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Evidently, we can do what we want


fruit and veg prescription


Uh? In fact, double uh?

‘Uh’ #1 is the news that NHSE is devising an enhanced service to enable we GPs to provide Long Covid services. At least, that’s my interpretation of the frankly baffling sentence  in a recent NHSE bulletin (‘Up to £30 million will also be made available to GPs to support around Long Covid through a new enhanced service”), and it’s Pulse’s, too.

I just wonder what the specification will say this enhanced service might be, exactly, and for whom.  After all, this is a disease which has a woolly and arbitrary definition. Which doesn’t require a proven diagnosis of prior Covid. Which apparently bears no relation to the severity of the original Covid illness. Which has no diagnostic test. Which has a multiplicity of symptoms the cause of which remain unclear. Which may last for we don’t know how long. And which we don’t know how to treat.

In other words, this merely requires patients to say ‘I have Long Covid’ and to report the kind of common and unexplained symptoms GP have been used to fielding long before Covid was even a twinkle in our eyes, and for us to say that we’re sorry to hear that, let’s give it some time.

‘Uh’ #2 is the further news that we’ll be asked to screen for AF in the over 65s when they attend for their flu or Covid-booster jab. I do realise there’s been increasing momentum to anticoagulate large proportions of the population. And in the face of this apparently unstoppable enthusiasm, there’s probably little to be achieved by pointing out that, as far as I know, there is no good outcome-based evidence for AF screening, it’s (quote) ‘not recommended’ by the National Screening Committee (though, clearly, they know nothing about, er screening) and patients diagnosed in this way may not be at all representative of the group of patients who we know actually benefit from anticoagulation. But I will, because of, you know, science.

It does seem ironic that we’re witnessing one of medical science’s modern miracles (Covid vaccination) and at the same time indulging what appears to be unscientific whimsy or drum-banging. You might be prepared to entertain these pet projects if this was a time when the system was drowning in surplus cash and spare time. But I don’t think it is. I don’t have any evidence of that, but then again, that no longer seems to matter.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

READERS' COMMENTS [8]

Decorum Est 18 June, 2021 12:05 pm

Some patients who were diagnosed fairly early in the pandemic did seem to suffer from some sort of post-viral syndrome. There seems to have been a tsunami since that has sucked up all the MEs, CFSs, TATTs, Fibros and related suffers. Not sure this bodes well for anyone.

Jonathan Heatley 18 June, 2021 12:53 pm

Tony they have now added an obesity DES. We will need to record BMIs and send the heavy ones to the NHS obesity clinics/wellbeing hubs. Radio 4 reported this week that obesity is nothing to do with greed but is a medical illness. All my obese patients have already tried every imaginable diet (and my goodness its boring hearing about them) or have decided not to engage. Telling them to try yet another weight busting idea won’t go down well. How will making us responsible for this tidal wave of lard help? The extra weight is likely to sink the good ship HMS general practice

Decorum Est 19 June, 2021 2:03 am

‘tidal wave of lard’???
Not convinced?
Surely lard floats?
But then again, if lard floats, it’s less dense than water and the ship more likely to sink.
Think I’ll run it past genius Hancock!

Dylan Summers 19 June, 2021 10:42 am

Surely any money being made available for Long Covid should go into research – to find out how best to treat it, perhaps? – rather than to pay clinicians to sit at a desk telling patients “we don’t know how to treat this”.

Scottish GP 21 June, 2021 10:15 am

Probably end up yet another pseudo-indication for gabapentinoids….

Patrufini Duffy 21 June, 2021 2:20 pm

Long covid clinic, for those never hospitalised and with normal work-up, will be like back pain clinic for an orthopod. Fix me, but I can be bothered to work on myself and get on with it. Death by clinic and zoom. Insurance companies will love this Snowmed code. Lucky for sertraline. The NATIONAL HYPOCHONDRIAC SHINANAGAN (nhs trademark) continues.

James Cuthbertson 21 June, 2021 6:47 pm

Unfortunately if you have a diagnosis which cannot be proven and gives people material gain, you will be inundated with cases.

Anne Largie 26 June, 2021 10:41 am

There is good evidence emerging that spike protein damages organs and that autoimmune and other cellular injury from this after Covid (or even after the vaccine..)
I understand your prejudices since I’ve been a Gp a long time ,but it’s time for drs to be open now to realising that normal bloods & scans doesn’t equate to hypochondriacs!
And to start thinking outside the box to find treatments