17 June 2020
In the penultimate blog in our series sharing the experiences of our members during the pandemic, we speak to Prof Ian Giles, Professor of Rheumatology at University College London Hospital (UCLH). Here, he talks about recovery planning and what he’s learnt from the pandemic.
“During the initial stages of the pandemic, I was involved in setting up a COVID ward, as well as the organisational planning of our response to the pandemic at UCLH, which has been very impressive and effective at creating new teams and patterns of working.
“It’s been a very challenging time. We’ve had to get our heads around alterations to rheumatology services and dealing with our patients differently; whilst many staff have been redeployed to support the incoming wave of COVID patients. Despite these challenges however, the camaraderie and team working has been incredible.
“In rheumatology we made a full-scale switch from face-to-face consultations to telephone calls over the course of a week. Initially we hoped to be able to retain seeing new patients because a physical examination is so important to get to grips with a new inflammatory arthritis or multi-system disease, but it became clear quite quickly that it was best to avoid bringing patients to hospitals during the anticipated peak of the pandemic in London.
“We had to accept the limitations that come with converting everyone from face-to-face to telephone. Thankfully, the introduction of a new electronic health record service at UCLH one year ago made it possible to conduct telephone clinics safely and effectively from home.
“We’ve been balancing ward work with COVID patients and retaining as much rheumatology activity as possible that included covering clinics at short notice because of staff sickness. Therefore, we’ve had to thin the patient list because a large portion of the workforce was being pulled in different directions due to redeployment or being lost to sickness.
“Now we’re trying to manage the return of services. We have our own recovery plan that is being coordinated with other hospitals in the North Central London sector. This arrangement will ensure there is an agreement about the way services will prioritise patients so there’s equality across the sector, so that no patients are disadvantaged.
“We’re developing a triage system to ensure patients with the most serious conditions are seen most quickly. Another factor to consider in our planning is which patients need face-to-face consultations since a physical exam will remain an important part of managing various inflammatory rheumatic conditions.
“It’s been a rapid learning process and there will be things that we retain going forward. Before COVID there was a request to do more telephone consultations and having made a complete shift to telephone consults, that will be something we would like to retain for some patients, but it is not appropriate for every consultation.
“We know that there will be patients who won’t want to come into the hospital, plus we can’t have the same number of patients sitting in our waiting rooms with new social distancing rules. Space is an issue in London, so we’re going to need to work out room availability with more space to socially distance patients. Telephone consultations is one way we can help address that issue.”
Thank you to everyone who has contributed to our series of blogs about how all our professional lives have changed during the pandemic. We are proud of all our members who work so hard to care for their patients during this challenging time.