UK Doctors outline Coronavirus concerns to NHS England

Chief Executive of the NHS Sir Simon Stevens

***A CALL TO ACTION***

EveryDoctor is co-ordinating a mass statement from UK doctors to Chief Executive of the NHS Sir Simon Stevens.

As the coronavirus crisis intensifies, UK doctors must be given the means to protect ourselves and our patients, particularly those most vulnerable.

What’s certain is that with 100,000 job vacancies already1, the NHS will not survive this crisis without protecting its staff and providing doctors with the support and resources we need to safeguard the health of our patients.

Please read our statement below and add your signature.

We hope to get thousands of doctors signing in order to highlight the deep concerns of UK doctors across the NHS. We sent a copy of the statement to NHS leaders today and will keep you updated on their response.

If you haven't joined yet, please join EveryDoctor today. We're building a movement to support and empower UK doctors, and we rely on our members to support our work. Thank you so much.

Join here: https://www.everydoctor.org.uk/join

References

1. The New York Times 18.03.20: https://www.nytimes.com/2020/03/18/opinion/coronavirus-uk-nhs.html


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To: Chief Executive of the NHS Sir Simon Stevens
From: [Your Name]

Dear Sir Stevens,

We are writing to you today in your role as the Chief Executive of NHS England.

We run an organisation called EveryDoctor, which advocates for UK doctors and the patients they serve. We are a membership organisation for doctors. We also run the UK's largest medical political Facebook forum which welcomes UK doctors of all types. Our forum has 25,000 members, and 15,000 doctors check in every single day to read articles relevant to the medical profession and engage in discussions.

Part of our work is in mapping out the issues affecting UK doctors in their workplaces, and highlighting these through work with the media to raise awareness and seek solutions. As such, we are fed huge amounts of confidential information from doctors, and it gives us a palpable sense of the experiences of UK doctors at any time. 

UK doctors are of course unbelievably concerned at the moment, both for the welfare of their patients, and the ability of the NHS workforce to withstand the pressures coronavirus will exert on our systems. I know that you share these concerns and have been welcoming feedback from those with suggestions regarding the impending crisis.

We decided to compile a list for you of the immediate, grave concerns of UK doctors. We have crowdsourced the issues outlined below (we began collating these views on our forum at 7.30am on Wednesday, 18th March and around 300 UK doctors have contributed their views). We have structured our concerns into 3 main areas (outlined below).

Please let us know if we can be of assistance in the coming weeks and months in planning services, or collating/ disseminating information.

We would also like to request a meeting to further explain the concerns listed below. I know you'll be inundated with requests for your attention, but we hold a unique position in communications with the medical profession and this liaison role could be exercised to the betterment of the NHS and its workforce over the coming months. 

Thank you for your time,

Dr Julia Patterson

EveryDoctor lead.

EVERYDOCTOR STATEMENT TO NHS ENGLAND, 18.03.2020. 

UK doctors have compiled this statement to NHS England on Wednesday 18th March 2020. We feel that the following issues need to be addressed immediately to safeguard the health of the public and optimise the NHS workforce during the national coronavirus crisis. 

1. Issues pertaining to medical equipment, in order to safeguard the health of the public. 

* There is a shortage of sufficient PPE equipment currently; many healthcare facilities are already running low on the materials which have been provided so far, and  some areas have not received any PPE at all. We have been given anonymous testimonials of hospitals with less than 7 days' PPE equipment remaining, PPE stores being broken into by members of the public, expired PPE being sent to GPs, and psychiatric hospitals which have not received any PPE equipment at all. UK doctors are desperately concerned about contracting coronavirus themselves, thereby becoming potent vectors in spreading the virus to patients.

* We are also hearing reports that clinical staff belonging to certain religious groups are unable to wear the fitted masks/ hoods provided. We would ask that consideration is made for this by appropriate consultation with religious leaders. We request that NHS England sets procurement of PPE as an absolute priority in the coming days. We also feel strongly that the NHS should be following expert guidance from the WHO in its utilisation of PPE to best safeguard the UK population from coronavirus.

