Every aspect of medical care is being reorganised in these challenging times. Doctors untrained in certain specialities are having to learn new tricks. Healthcare workers are supporting patients in ways they never have before.
It’s all hands to the pumps.
John Willan, consultant haematologist at Oxford University Hospitals NHS Foundation Trust and colleagues, in their editorial in the BMJ, gave a good explanation of how it will unfurl amid the chaos.
Over the next four weeks, thousands of medical students are likely to be allowed to begin work as junior doctors. They’ll work side by side with doctors who have retired within the last three years and are being asked to consider returning to work.
Those working in education and research are also being encouraged to return to clinical duties.
Hospital doctors may be redeployed from specialities to the areas of greatest need. Many may also be asked to practise outside their defined areas of expertise or to work longer hours.
Some groups of doctors may lack confidence in their clinical skills because they have moved into a very different clinical role, graduated early, or retired and not worked for some years. Many changes to hospital routines are to be made so medical beds and critical care capacity require substantial expansion.
This is already being enabled by cancelling elective work, re-purposing operating theatres, and taking over use of private facilities. Increased support for discharging patients home is also under way.
Routine outpatient work is being scaled back to reduce the burden on the hospital and the risk of infection to patients. And appointments are being moved to phone or video calls to avoid face to face visits. Administrative and managerial tasks must not take healthcare workers away from looking after patients.
To ensure this doesn’t happen, hospitals should consider bringing in teams of highly trained professionals, such as project managers, from outside the NHS to work alongside current managers and administrators. They would have the expertise to deliver logistics solutions to hospitals enabling them to deliver more efficient healthcare.
It’s impossible to know what the next weeks and months may bring.
In this new normal, it’s important for those in charge to be mindful of the strain every healthcare worker will be under and the mental, emotional, and physical risks involved in responding to an unprecedented crisis.
NHS staff are its most valuable asset and will react with energy and flexibility – but urgent consideration must also be given to supporting their health and wellbeing, for the benefit of us all.