Patients ‘afraid to seek healthcare’
But NHS boss emphasises that services are open to anyone in need
THE NHS in Wales remains open despite concerns raised by doctors yesterday that patients are “afraid” to see their GP or visit hospital during the coronavirus crisis.
Dr Andrew Goodall, chief executive of NHS Wales, said the health service had not been overwhelmed by the
Covid-19 pandemic and was still there for people who needed emergency care.
The Welsh Government revealed the number of people attending Welsh emergency departments had fallen by up to 50% since the pandemic’s start.
Dr Goodall said emergency admissions to hospitals had fallen by a third, while there were 10% fewer people being taken to hospital by ambulance and “activity” at GP surgeries had dropped by up to 25%.
“We need to recognise this is going to be a cautious and progressive approach,” he said. “Urgent and critical care continues whether there is a virus around us or not.
“We are moving to a phase where we
have to balance the responsibilities of responding to the virus, alongside the responsibility to make sure people who need care and treatment can access it.
“I don’t think it is a switch we can just press; I think we are going to need to review how we roll this out.”
A GP had told the Senedd Health Committee earlier yesterday that patients did not want to be a burden on the health service and were staying away.
Dr Robert Morgan, of the Royal College of General Practitioners Wales, who practises in Bridgend, said: “They are afraid of coming into the general practice, they are certainly afraid of going into hospital.”
At the daily Welsh Government briefing, Dr Goodall said that in the early stages of the pandemic staying away from hospital did help the NHS prepare for the peak.
“We now need to look after those areas and I remain concerned that our A&E attendances, our emergency admissions and our referrals are lower than we would expect at the moment,” he said.
“We are going to have to recognise that working through this virus we are going to have to catch up on a backlog of patients that still need to be treated.”
First Minister Mark Drakeford is expected to publish a coronavirus exit plan for Wales today.
Dr Goodall said he was also sure Welsh ministers would “make some steps backwards” and reverse lockdown measures that had been relaxed if this was needed.
“It is quite clear we are through that initial peak and I would hope that we can continue to deploy mitigating actions if there was to be either a second or a third peak in the future,” he added.
Dr Goodall said he was worried about the fall in the number of cancer referrals but thought they were beginning to rise.
“The number of people added to the waiting-list is twice the level just three weeks ago, but in overall terms the number remains lower than in previous years,” he said.
Meanwhile, Public Health Wales said a further 10 people who had tested positive for Covid-19 had died, bringing the total number of confirmed deaths in Wales to 1,164.
It also announced that the number of people testing positive for the virus has now reached 11,834 following an increase of 128.
In addition, the number of overall
tests carried out since the outbreak began has increased to 53,163 after 1,300 more were conducted on Wednesday.
Dr Goodall confirmed the number of coronavirus cases being treated by the Welsh NHS was continuing to fall, and said there was a “stabilisation and reduction” of new confirmed cases.
But he warned there remained “real potential” for a rise in community transmission rates that could lead to a damaging second peak as lockdown measures are eased.
Dr Goodall highlighted that: All Welsh health boards are currently operating at green, or level one, status;
Just one in nine tests have been positive over recent days;
Some 581 people with confirmed coronavirus are currently in hospital along with a further 298 suspected cases. This was lower than last week and the lowest number of Covid19-related hospital patients since the start of April;
Some 385 critical care beds are available including in surge capacity. Around 67% are empty and available for use;
Some 66 people are being treated in critical care capacity for Covid-19 across Wales, lower than last week and more than 60% lower than the peak in April, and;
More than 3,100 coronavirus patients have been discharged from hospital so far.However Dr Goodall said while around 39% (2,700) of acute hospital beds are empty this was a drop on last week’s figure due to the fact normal NHS activity was starting to pick up again.
And even though the number of Covid-19-related hospital admissions was reducing he
warned it was still the equivalent of three whole hospitals full of patients.
Meanwhile, Dr Goodall said the national video consultation service has begun supporting remote care home consultations.
He said the number of prescriptions dispensed at the end of March and start of April increased by as much as 50% on the same period the year before.
As a result, he urged people to order prescriptions seven days in advance.
He said pharmacies have been a “vital source of support” for people’s health since the outbreak and dispensed seven million prescriptions in March, an increase by as much as 50% on the same period last year.
“Community pharmacy services have been maintained throughout the pandemic, often in the face of significantly increased demand,” he said.
“We have been working with military planners, private and public organisations – including the British Red Cross – to draw upon the many people
across Wales who have volunteered their time.
“And we are also working with the Royal Mail to allow community pharmacies to post prescriptions where there is no other alternative available.”
Dr Morgan said: “I think there is a cohort of patients who aren’t coming for their own reasons.
“There is a slight positive to all of this that patients might be managing minor illnesses with self-care without resorting to a pharmacy or a GP. Those behaviours might be something that people can take forward.”
Dr Morgan warned of the danger of telling patients that suddenly doctors’ surgeries were open.
He said: “Working with Government, we need to give the right messages to patients, and saying ‘as from tomorrow general practice is open’ will create more harm to both the wellbeing of GPs and the structure we can currently offer, and patients.
“We will be overwhelmed and we are busy enough at the
moment. I think we need to look at a progressive opening, with the same messages coming from Government as from health boards and general practices.
“And trying to take account of local variations in current infection rates and what different practices can offer at different times.”
Dr Peter Saul, joint chairman of the Royal College of General Practitioners Wales, said England’s rules on the lockdown were “confusing”.
“My practice is on the Welsh border and a lot of my patients will work in England.
“I think confusion is the only word I can use in that people don’t know what they should be doing,” he told the committee.
“I think the English advice is confusing enough on its own but combined with... ‘I’m going to work in Wales and does that mean I have to obey the Welsh rules?’ or ‘I’m picking up the children from England, can I still do that?’
“It’s confusing to have and I can’t say any more than that.”