Derbyshire's health system has made a plea to local people to think more carefully than ever before about their service choices, as pressure mounts. Staff in GP practices, ambulance crews, 111 and 999 call handlers, emergency department staff and many others are reporting significant challenges, with a wide range of factors potentially contributing to the rise in demand.
The reasons for the surge in NHS activity are unclear but likely to be the result of several competing factors. Patients have returned to pre-pandemic use of services, with many walk-ins at Emergency Departments and Urgent Treatment Centres being seen for conditions that could be treated in a pharmacy or even at home. Numbers of calls to 999 and 111 call centres have broken records in recent days, and GP surgeries are under significant pressure, with large increases in requests for appointments compared to the same time before the pandemic.
Many health service staff have also needed to self-isolate, having been 'pinged' by the NHS Covid-19 app, and this has put additional pressure on already-stretched services. At the same time, pupils are being sent home from school as year groups and class bubbles burst, meaning staff needed emergency time off to cover childcare. What is not yet a factor in the pressure is Covid-19 itself, with the vaccination working well in keeping more people healthy who have tested positive for the virus and hospital admissions relatively low, although even these are beginning to rise.
Magnus Harrison, Executive Medical Director at University Hospitals of Derby and Burton, said: "Our NHS and social care staff are working tirelessly to help patients and people who need them most. Please help us to help you. The entire health community has never been under so much pressure at the same time before, and this means we are not able to redirect some patients to other services as we would usually. We need people to help by using services wisely – for anything that isn’t immediately life threatening or serious, see your local pharmacy or visit NHS111 online first to seek advice."
Ben Pearson, Executive Medical Director at Derbyshire Community Health Services added:
"Services are reaching the limits of their capacity and we need everyone to think really carefully about which service they need to use. The most convenient service could be closer than people think. For example, it is not true that GP practices are closed – they are open and busier than ever before, seeing more patients face to face than they are treating over the phone. So please don’t make an assumption and try the emergency department first, unless your condition is serious or life-threatening."
To prevent further pressure, there is also a reminder that the COVID-19 pandemic is still here and a plea for everyone to continue to act responsibly and with caution. The Covid-19 vaccination is proven to work, and everyone who hasn't yet taken up the offer of a vaccine is being asked to help the NHS to help you, by getting vaccinated if not already done so and are eligible.
It is acknowledged that the health service can be a difficult place to navigate with a wide range of services, particular following an accident or injury, or when feeling ill. To support patients with their decisions, a series of 'rules of thumb' have been compiled which aim to give a guide towards the most appropriate service. These include:
- If you are planning to go to school, college, work or socialising after visiting an Emergency Department, then you likely didn’t need to be in the Emergency Department in the first place: self-care, pharmacy or an Urgent Treatment Centre is the right place to start.
- If you're prepared to wait for 12 hours in an Emergency Department and are not unwell, then you likely don’t need to be in an Emergency Department in the first place: getting an appointment with an Urgent Treatment Centre via NHS 111, or seeing your pharmacist is the right place to start.
- If you can buy the medication for your condition from a supermarket then you don’t generally need to visit your GP for it: check symptoms via NHS 111 online.
- If you're feeling well enough to drive yourself safely to an Emergency Department then it's certainly possible that you don’t need to be there in the first place. An Urgent Treatment Centre or pharmacy to check you over first could be the better place to start.
- Do you have to drive past a pharmacy or Urgent Treatment Centre to get to an Emergency Department? You may save yourself a significant amount of time if you call into the UTC or pharmacy on your way. Average waits at a UTC are currently 1-2 hours; at an ED this is around 6-7 hours; at a pharmacy it is around 10 minutes.
The pressure seen at present is higher that would usually be seen during a busy winter period, with no real sign of relief. The message to everyone is clear – help us to help you and consider your choices more carefully than ever.