Alarming drop of enquiries into non-covid health issues

There are countless anomalies taking place in society due to covid-19, but one of the more dangerous aspects that has changed in our everyday lives is the reduction in people contacting their doctor with enquiries about non-covid health issues.

-Sunday Times maps out key events in run-up to lockdown. Timeline here
Photos and footage of an empty Aberdeen as lockdown is imposed

Not presenting

One of the consequences of social distancing we are seeing is people with other illnesses are not presenting themselves to hospitals because they are assuming covid takes priority and nothing else is happening..”

Professor Kevin Cooper, consultant gynaecologist, Aberdeen Royal Infirmary

Professor Kevin Cooper, consultant gynaecologist at Aberdeen Royal Infirmary raised the point about reduced patient referrals whilst discussing how Aberdeen’s Foresterhill medical campus is coping with the covid outbreak.

Professor Cooper said; “one of the consequences of social distancing we are seeing is people with other illnesses are not presenting themselves to hospitals because they are assuming covid takes priority and nothing else is happening.

“From a gynaecology point of view emergency admission rates have dropped significantly since covid has gone on.”

Dr Alistair Bell, a GP who graduated from Dundee University and now works in Preston, says his practice has also seen a drop in enquiries.

“Yes, very much so. People are not presenting when they should which is a problem. Since the crisis I have done hardly any referrals where normally I would be referring.”

Dr Fergus Cooper, an ears, nose and throat speciality trainee at Raigmore Hospital Inverness, says he has heard of “adverse things” happening in the community that would normally be dealt with by the health service.

“I’m in WhatsApp groups with other health care professionals and there have been a lot of reports of adverse things happening out there in the community that normally wouldn’t be happening.”

Professor Cooper refutes the assumption covid cases automatically take priority.

“I want to make it clear that it is not the case that covid automatically takes priority. Anyone with any illness should still be able to receive treatment. If you are concerned or unsure of anything you should still contact the NHS.”

Professor Cooper, based at Aberdeen Royal Infirmary, says the gynaecology department has seen a drop in enquiries

Why are people suddenly deciding not to see their doctor?

It’s not good is it? That it’s a myth that we are snowed under and we cannot see you if you have maybe a bleeding artery which can be the first sign of cancer.

Dr Alistair Bell, general practioner, Worden Medical Centre

As a GP, Dr Bell is in a medical post which receives a high number of enquiries. He feels the emphasis on staying at home, whilst vital in combating the spread of covid, has had side-affects on other treatments.

“I think there is so much in the media about GPs being overly busy but actually we are not that busy at the moment. We are preparing for the possibility of getting busy but we are not.

“It’s not good is it? That it’s a myth that we are snowed under and we cannot see you if you have maybe a bleeding artery which can be the first sign of cancer. But people think I do not want to bother the GP. People think we’re shut but we’re not.”

Dr Bell now works in England where rates of admissions has dropped in the month of March

Could we further overload an already stretched NHS?

There is an issue that advising people to reach out to their doctors in these unprecedented times could create a maelstrom of work for an already stretched health service. But Dr Bell explains that practices find a way to work round things getting busy:

“We do get a lot less non-emergency enquiries right now which is a great thing, but it’s our job to filter through these enquiries to help those most in need.

“I think you should say you have got to see us because it is your GP’s job to decide whether you are ill or not. And if we did get really busy we’d just prioritise and find ways of working round it. People should still be contacting their GP under the same threshold they had before covid.”

Contact your GP over the phone and receive consultations from home

So how does it work if you want to speak to your GP about non-covid related issues? Whilst Dr Bell now works in England he still describes the process that takes place to contact your GP.

Dr Bell explains: “If you want to see a GP, phone us. Our phone lines are open as normal. What will happen is you’ll speak to a receptionist who will say we have no appointments but put you on a call list and a GP will phone you back in around an hour and try sort the issue over the phone. If we cannot do that we will arrange for you to come to the practice.”

Cults GP practice open as usual

Is non-presenting a worrying trend?

Dr Bell’s primary concern about the lack of patient presenting is with early cancer diagnosis.

Dr Bell says; “for cancer referrals, yes.

“The thing with cancer is you’re supposed to refer anyone with a 3 per cent or more chance of potentially having cancer. Basically they want you to do lots of referrals in order to catch cancers early. Cancers are still happening now so undoubtedly, as an outcome of this, people are going to get diagnosed later.”

Professor Cooper, a health care professional for over thirty years, raises the point that a reduction in enquiries isn’t necessarily a completely bad thing.

“People who previously would go directly to hospital with things that were not real emergencies are just not presenting any more. If that attitude can carry on then there may be a positive benefit for the NHS.

“I think once we are through this there will be a change in the way the public use and access the NHS, particularly emergency care. I hope there will be a rise in awareness about how fragile the NHS really is.”

Collateral damage

Sadly there are so many facets of society taking a hit at the moment, but Professor Cooper believes this area of social peculiarity could be one of the more serious indirect consequences of the covid outbreak.

“It could be one of the collateral affects of covid-19 that other people are going to come to harm for not seeking attention for things they would normally see a doctor about.”

For guidance on any health issues visit the NHS website (Scotland link)

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