NHS Heroes

At 5pm yesterday, 5^th July 2020, my family stood in our front garden alongside the British population to applaud the 72 ^nd birthday of the NHS and social care system.During the Covid-19 crisis the public has become even more appreciative of all nurses, doctors and other health service workers who have worked in the front-line, to care for over 100,000 patients with the disease during the last few months.

Sir Simon Stevens, Chief Executive of NHS England has publicly stated that 2020 has been the most challenging year in NHS history.To demonstrate our gratitude, the British public stood united to clap, cheer and bang pots and pans every Thursday at 8pm for 10 weeks, thanks to the initiative started by Annemarie Plas on 26 ^th March. It is abundantly clear that the love and respect that we all have for our NHS heroes has grown significantly during this extremely tough period and let’s hope their dedication and commitment is never forgotten or taken for granted in future.Thank you, NHS.

Lymphoedema Treatment

During these unprecedented times, a large number of nurses and NHS staff were redeployed from their usual roles, to join the front-line in caring for patients with Covid-19.In addition, non-essential services were closed during lockdown due to the high risk of passing the disease onto others, especially the vulnerable. Personal Protective Equipment was in short supply and was issued in order of priority to those caring for Covid-19 patients.

As a result, there was almost a blanket closure of lymphoedema practices as many NHS therapists were called onto the front-line or trained in preparation for being called.I understand that is was the case at St George’s Hospital, where for almost 10 years, I have been cared for by a dedicated team of therapists.As you may know, the layout of the department, especially in the waiting area, would make social distancing very challenging.

With the St George’s Lymphoedema Service closed, it became even more important for lymphoedema patients like me, to help themselves with the self-management of their condition.

Due to the current closure, it seems very likely that there would be an enormous backlog of patients requiring help, treatment and measuring for new compression garments.My next appointment for new garments was due on 3rd July and I had wondered how and if this would even go ahead.My question was answered swiftly when I sent an email in June to my therapist..They had a plan in place and he explained what would happen, and it did so, perfectly.

Virtual Appointments

On 29^th June, I received a text informing me that my consultation appointment would take place as a telephone call at 9.30am on 1 ^st July.

We have all received texts that seem suspicious, but this was from “NHS-NoReply” and stated “Dear Matthew Hazledine, your appointment at Clinic B Lanesborough Wing St Georges Hospital Tooting on 1/7/2020 at 9.30am will now take place as a telephone call by one of our clinicians.Please note that they may not call you on the same day or time as your original appointment.The number they are calling from may be withheld or unknown. Please do not attend the hospital, unless you are specifically instructed to do so.”

I then received a second text confirming another telephone call on the same day at 10.30am from another clinician..

At 9.30am prompt I was called by my therapist, who is always an absolute pleasure to talk with.He has been working from home since lockdown and was keen to get back to St George’s as soon as possible.During the call I was asked about my health, how my leg was behaving, and whether there had been any increase or decrease in size. We also spoke about the results of previous treatments I had experienced and concluded that at this point in time, all is well with me apart from some rebound in the calf.Not content with anything other than perfection, my therapist proposed that next year I should have a lymphoscintigraphy of my deep lymph system in the calf, to see if there was any further information that could help to improve my condition.It gave me huge confidence that even during these difficult times, he was still trying to explore ways to enhance my quality of life, which is greatly appreciated.The call lasted 20 minutes and did not feel at all rushed. He said a letter would follow shortly confirming the points discussed.This arrived two days later on 3 ^rd July, which was very efficient indeed.

Measuring from a distance

At 10.30am I was called by another therapist at the clinic, to discuss my current situation with health and garments.He said that all therapists are working remotely and although face to face is ideal, this was the best solution in the current climate with Covid-19, as it is very difficult to social distance.The St George’s lymphoedema team dealt with an incredible 16,000 appointments last year, which demonstrates the importance of keeping in contact with their patients by phone, so at least they can keep abreast of any complications and prescribe new compression garments to try and control the limb size.

I was asked if I had seen any change in my leg size or shape, which I hadn’t.I told him that I had a tape measure, if that helped him in anyway for me to check a measurement or two.This proved very useful, as he gave me instructions on how and where to measure, giving him two key sizes to compare to his previous report.As I had thought, there wasn’t any great change in size and he could therefore prescribe new compression garments based on the same measurements taken in January.

My therapist also arranged some toe caps for me, which I received from Haddenham 48 hours later, which was extremely efficient.

On 3^rd July I received two texts each asking me to provide feedback following my ‘visit’ to St George’s Hospital.I was asked to click on a link to complete an anonymous survey, which I did and I highly recommend that you do if asked.One of the questions asks if you prefer face to face or telephone appointments and why.I believe the answer to this is important if you wish to see your consultant and therapists in person in the future.My answer was “Lymphoedema treatment requires face to face meetings to properly assess the condition and measure accurately for compression garments.”

The Future

It is totally understandable why face to face appointments have been suspended for the reasons I have mentioned.In addition to NHS staff, the health and safety of the patient must also be paramount, as it is likely that some lymphoedema patients may have other underlying health problems to consider like diabetes for example, which could mean a higher risk of death if Covid-19 is contracted.

However, as lockdown rules ease and the Government state that there is more than enough PPE for a second wave of Covid-19, I urge the NHS to resume normal lymphoedema services as soon as practicable.If we can go to the pub and get a haircut, then we should be able to see our consultants and therapists in person. That is the only way to accurately measure for compression garments and to ensure the condition continues to be managed properly by medical specialists.

As a result of the Covid-19 pandemic, we have all found new love and respect for the NHS and we have no doubt missed seeing our lymphoedema therapists and consultants. I am sure I speak for many when I say I appreciate the ongoing care they provide to improve our wellbeing and manage our lifelong condition.Thank you.

About the author

Matt got lymphoedema in 2011 at the age of 40, at the time of a young family and starting a new business. In 2016, he joined The Lymphoedema Support Network as a Trustee and over the years has raised a significant amount of money by running several fundraising events and obtaining a large corporate donation.His passion for helping people with lymphoedema continues, and Matt is now working as a consultant for Haddenham Healthcare since November 2019, to provide guidance from a patient’s perspective.