I am an RN in a community health program looking to inquire about some public health concerns for informational purposes only. I am not looking for private information or trying to advertising anything. I am just trying to understand barriers to healthcare specifically that occurred since covid hit. Did anyone struggle to access health care, appointments, treatments during the pandemic preventing the appropriate management of any medical conditions or mental health illnesses? What did you do for support during these challenging times? Did anyone find telemedicine appointments helpful? Have these community forums been supportive during these challenging times?
I appreciate any feedback or insight in advance.
Thank you.
Sam
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RNtoBSNstudent
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Hi. I was receiving EMDR therapy for PTSD on the NHS when the first lockdown happened in the UK. Appointments were suspended and I had weekly telephone calls with the psychologist that was treating me. It was very confusing for weeks, as my psychologist couldn't tell me what would happen despite her being the Lead Psychologist at the centre, because she didn't know what would unfold.At one point I was told that the managers were considering discharging everyone until appointments could resume. That would have meant no phone support. I didn't blame my psychologist, but I told her that if that happened I would put in a formal complaint. I reminded her that I had previously had a period where I had been suicidal and I did not intend that to happen again.
There was also talk of reducing the calls from one hour a week to either half an hour each week or one hour every two weeks. None of this had been decided upon when I was told that face to face appointments were to resume and that I would be the very first person to restart my treatment.
I had a gap of over two months in my treatment and it was appallingly hard to endure. With EMDR, the reprocessing of traumatic memories carries on between sessions, so it was especially hard every day.
I was offered Zoom meetings with my psychologist, but it wasn't suitable for two reasons; I have an acquired brain injury and get extremely fatigued by using technology like that, plus my psychologist agreed that I needed to be in a safe space with her if we were going to go into difficult stuff.
This sounds extremely frustrating and downright exhausting. I am glad to hear that your psychologist kept in touch via weekly phone calls, but I am sure this did not feel like enough at the time. Why were they considering canceling telephone support? Have you ever had telemedicine or facetime appointments- were they useful to you? It sounds like the teleconference would not be appropriate for your specific PTSD treatments but for supportive purposes, do you feel touching base and seeing your doctor on video conference would have been helpful? What else did you do during this difficult time for support- were the community support groups helpful?
I know some of my family members had similar concerns about switching to telephone therapy appointments; it is definitely not the same connection, and I am sure it was a difficult transition for all. Amazingly, technology had offered us some means of communication with each other when the entire world was seemed to be placed on pause due to covid.
Hi Sam. I believe that the proposal to stop telephone support was so that the managers could deploy people to do other tasks. I have never had telemedicine or facetime appointments, partly because I couldn't manage it with my brain injury but also I would refuse that type of appointment. I feel those appointments to be impersonal and not conducive to connecting people properly. I have no desire to video conference with my doctor. Having worked in mental health as well as being a patient, I believe the connection between the participants to be the most important factor in a successful appointment.
I am concerned that the managerial side of things will try to use the pandemic to push remote appointments to become 'normal,' because it would be more convenient for them and could cut costs.
I normally attend a brain injury support group each week, but that was suspended for two quite lengthy periods last year. I did have weekly telephone calls from a staff member, but I found it very tough as I don't have any other social contact at all. I couldn't find any other support so I would have two telephone calls a week but no contact with anyone else. I did find getting involved with Healthunlocked made a difference, but I really missed actually seeing other people. Before my brain injury I had a full time job which I loved which I still miss.
Sorry if I seem negative about these innovations, but I am just giving my honest opinion.
All routine checks were put on hold, diabetes, dental, respiratory, the only check I had last year was blood glucose levels (blood test) and respiratory and diabetes check over the phone. Certainly not full precautionary care by any means and definitely should not replace Face to Face long term. The other side of that because of covid apprehensive about getting any checks done anyway because of the risk, even with all precautions. Sheilding for over a year CEV. But thankfully I've not had to get concerned about lung infection and taking steroids which automatically put my blood sugar levels up.
Having a neighbour with anti social behaviour has not helped and there has been no support from the police or local authorities with that either, that naturally impacts on mental health long term.
I had no change in medical healthcare. But I did for my mental health care. I was told by my therapist that therapy sessions had been limited to 10 sessions, no matter what. The reason was so many people needed help during this time. So quantity, not quality is the reason. They were by telephone and that was fine. I’m looking for another therapist, but no luck so far. I loved my therapist.
I was in isolation, I have talked to many doctors and specialists, but like Marnie, I have brain issues, and was not really able to connect via phone , I lost a lot of confidence, and really deeply affected me mentally. I felt I was not getting over my particular medical or mental shortcomings, somehow losing my case to the particular jury for my defence. Technology in this respect scares the 'crap' out of me, I know my particular health 'shortcomings' are rare, indeed a number of my specialists have called me "a one off!" Trying to discuss over the phone my pains and woes does not fill me with any confidence, quite regularly I am mentioning symptoms which are not in their particular field. Listening to "due to the pandemic situation this ....." giving impossible hours of contact, quite plausible reasons for doing so. A double epileptic seizure in 2018 means since then I have lost any faith I had watching TV in recent years, trouble with my hearing, eyesight, and balance have made the glow and appeal of the box in the corner of the room dimmer quite comprehensively! The isolation of the pandemic has increased my woes mentally in the last year. I have been lined up since December 2020 for a skull MRI repeated calls, always leads to the same reply via my GP and epilepsy neurologist "you have been put down for a skull MRI you're name is definitely on the list!" Having been diagnosed with diabetes 2 since the start of isolation in March 2020 does not help matters?
