Covid pandemic has forced medical care to change – and change can be good

During the past year or so I feel we’ve found new ways of living our lives that we really should consider keeping.

In an attempt to find a silver lining to the pandemic, it’s beneficial to ­realise the Covid crisis has accelerated and enabled the adoption of some NHS practices we might actually like to continue with.

David Oliver, consultant in geriatrics and acute general medicine at the Royal Berkshire NHS Foundation Trust, makes a few pertinent suggestions about not going back to our old ways.

One of the most dramatic changes we’ve embraced is telephone and online consultations between patients and doctors, replacing previous routine face-to-face appointments.

Personally, I can see why some patients might not like it. It does exclude patients who are unable to use digital technology, who will miss doctors’ hands-on examinations.

But for others it has improved access, convenience, ­flexibility and choice. So it looks as if we’re in need of a better balance between remote and physical consulting.

Covid forced on us more efficient and faster medical assessment in the community and access to care. We know patients like home rehabilitation after hospital, and home care is cheaper than comparable treatment in hospital. Because of having to fine-tune discharge policy, access to community services has become much slicker.

And using ‘discharge to assess’ bedded units turned out to be popular, where people’s ongoing care needs could be monitored, and should be kept. Virtual medicine has its place too. Home-based rapid assessment in virtual wards has helped to avoid needless hospital admissions.

It turns out that ‘virtual wards’ for people with respiratory Covid symptoms mean they don’t need to stay in a hospital just for symptoms, and oxygen ­saturation can be monitored at home.

With telephone support, self-monitoring, reporting of symptoms and the ability for immediate recall if a patient deteriorates, thousands of people remained out of hospital. Surely we should maintain this approach.

Care homes moved centre stage as a result of the pandemic. But what has emerged is a real step forward with an emphasis on infection control and more careful transfer of patients to care homes.

Also, support for care homes became mandatory, relying on multidisciplinary teams, advanced care practitioners, geriatricians and palliative care, plus rapid interventions. This helped people to stay out of hospital or leave sooner. Surely, we should build on this?