It is an understatement of somewhat heroic proportions to say that the last year has been a challenging one. Our normal patterns of working have altered radically – probably never to return to pre-Covid ways – and lockdown and social distancing measures have also dramatically impacted on conferences and medical gatherings in general. I have chaired and spoken at Pulse LIVE events for many years all around the UK and have always thoroughly enjoyed the combination of education and peer camaraderie that such meetings generate, so it was with a sense of curiosity and slight anxiety that I chaired the first of the Spring season of the online Pulse meetings in April, with the theme of respiratory issues and Covid-19. I need not have worried – it was a success from start to finish, with excellent speakers throughout, and tremendous audience interaction with every session.
The day started with Waqaar Shah, chairman of the expert advisory panel on the management of the long-term effects of Covid-19 at NICE, talking about the current Cocid-19 rapid guidelines on what GPs should be doing to help those patients whose symptoms persist following their initial infection with Covid. This highlighted the need for us to think about involving all the branches of NHS health care in this population, as well as how to continue long-term assessment and remember referral criteria if necessary. It was a thought-provoking and stimulating start to the day, generating many questions and much discussion in the audience.
Next up was Professor Dave Singh, professor of respiratory medicine at the University of Manchester, who talked about evolving developments in the management of asthma. Many GP’s (including myself!) can sometimes find it tricky to keep up with the incredible speed at which asthma treatments are continuing to evolve, so this was an excellent overview as to where we currently are in this clinical area. There was a lot of discussion around the use of combination inhalers, their benefits compared to using multiple monotherapy inhalers, and the cost savings of such treatments and there were many questions from the attendees around day-to-day problems they were facing with optimising asthma treatments for their patients. Dave did a great job in condensing such a huge topic in less than 40 minutes!
Remote consultations have become a way of life for all of us now, along with the concerns and anxieties that can accompany them, and Dr Sanjeev Rana spoke in the next session on lung function tests and breathless assessment in this type of consultation. Sanjeev is a GP and GP trainer, as well as a member of the service development committee for the Primary Care Respiratory Society, and provided excellent and practical advice to us as to how we can safely assess our breathless patients remotely, with clear guidance on red flag symptoms and when face to face assessment was required. This was a hugely helpful session concerning this new way of working and generated much interest and many questions.
Dr Sharon Raymond – a GP and director of Covid Crisis Rescue Foundation – was the next speaker, discussing the vaccine rollout and both what we have learnt from it and what we need to do next. Not surprisingly, this was a very popular session and it was obvious from the feedback during it that GPs are concerned about the added pressure that annual Covid vaccination campaigns will add to our workloads. It has been interesting to see that the predictions Sharon made about vaccine rollout speed and effectiveness have come true in the months since then.
After a very quick lunch break, the next session was a ‘double header’ presentation looking at the role and relevance of nutrition in Covid-19 recovery – a huge topic and one which is going to be very important to all our patients struggling to recover from Covid infection. This was presented by consultant dietitian Dr Anne Holdoway and honorary consultant Dr David Strain, and emphasised the often-forgotten key point as to how crucially important nutrition is in all patients recovering from illness but especially those who have been affected by Covid-19.
Following on from this as a nicely logical step, the next speaker was consultant respiratory physician Dr Toby Hillman from University College London Hospitals NHS Foundations Trust who talked about whether long Covid was credible and curable. Fortunately the answer was yes to both questions, but Toby gave an excellent precis as to just how long it may take for some patients to return to normal levels of functioning and activity post-Covid, as well as giving excellent advice as to we can all best deal with this growing part of our workload. Multiple questions from the audience confirmed just how interested GPs are in this new area of medicine, and there were many practical tips swapped between attendees as helpful tips!
The day closed with the GP and respiratory medicine GPwSI Dr Mukesh Singh talking about the challenges of managing COPD in primary care. This huge topic was covered succinctly and effectively, with everyone agreeing it was the perfect way to end the most interesting of days.
From my point of view, it was a fascinating and exciting event to chair from the comfort of my study, without any of the hassle of travelling to an event! There is much debate as to whether such events will fully revert back to traditional face to face conferences post-pandemic and I suspect the answer is that – just as remote consultations will remain part of our clinical practice – there will be a mixture of traditional and remote conferences as standard in the years to come. The advantages of not having to travel to an event, being able to watch it at your convenience and ask questions live during the streaming are significant and my experience so far is that these are hugely popular with GPs, particularly with the workload we are now having to deal with. Meeting our colleagues face to face as well as being able to talk to sponsors at their stands are things many of us miss but pragmatism reigns at the moment and this first Pulse LIVE meeting was the first in a highly successful series of six that received excellent feedback and provided top-quality medical education for everyone that attended. I for one look forward to the next series!
Dr Roger Henderson is a sessional GP in London and Pulse Live speaker