Technology was my biggest challenge - I need a teenager to show me how to do it! Telemed was used by most of my docs, and the others cancelled until late April/May. One of my doctors consistently missed the monthly appointment and would call for telemed whenever it was convenient for her - most often around 7 pm. My primary did not do telemed, instead handling things through email - it is not good. One doctor decided tohandle the stress by retiring - finding a new doctor hasn't happened yet even though I need it.
Felt angry that could not be seen by a GP at my practice-(did manage one face to face for gynaecology appt)but have other problems (skin mainly) which need face to face support.I had to send photos of my skin condition several times -am still not better!
Isn't it continuity of care what GP's should provide ? I am not happy!!
Re GP services : during the first lockdown I was unable to have my B12 injections so I was given a course of tablets which weren't as strong and effective. My asthma and medication reviews were done over the phone last year , and I had to do my blood pressure monitoring myself and send the results in. I didn't need any other appointments. However, on Friday last week, my husband phoned his GP surgery and was told they were not doing face to face. He explained his symptoms and requested a telephone appointment but was told he had to submit details online! I had both of my hospital rheumatology appointments face to face last year and while I was shielding , was offered the chance to have someone come to the house to do my blood tests.
Up to July last year the dentist was doing emergency appointments only- no hygienist ones. From July, all routine appointments and treatments were offered, including a limited hygienist service.
I can't recall when I last seen my GP, maybe two years ago. It's 11 months since I had an operation for the removal of a growth in my bowel (cancer). Last month I had a follow up check appointment. Result, it was cancer. As I already underwent a Total Gastrectomy ten years and eight months ago I did not wish to have a scan and was told that I've survived so long was because I keep fit. Much as I would like to see my GP to have a check up to include Blood pressure, blood, skin problems and review of medications: B12 every twelve weeks, daily thyroid medication and Laxido. None of these have been reviewed in years. My second Covid-19 was due on the 10th of this month. I received a call some days before it was due to say that I could have it. When I explained that I required a little more time to arrange transport to attend, as I'm still not fit enough to attend alone. I'm still not fully recovered from a fractured hip and required a day or so to make arrangements. I've heard nothing since. When ever I have tried to phone my GP or other medical department, All I get is an answering machine: "You are number 20th etc on the waiting list" so I put the phone down as I find it so stressful. Most of my teeth are either gone or falling out Like always I'll just keep on living my way to the best of my ability. Guess I can't really complain as I'm now less than six months to age 90. For me living alone is no big deal after almost 14 years as a widower.
No diabetic reviews or blood screening - were 6 monthly. No dental checks - only an emergency appointment after a tooth broke - would it have done if normal checks done?? Annual CLL hospital appointment with CLL specialist went ahead under revised conditions only delayed by a couple of weeks.
I've felt very well supported by my healthcare providers who are the National Health Service and my GP practice. With the help of 111 services I was over-provided for on one occasion. I had a little difficulty with one health problem in obtaining secondary service, X-rays were not available for primary care patients), but my GP practice stepped in and agreed to treatment without the usual X-ray check, and I was fine. Not first hand feedback, but my sister who is the carer for her husband with dementia. She has had no hands-on support and has had to find her own way almost entirely throughout the whole of the pandemic.
I have not had a face-to-face consultation with my GP since before Covid although he has phoned me a few times either to give me results of tests or just to see how I was. On the last call he told me he was leaving and we discussed who I might be assigned to in future but I have not had this confirmed as yet. I also see a different GP from the local Community Cardiac Team and I have seen him in person a couple of times plus several phone calls. I also had a telephone call from the Cardiac Nurse attached to the team. I have had several blood tests including those for my annual review. One of these had to be repeated and led to me having an ultrasound scan at my local hospital where are I have also been twice for pacemaker checks. I have also been to Podiatry a few times because of chilblains due to poor circulation. I feel that I have had excellent care throughout the pandemic. I have not had any contact with my Cardiologist but am not sure whether I would have done anyway.
I haven't seen my oncologist since December 2019. My 3 monthly appointments are now conducted over the phone and are much briefer than a face to face appointment. Access to a GP is extremely difficult. The e-consult document is tedious and it's difficult to put across the relevant information. I was told that I would receive a phone call by the end of the next day, it was actually 4 days later. Access to any sort of mental health support takes months. I totally understand why all of this is happening, there are just not enough staff, limited resources and of course social distancing. Staff are doing their best in the circumstances.
Because my fave to face appointments were cancelled and the monitoring of my multiple auto immune diseases weren't so diligent, I landed up in hospital for 6 weeks. I was finally discharged home but although I needed carers (I'm 39) I declined them because of risk of Covid and lack of PPE. When the second wave hit, again my disease wasn't monitored and I landed up in hospital for weeks again. And now my prognosis is very poor.
I was on top of everything prior to Covid.
A doctor cannot listen to your chest, examine your joints, palpate abdomens over the phone, it's just not possible.
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