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