The Ticking Health Time Bomb

heart valve awareness week

One of the main problems facing older Londoners since the pandemic has been how the “normal NHS” has been scuppered. Many older people have reported delays in treatments and having to have consultations via zoom or by phone.   According to Age UK 47 per cent of older people are less confident going to hospital and 40 per cent less confident going to a GP surgery. The problem is that conditions may not be treated and we’re already seeing non Covid deaths such as cancer increasing.

The NHS in London has been looking at these issues and what needs to be done.  Virtual workshops were held over the summer which did include older people as a way of getting inputs from local populations. Some of the key messages from these engagement workshops were:

Elective care

Participants’ accepted the need to prioritise patient lists for elective surgery in the current climate. The main consideration when prioritising patients was clinical severity, which included judgements of how life-threatening the condition was, its potential for deterioration and other risks facing patients. Following this, the inter-linked factors of the patient’s level of pain, quality of life and age was important. Other secondary considerations included the impact on the patient’s mental health and their employment and financial status

Virtual first – services online

Participants strongly felt that the virtual first approach would not work for all. They wanted the NHS to continue to offer face-to-face appointments to people who might be disadvantaged by the policy, such as those experiencing digital access barriers and / or communication issues. They also believed it was key to measure the impact of the policy on the most vulnerable as it had the potential to exacerbate health inequalities.

Consolidating services into elective care centres and diagnostic hubs to prevent Covid being transmitted

This was accepted but while participants were willing to compromise on choice, they recognised the importance of still offering it for people in vulnerable circumstances (for example, those not able to travel easily, those needing regular care, and those who want or need continuity of care above anything else).

Access to urgent and emergency care  

Concerns were expressed about the existing 111 service potentially being used as a triage function, mainly around its ability and capacity to cope with the increase in demand, the training of call handlers and clinicians’ ability to pick up certain conditions over the phone

The full feedback is contained in this very long and weighty report being considered by the NHS (

Whilst it is helpful that the NHS is talking with the public about these issues, there needs to be proper communication about these changes and true consultation. Older people are big consumers of the NHS and should have a stronger voice and input than just a few places on some workshops. What has been your experience of the NHS changing in London since the pandemic – it would be helpful to hear your views – please email

The Ticking Health Time Bomb

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