* There is widespread concern amongst UK doctors about the lack of coronavirus testing being made available for NHS staff. Many doctors (and other healthcare workers) are being forced into self-isolation because of mild respiratory symptoms. Many of these clinical staff may not have coronavirus, but without coronavirus testing they are unduly removed from the workforce for significant periods of time. 


* Doctors are deeply concerned about adequate provision of palliative care medicine and equipment for coronavirus patients. The medical profession would like assurances, please, that this aspect of the situation is being carefully considered and planned for. 

* Many clinicians require access to laptops and other equipment (for example to enable teleconferencing) which work remotely in order to safely access patient information and minimise face-to-face contact during the crisis. This requires urgent investment in technology equipment please. Many GP practices are currently communicating with their patients via text messages to avoid face-to-face contact and safeguard patients. This is costly; we request that funds are set aside please to remunerate GP practices for this additional cost. 

2. Issues surrounding support of individual NHS staff during this national crisis.

* A significant proportion of the NHS staff workforce are "locum" or "bank" members of staff. Many of these temporary workers will become unwell with COVID-19 because of their work, however they lack the standard workplace supports offered to other NHS staff. Please provide assurances that any "locum" or "bank" member of staff will be supported through paid leave if they become unwell or are forced to self-isolate due to the illness. We know that this provision is currently being offered in some NHS Trusts, but this is not widespread currently.


* We are concerned for the mental health and well-being for NHS staff, who are enduring stressful and traumatic experiences in their daily work. We would request that NHS England provides resources to support NHS staff, including ready access to trained clinical psychologists both during, and following the end of this stressful period of time. 

* We are hearing from doctors who rent bedrooms in shared houses, who have been asked to vacate the premises (due to concerns from the landlord about NHS staff infecting the other residents with coronavirus). We would like a fund to be set up to support individuals facing this situation, to ensure their safety and well-being, as well as their continued ability to work within the NHS. 

* National occupation health policies regarding exposure to coronavirus are required as a matter of urgency. We are receiving conflicting reports from NHS trusts; some pregnant doctors are being told to carry on as normal, others are sent home. Immunosuppressed NHS staff and those with other health problems are receiving inconsistent advice. Clarity is needed here please. 

* Doctors who are not currently working (but are seeking to re-join the workforce to help the national effort against coronavirus) would like clear advice about how to seek medical indemnity promptly.

* Doctors have specific requirements placed on their practice. Many training doctors will see a delay to the completion of their specialist training as a result of the crisis; revalidation of doctors may be delayed. Doctors would like assurances that they will be supported through this time period; that necessary delays in revalidation will not result in blame towards individual clinicians, and that doctors' specialist training pathways are not extended unnecessarily due to this situation beyond our control. This is obviously an evolving situation; regular communications from NHS England to UK doctors would be greatly appreciated.
 
* GPs request that the QOF expectations for the year 2019/ 2020 are dropped, to avoid primary care facilities being financially compromised during the coronavirus crisis. 

3. Issues related to NHS workforce resilience and optimisation

* We have heard many reports that PPE mask "fit-testing" is being limited; this is because in many clinical areas inadequate numbers of staff have been trained in running the fit-tests. We would ask that this effort is stepped up, to ensure that the body of frontline staff are fully prepared for coronavirus as the level of illness builds in our communities. 

* We would like a clear plan regarding childcare provision in the eventuality that schools and nurseries close entirely. (We understand that currently there are plans to continue accommodating these children in schools, but these plans may change.) Many NHS staff live geographically distant from family; this is particularly true of medical staff who rotate between hospitals. It is imperative that the NHS workforce is not diminished in scale due to childcare concerns.

* There have been many instances in the past week whereby doctors have been forced to engage in deep-cleaning of clinical areas following exposure to a patient who is suspected to have coronavirus. This is because cleaning staff have not been adequately trained in correct deep-cleaning methods. We have limited resource; our medical staff need to be focussing directly on patient care at this time. We request that any necessary training regarding deep-cleaning is provided to domestic workers in order to streamline clinical resource where it is most needed. 

* GPs have requested that there are changes to the community pharmacy contracts in order to provide 2 monthly repeat prescriptions for patients where it is appropriate and safe to do so.

Thank you so much for listening to our concerns. We look forward to hearing from you soon.

The EveryDoctor team
(www.everydoctor.org.uk)