Chapter 10: Strengthen the role and impact of ill-health prevention
Impact on health and social care services
Health services were reprioritised to manage the increased demand from Covid-19-related illness, and to allow for new social distancing restrictions, which meant fewer patients could be treated. While this was a necessary precaution, in most sectors this has led to reduced treatment of existing conditions and a backlog of unmet care needs.
In addition to managing our own demand, primary care is also dealing with the consequences of waiting list delays for patients who need to be treated in secondary care. They may need an operation. In primary care, we can only manage the symptoms they have as best we can until they are seen in secondary care and patients are getting really frustrated, it's having an impact on their mental health. It is really affecting their wellbeing and everyday living.
We understand that some patients are having a really difficult time and it is more difficult to access services at times. This can make them frustrated and unfortunately some take it out on practice staff. We've had to remove a patient from our list who was regularly aggressive and abusive as it was affecting staff health. Recruiting extra staff is really difficult at the moment - locum GPs, locum nursing staff and receptionists. We're finding it difficult to get locum cover for annual leave, even paternity leave and that's affecting staff morale.
Teresa Graham, Business Partner and Practice Manager, Second Street Surgery, Oxford Terrace and Rawling Road Medical Group and CBC Health GP Federation.
This pandemic has been the biggest challenge the NHS has ever faced. I'm so proud of the speed and the way we have risen to those challenges.
We have transformed the whole organisation to care for patients with Covid-19. Our staff have worked tirelessly and have gone above and beyond.
Despite the ongoing challenges of the pandemic, we have continued to provide maternity services, vital cancer treatments and all the emergency services you would expect.
We also launched our Covid vaccination hub which delivered over 10,000 vaccines involving staff from across the hospital's teams, alongside practice staff, volunteers and local partners including Gateshead Council and Community Based Care, and GPs.
We continue to encourage the public to get their Covid and flu vaccinations as well as continuing to follow guidance to keep themselves and their loved ones safe.
Andrew Beeby, Medical Director, Gateshead Health NHS Foundation Trust
Access to dental care has worsened significantly because of the pandemic. In the latter half of 2019 (prior to the pandemic), data shows that 33% of Gateshead residents accessed NHS primary care dental services. Dental practices subsequently closed in March 2020 for all but the most urgent cases, reopening in June 2020 but with much restricted capacity due to increased cross-infection requirements. This led to only 9% of Gateshead residents accessing care in the latter half of 2020. This figure increased to 18% in the first half of 2021, reflecting the fact that capacity in dental services is improving, but has not yet returned to pre-pandemic levels.
Lorenzo Iafrate, Dental Core Trainee 3 in Dental Public Health and Dr Rhiannon O'Connor, Specialty Trainee in Dental Public Health
Adult Social Care is an essential service to help people with disabilities and/or additional needs live a thriving life. In the first year of the pandemic, Adult Social Care in Gateshead has seen demand for its services often change in response to national lockdowns, with some areas seeing a marked increase in activity.
Between the end of March 2020 and the end of March 2021:
- An additional 1598 contacts were made to Adult Social Care (a rise of 18%)
- To ensure people were receiving the right type of care and support 747 more reviews were carried out (a rise of 16%)
- Contacts from the QE Hospital rose dramatically across this period with 1349 more received (a rise of 100%), much of it linked to the increased demand on the NHS to move people out of hospital and into the community
- More adults needed to be assessed as a result of safeguarding concerns with 130 more safeguarding enquiries being undertaken (a rise of 36.7%) Neglect and acts of omission being the single largest reason for the concerns
- More adults were assessed for care and support needs, 236 more assessments were commenced (a rise of 7.3%) and 230 more completed (a rise of 7%)
The figures above reflect activity to the end of March 2021. Since then, the demand for support from Adult Social Care has continued to increase as the pandemic has continued with on average 20% more contacts coming into Adult Social Care per month compared to the same period over the previous year (a total increase of nearly 900 contacts).
The Adult Social Care system in Gateshead is under significant and sustained pressure, as a result of a range of factors relating both to the pandemic and post pandemic changes. As with many other sectors, the social care workforce is markedly struggling post pandemic, with colleagues experiencing fatigue, people leaving to join other sectors, and new worker recruitment being very challenging. The impact of these pressures is felt directly by our most vulnerable people in Gateshead, at a time when the whole health and care sector is experiencing increased demand with reduced capacity.
Steph Downey, Service Director, Adult Social Care, Gateshead Council