human, we are under pressure, we are stretched and there is a breaking point that us as human beings will reach as well.\u2019<\/p>\n\n\n\n

\u2018Eroding trust\u2019<\/strong><\/p>\n\n\n\n

The timing of Government communications has also sparked anger among the profession \u2013 with one of the most recent examples being the Government\u2019s move to change the dosing schedule for the Pfizer vaccine on New Year\u2019s Eve \u2013 an announcement that would result in the cancellation of thousands of appointments at very short notice.<\/p>\n\n\n\n

\u2018When we talk about trust within the vaccine programme, people are already sceptical and this erodes that trust both from a clinician and a public point of view,\u2019 Dr Patel says.<\/p>\n\n\n\n

The chief medical officers acknowledged<\/a> the change would be \u2018operationally very difficult\u2019 and distressing for patients \u2013 but it\u2019s a move Dr Patel deems \u2018utter madness\u2019 and one that has created a \u2018postcode lottery\u2019 due to the way different areas chose to respond to it.<\/p>\n\n\n\n

Some PCNs opted to honour existing second dose appointments<\/a> before adopting the change, others sent out blanket texts to patients, and some took an approach similar to Dr Patel\u2019s \u2013 which was to spend two hours on the phone to patients explaining all the information and giving them the option of whether or not to agree to a cancellation.<\/p>\n\n\n\n

\u2018If the patient knows all of the information and then says doctor I will delay my appointment, I will feel more comfortable because they\u2019ve been given all the right information \u2013 I\u2019m not going to do it without that because it\u2019s not ethically correct,\u2019 he says.<\/p>\n\n\n\n

Not one of Dr Patel\u2019s patients agreed to a cancellation, but he\u2019s \u2018quite happy to stand by that\u2019: \u2018I might get told off by senior managers or the powers that be who aren\u2019t clinically front-facing, but ethically and morally I have to take responsibility for my own decision.\u2019<\/p>\n\n\n\n

\u2018More flexibility\u2019<\/strong><\/p>\n\n\n\n

The latest figures show more than four million people in the UK have now received their first dose of a Covid-19 vaccine and the vaccination programme continues to accelerate, with 10 new mass vaccination centres opening this week and more pharmacy-led sites.<\/p>\n\n\n\n

But as the vaccination effort ramps up, Dr Patel says the Government needs to be more transparent about vaccine supply \u2013 he\u2019s heard of vaccine hubs getting deliveries cancelled \u2018at the last minute and therefore rushing to cancel patients\u2019, others getting a delivery they weren\u2019t expecting and rushing to book in patients, and one area that was \u2018doing so well at vaccinating that they asked for more vaccines and have been declined\u2019.<\/p>\n\n\n\n

\u2018There isn\u2019t this kind of coordinated approach that you would expect and again that would really take knowing what the number of vaccines are, where there are scheduled deliveries and what to do with it \u2013 we can\u2019t have this postcode lottery,\u2019 he says.<\/p>\n\n\n\n

He\u2019s also calling for more flexibility in the primary care contract for the programme \u2013 \u2018as long as its resourced and is a choice\u2019 \u2013 to allow for some of the Oxford vaccines to be given to individual GP surgeries, because they know their patients and can organise it.<\/p>\n\n\n\n

\u2018If they really want the vaccination programme to work then back it \u2013 show that they back it by giving good flexibility in the contract, understanding the complexities on the ground and giving us the opportunity \u2013 we know our patients and we know our staff,\u2019 he adds.<\/p>\n\n\n\n

The reality, Dr Patel concludes, is that despite feeling stretched, \u2018we don\u2019t want to stop because this is our vocation, we want to help, we are considering volunteering for the Nightingale hospital, we are trying to do the best we can to fill these [vaccine hub] shifts.<\/p>\n\n\n\n

\u2018But without the Government listening and being transparent on the problems we face \u2013 both with us and with the public \u2013 there is only so much goodwill that can continue.\u2019<\/p>\n\n\n\n

Read the article here: https:\/\/healthcareleadernews.com\/views\/interviews\/there-is-a-breaking-point-that-us-as-human-beings-will-reach-as-well\/<\/p>\n","protected":false},"excerpt":{"rendered":"

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