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Flu: Catch it, report it, deliver care

In December we wrote about the challenges faced by A&E departments and in the process made a passing mention of the effects of winter flu on the health service. Now that potential has become a reality with “Australian flu” rapidly spreading across the country and in the process placing even further strains on health provision.

At the time of writing according to the Influenza survey operated by Public Health England, there are only a few pockets of resistance which have yet to report flu cases with many areas heading rapidly towards the red, or very high, end of reported cases. Having said that, whilst any flu is a matter for concern, according to PHE the number of cases reported to date is broadly in line with previous years.

The flu survey, which was originally launched in 2009 in response to the swine flu epidemic, is part of a pan-European initiative to monitor influenza like illnesses. These are described as sudden onset symptoms displaying:

  • at least one of Fever (chills); Malaise; Headache; Muscle pain and
  • at least one of Cough; Sore throat; Shortness of breath

More than 7,500 people across the UK already participate in the flu survey but Public Health England would like more people to take part by signing up online in order to boost research and understanding. In the meantime there are a number of measures which people can take, either on their own or in the workplace, to reduce the spread of flu. These include regularly washing hands, sanitising common work areas such as phones and keyboards and encouraging the use of tissues to catch and bin coughs and sneezes.

Nevertheless, flu is placing a strain on health resources with elective surgeries being postponed and health staff, including backroom employees, being redeployed in order to maximise care time. Although only the most serious cases should end up in hospital, inevitably pressure on hospital resources has a knock on effect right throughout the health system. For example, physiotherapists and others may have to continue to provide a level of ongoing care for those whose operations have been postponed. Similarly, with pressure on hospitals to discharge patients in order to free up bed space, additional post-operative treatments may have to be carried out in the community, adding to pressure on health resources.

All this at a time in which health professionals including physiotherapists and osteopaths together with their own support staff may be short staffed due to flu. As with any patient-facing service there is little option for people to work from home. Nevertheless, sending staff home when they feel unwell does make sense if it avoids them passing illness around the health practice. This is where a virtual assistant service may come in handy. Delegating routine tasks such as phone answering and diary handling over to an external virtual assistant service enables continuity of care whilst maximising front line resources. Similarly, switching to an online patient records service could save administrative time and enable patient details to be available at the touch of a button rather than found by searching in a filing cabinet.

However the flu season develops it pays to plan and be aware. By catching possible cases early staff can be sent home before they affect others. Online reporting will help to monitor the outbreak and provide data for future research whilst moving processes online could help to provide continuity of care. The flu season affects everyone in the health sector; it’s never too late for all of us to play our part.

Waiting for A&E care

Accident & Emergency; we can’t live without it but it appears that increasingly we are having to be patient if we have need of its services. So much so that research carried out by the BBC has revealed that in the past year three million A&E attendees had to wait in excess of four hours in order to be treated.

To put that in context, nearly twenty-four million people were treated or admitted within the four hour time band. Or to put it another way, if each A&E attendee visited once then 41% of the UK’s population stepped through the A&E doors in just one year. It’s hardly surprising therefore that the president of the Royal College of Emergency Medicine, Dr Taj Hassan, commented to the BBC that the A&E system had been “stretched to its very limits.”

Accepting that the answer probably isn’t going to come from finding the money required to set up and staff an additional twenty A&E units, health services across the UK are looking to new ways of coping with demand; adopting a variety of methods in order to reduce footfall and speed up throughput. Whilst the Department of Health has turned aside suggestions that patients should be required to receive a referral from their doctor or NHS 111 before visiting A&E, it is true that just 20% of those attending A&E have first tried to access health advice via the 111 service. Perhaps if they had sought alternative advice either from 111 or their local pharmacy they would not have resorted to A&E for help with broken false fingernails, splinters in finger, paper cuts or shaving cuts; all of which featured in the 2016 top ten list of inappropriate trips to A&E in Cambridgeshire.

It’s hardly surprising therefore that a number of health trusts have been launching awareness campaigns in a bid to educate people on A&E alternatives including one video from NHS Wakefield Clinical Commissioning Group set to the tune of the 12 days of Christmas. Inappropriate visits aside, health authorities are also working to free up beds in order to speed up treatment times. Measures here include partnering with care homes and other health care professionals in order to deliver more health care in the community.

Undoubtedly this will put additional pressure on external health care services but perhaps it will also help to ensure that treatment is available at the most appropriate point of contact. For example, another on the Cambridgeshire inappropriate visit list was an individual who had suffered months of back pain without calling on the services of a health professional. Had they been given access to a physiotherapy service they could have saved themselves months of pain and saved the A&E department from having to assess their needs.

The winter flu season is not yet upon us and that will undoubtedly bring further challenges for A&E departments as will an increase in demand for treatment of strains and sprains as a result of icy conditions. Many of these conditions can be treated equally well by health providers such as pharmacists, physiotherapists or chiropractors. We’ve already seen pharmacists take up the strain in respect of flu jabs; perhaps this is the start of a wider acceptance of alternative providers helping to deliver health care in the UK.



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