A spotlight on the Isles’ medical and dental care available during the lockdown

Most of us have taken the slogans to ‘Stay at Home’, ‘Protect the NHS’, ‘Save Lives’ on board during the nine weeks of lockdown, so much so that tragically some people did not seek medical care when needed causing a spike in deaths from medical conditions other than Covid-19.

The situation has caused the NHS to issue slogans such as ‘If it is Urgent, it is Urgent’ and ‘GPs and Hospitals are Still Here for You’.

At the end of April, Cancer Research UK highlighted that the number of urgent referrals by GPs for cancer treatment had dropped significantly since the pandemic began, with cancers of the lung, stomach and throat thought particularly likely to have been affected because of concerns of exposing medical staff to Covid-19.

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As face to face contact with doctors and dentists is currently restricted the Gazette asked NHS Western Isles, exactly what patients can expect if they need to seek medical treatment and we used the example of a woman finding a breast lump during self-examination.

In answer, NHS Western Isles Medical Director, Dr Frank McAuley, said: “GP practices are open and available to patients. So, for any non-coronavirus symptoms or health concerns, you should contact your GP as normal.

“In terms of breast lumps, or any other potential sign or symptom of cancer, anyone concerned should not delay in contacting their GP. It’s best to get checked early as the earlier a cancer is found, the easier it is to treat.

“Referrals are being assessed either virtually (by telephone or video conferencing facilities); or face to face at home or in the GP practice.”

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When asked if patients could then access further investigations such as a scan to determine what was causing the condition, Dr McAuley, explained: “Our hospital specialists are seeing urgent referrals, and our radiology/laboratory departments are providing diagnostic support as required.

“We continue to deliver our chemotherapy services on Island.”

In regards to other medical clinics , he added: “We are just beginning to see the managed return of our visiting consultant teams for urgent cases – ophthalmology from NHS Highland at Raigmore, for example, restarted this week.

“The National Screening Programmes remain on hold, as restarting them requires all related patient pathways to be in place. Productive collaborative work between the Scottish Government and the National Clinical Leads is ongoing to ensure safe and appropriate resumption of clinical treatment.”

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In regards to dental care locally, patients are able to access only emergency dental care.

Explaining exactly what treatment is currently available, NHS Western Isles Director of Dental Services, Colin Robertson, said: “On March 23, all routine dental services in Scotland were suspended by the Chief Dental Officer.

“The intention was to promote social distancing, but the decision also recognised the danger to dental staff from a new disease which is both highly contagious and life-threatening.

“Strict guidance was issued to define ‘Dental Emergencies’, and also the range of care which could be offered.

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“NHS Western Isles staff have provided emergency care as permitted by those rules.

“At present, dental nurses handle calls, and prioritise cases by urgency.

“At the moment this is often a choice between extraction or antibiotics.

“A dentist should always be available to consult, but there will be occasions the dentist on duty is with a patient, and unavailable.

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“Patients can request a call back from a dentist, and reception staff will be reminded of this. We expect to offer a wider range of treatment soon, in line with Government guidance.”

Dentists across Scotland are expected to reopen under a phased plan, which is currently being put together by healthcare officials, although it has been stated that the reopening of normal dental services will be difficult and is not likely in the next few weeks.

Talking about the reintroduction of normal medical and dental services in the Islands, a spokesperson for NHS Western Isles highlighted how complex such work is and also revealed how the lockdown, in some areas, has actually sparked a better way of doing things.

They explained: “NHS Western Isles is currently working on a plan for the reinstatement of services alongside Scottish Government guidelines.

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“This work is extremely complex as it will involve the reintroduction of services, many of which will have to be provided in different ways, alongside the continued risk of Covid-19.

“This means that maintaining physical distancing and PPE requirements will be key considerations in the reinstatement of each service, as the safety of staff and patients remains our priority.

“We will only reintroduce services when it is safe to do so. In many areas we will not be going back to the old way of doing things, where a new method benefits all concerned.

“The use, for example, of virtual appointments, through ‘Near Me’ will be an ongoing and increasing feature of services into the future.

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“This service is already developing in its use and availability as the following local statistics demonstrate: March saw 183 consultations with 36 clinicians; April saw 446 consultations with 63 clinicians and in May there has been - so far - 501 consultations with 70 clinicians.

“The total number of video consultations in the last three months is 1,130.”

Talking about the services currently available and the way back to normal access to medical and dental care, Western Isles MSP Alasdair Allan, said: “While things like non-urgent elective operations and screening programmes have been suspended to create more capacity in hospitals, vital cancer treatments, emergency, maternity, and urgent care are continuing.

“I know that people might be reluctant to put additional pressure on the NHS right now, but if you need urgent assistance or discover something like a potential cancer symptom it’s important that you seek help without delay.

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“GP surgeries and hospitals are still there for you if they are needed.

“I know that restrictions on dental services are proving very difficult for many people at the moment.

“I hope that the roadmap published by the First Minister provides a clearer pathway back to the normalisation of dental services as soon as it is safe to do so. Meanwhile, people should be aware that dentists are still carrying out emergency treatment.”

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