We need to talk now about the NHS.

All of us display a deep debt of gratitude to the efforts of the NHS during the pandemic. But now as “lockdown liberation” is proceeding apace, many older Londoners face an uncertain autumn with a fully stretched NHS.

It’s vital the needs of older people are at the forefront of any changes in services, and this requires recovery thinking, for example in the London Recovery Board to be also about access to health services now as much as public health issues.  An age-friendly city needs the right designed services for the range of older people’s health needs as well as good access. But there are several challenges ahead.

The backlog in treatments is causing misery for many. Seven million people missed out on regular healthcare during the pandemic, but there’s also the specter of the hidden waiting list” – those who may have put off seeking help after discovering illness symptoms. Clearly, we need extra resources to clear this backlog, but also better information for patients about the patterns and better estimates of wait times in London.

One of the big consequences of Covid has been the shift to online consultations for GPs and hospital appointments for “efficiency reasons”. Whilst some older people adapted to this, the downside as a big study by Healthwatch has shown is many others experienced difficulties. As the report says, “Not knowing how to seek alternatives to remote booking systems or appointments meant some people became entirely reliant on their families for accessing healthcare, received poorer quality care, or abandoned attempts to seek healthcare altogether”. What’s required are a mix of online and face-to-face options and letting older people decide what kind of appointment is right for them. Yet inevitably older people need support to develop their digital skills to go online and should this also be a responsibility of the NHS?

We also are picking up issues about the lack of health community services which may not be mainstream but nevertheless are important for many older people. Reports show an increase in the number of people with problems of accessing NHS dental care. Cuts in podiatry services may restrict people from being active and rehabilitating post covid.  Removal of earwax is no longer offered by many GP practices, and some older people pay privately. But all these and other services shouldn’t be a postcode lottery and it’s important to know where the gaps exist within London.

Finally, there are big changes ahead with the re-organisation of the NHS with integrated care systems. Questions have been raised about what the impact will be in London and accountability. But there is a sense this has all happened under the cover of covid without the debate for older people about what sort of NHS we want in London.

Tim Whitaker

We need to talk now about the NHS.

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