23 May 2020
Hopefully, you saw the last blog from Julia Cook about her experience of working during the pandemic. Julia is back with some more reflections, and again is focusing on the positive changes in primary care. It is interesting to hear her thoughts about the impact of isolation on cognition and frailty, and about the benefits of social prescribing.
Greetings from a semi-rural practice coping with all that Covid 19 is bringing in its wake. We are like many practices guided by the GMC guidance and are seeing some patients (wearing full PPE) and trying to clean down after each consultation. However primary care has changed, and, in some ways, this has been incredibly positive. The digital changes that were grumbling away in the background have taken centre stage. I mentioned in my last blog that we were using accuRX as a portal to conduct remote consultations and this has been so useful for asthma and COPD.
In recent weeks I have found that it is also helpful to connect with some of our patients who are shielding. In the coming months I am sure that we are going to find that these patients have struggled with isolating. I wonder how much impact it will have on their cognition and frailty and this may be an area that will need consideration. Many that I have connected with have felt extremely lonely, a proportion are elderly and already live alone, they have friends who have died and shielding for some of them has been extremely hard. I can tell you how delighted one patient was to hear from me. It made me want to cry for her; it’s such a small thing to connect with someone but could serve as a lifeline.
I have also noticed how the social prescribing service has been of enormous benefit to this same cohort of patients. We use our service by emailing through nhs.net secure emails and sending some basic information about the patient who would like some support. In the past I think I have felt (possibly like many) a bit sceptical of their benefit but I was asked to add some feedback onto a patient’s notes only yesterday and it honestly made my heart sing. The patient is housebound and shielding but needs carers and was extremely lonely. The prescriber has arranged a befriending service, and this has had a huge benefit. Its lovely to think that again a small thing has made such a positive difference to someone.
I also want to mention e-consults. This is new to us and as yet we have not had much feedback. This is now up and running on the website and enables patients to consider how to take responsibility for their own health. Again, only time will tell how effective and useful this tool is going to be. Further audit and research will be needed to fully understand its impact and whether it needs tweaking at all. However, it seems a positive step towards encouraging self-help and more self-reliance so that primary care can give the best care to those who need it most.
There is a great website from GSK which I have just started using and it’s proving invaluable: https://offyourchest.gsk.com/?cc=rx%3Amai%3Agb%3A412# (‘one-stop shop for educational respiratory content’)
Finally, I was sad to hear that the practice nursing forum is closing as no one is taking it on. I expect it is a huge undertaking, but I have found it useful as a resource to ask questions and get support. This can be a lonely and isolating role especially in smaller practices where you might be the only nurse (me)! I look forward to any input from anyone out there who knows of forums or support groups locally. I am in Huddersfield and ‘digitally challenged’.
That’s all folks……. Take care everyone and stay safe and well.