This week’s guest blogger is Dr Llinos Roberts, a GP at Tumble surgery in the Gwendraeth Valley. Dr Llinos is worried that patients with illnesses other than COVID-19 are not consulting with their doctors. She believes that because of this, “the devastating effects of the virus are yet to come”.

Dr Llinos Roberts "Has the appearance of the ‘new kid on the block’ pushed everything else aside?"

The surgery doors are closed, and there’s a big sign stating in no uncertain terms that no-one should walk in. Not the usual sort of welcome you’d expect to see at the surgery. You need to phone to obtain medical advice. Or if the surgery is on the front line, you can email or organise a video chat with the doctor. And if this causes you concern as patients, it might be some comfort to know that the procedure is new for most of us as GPs also! But although the doors are closed, we are still here, working hard behind closed doors.

A few months ago, I’d never heard of covid-19...but by now, it’s such a central part of my life I even dream about it! It’s difficult to believe how much our lives have changed over the last few weeks, and now, things we took for granted such as going to work, popping to the shop, and meeting friends feel so remote. But we have no choice – we must adapt, and it’s amazing how we’ve also succeeded in doing that, and we feel pride in the way surgeries have managed to change their usual method of offering medical care, in such a short time. Losing that close contact with patients is certainly difficult, and it can be challenging to get to the root of a problem without being able to read the patient’s body language… you can interpret so much from things unsaid.

And the phone has been busy over these last few weeks, with patients getting in touch with their concerns. But most of these are concerns related to COVID-19: people who have developed symptoms, or who are worried about the situation generally. That, indeed, accounted for the vast majority of recent calls to the surgery. This is only to be expected in the current climate. But it does pose the big question ‘where’s everything else’? What happened to the other medical problems which used to fill our days only a few weeks ago? Has the appearance of the ‘new kid on the block’ pushed everything else aside?

Before COVID-19 I and my fellow GPs dealt with at least 30 patients per day – some coming to discuss long-term problems, and others calling in with symptoms that weren’t all that serious. But there was another group, and the big question is – where are they now? This is a group who used to get in touch with symptoms which might be serious – the middle-aged man with chest pains very similar to heartburn, the woman who’d noticed a hard lump in her breast, the patient who was short of breath and coughing up blood, the very pale child who was extremely lethargic. Where are they now? For they don’t contact the surgery as they used to, and from what I understand, neither are they in hospital. Do they opt to stay at home so as to reduce pressure on the NHS? Are they waiting until the symptoms worsen before picking up the phone? Has the message to stay away from the surgery gone too far?

When I drive home every Thursday evening and pass people outside their homes clapping health workers, it’s apparent that the people of Wales feel incredible pride in the NHS. And we have every reason to be proud of a service built on firm foundations by Aneurin Bevan and which is still, despite every challenge, one of the twentieth century’s greatest successes. Many refer to NHS workers as ‘heroes’, and there is a feeling that we should all ‘play our part’ in this battle against covid-19. But aren’t we also somehow expecting patients as well to be ‘heroes’ and martyrs? Is this the message we have conveyed as we encourage people to stay away from the surgery? Do patients feel somehow guilty as they consider picking up the phone to discuss an issue unrelated to covid-19 at a time when the NHS is under such severe pressure?

Of course, I’m worried about covid-19. But I also have another worry, which now looms large on my horizon. Where are the patients who usually fill my surgery? As the covid dust settles, will we see the true effect of the virus on the nation’s health – the indirect effect of stopping patients from contacting their doctor with other problems which might possibly appear ‘less important’ in the current climate?

This message needs to be got out to patients. Yes, the NHS is very different from our usual experience of it. But we are still here for each and everyone – covid-19 or not.

Because diseases such as cancer, heart attacks and strokes don’t suddenly feel merciful at times like these: they don’t stand aside to give covid centre stage. They are still there, and still active. An when the curtain falls on the covid-19 show, and all the encores have finally died down, that’s when we shall see the real devastating effect of this virus.