Return2Play Doctors on the COVID-19 Frontline

During the COVID-19 pandemic, the response of everyone involved in the NHS has been widely regarded as outstanding. 👏

Outpourings of public support for the NHS can be seen everywhere, from rainbows 🌈 and flags in house windows to the weekly #clapforourcarers ritual on Thursday evenings.

We spoke to a number of Return2Play’s doctors who are currently working on the frontline about their experience during COVID-19; what it’s like putting themselves at risk every day, how it has changed their working lives and how it may change the future of our National Health Service.

 

Name: Dr Sam Barke
Return2Play Role: Medical Director
COVID-19 Role: Intensive Care Doctor, South London

 

Away from Return2Play I work in elective orthopaedic surgery in London. Elective operating was stopped early on in the crisis and I was asked to go to NHS Nightingale North-West in Manchester for the first weeks of its existence. Like most Nightingale hospitals we ended up receiving far fewer patients than we’d prepared for. This is obviously a positive thing as it means the NHS has been able to manage cases within its existing resource.  I have now moved back to London and am working in an Intensive Care Unit (ICU).

My biggest take-away when this is all over will be what can be achieved when “needs must”.  People will have seen much in the news about how quickly the Nightingale hospitals have been built but, for me, what has been far more impressive is how quickly working practices have been conceived and implemented across all NHS hospitals in a situation that we had no blueprint for. Healthcare workers have had to adapt quickly and have been required by necessity to work out of their comfort zone and deal with situations that many have not felt prepared for.  I have felt great pride in seeing my junior colleagues – many who are only a year or two out of medical school – take on responsibility that is usually reserved for far more experienced doctors and doing so with great professionalism.  This is a credit to them but has only been possible because of a flattening of hierarchy and the return of feeling truly part of a team and being supported, something that I hope will remain when this is over.

While much of our work has been upsetting – the mortality rates in intensive care units is well documented – it has also been rewarding. I feel hugely privileged to have watched patients talk to their families (via FaceTime, of course) after weeks on a ventilator, see them take joy in eating for the first time in over a month, and clap them as they are discharged from the intensive care unit.  But, as hard as it has been, I also feel privileged to have been able to care for the dying.  To pass on messages of love from their loved ones who can’t be by their side, to hold their hand in their last moments, to be there to say goodbye.

It looks like we will shortly be starting to reopen non-emergency health services and I will await the call as to when I can return to orthopaedics. It is becoming increasingly clear that there are indirect health issues that have been created from delays in access to treatment during the crisis and will take significant resource to try and clear that back log and minimise the long-term impact.   We’ve learnt a lot from this crisis and I hope some of the positives will force change that is long overdue.

 

Name: Dr Alex Maxwell
Return2Play Role: Concussion Service & Match-Day Doctor
COVID-19 Role: GP, South London

 

As a GP my working day has changed tremendously with the arrival of COVID-19. I am now telephoning almost all my patients, only bringing them in when absolutely necessary. This has highlighted how much can actually be done over the phone or via a video call and I believe will change how General Practice works forever. We have been able to manage with our PPE and various local schools and groups have been generous with their time to help create more for us which is incredibly kind and much appreciated!

As the lead within my practice tasked with looking after the vulnerable people in our community, it has been very satisfying working with a motivated group to work out who best to contact and how best we can support them with their medical, social, mental and physical health needs. Outside of my GP role, being Clinical Director for Croydon’s social Prescribing service (“Croydon SocialP”) has provided an opportunity to support our community from a more holistic viewpoint which I am grateful to be able to contribute to. We have made an incredible 80+ page resource and disseminated it to anyone requiring it to help support people with anything they might require during this unique time. We have also provided appointments to talk to someone who can guide them to appropriate resources which has made real changes to their quality of life.

I think that COVID-19 has highlighted just what can be done if necessary and if the “red tape” we have become so accustomed to within the NHS is circumvented, just how effectively change can be implemented. Something to consider for the future.

Name: Dr Charles Tweed
Return2Play Role: Match-Day Doctor
COVID-19 Role: Mental Health Doctor

 

This is my second time responding to a large-scale public health crisis, having previously been deployed to Sierra Leone during the Ebola crisis. During testing times, I try to stick to a motto: “You cannot calm the storm, so stop trying. What you can do is calm yourself, for the storm will pass.”

I caught COVID early on in the crisis from a patient on my ward. I think my previous experience with Ebola made me less worried; the chance of death from catching COVID is much smaller than if you catch Ebola and, luckily, I wasn’t badly ill.

Currently my response involves treating mental health patients in the South London trying to keep them out of hospital. This sometimes means we are managing deteriorating physical and mental health in far from optimum environments. During emergency shifts I also cover London’s psychiatric hospital inpatient wards often with unwell patients that have COVID. Aggression or other harmful behaviours as well as not understanding the need to self-isolate makes it a challenge. This is a unique experience.

I expect that the mental health impact this crisis has on both patients, staff and those in the wider community will remain far after the virus has passed.

Name: Dr Tim McEwen
R2P Role: Concussion Service
COVID-19 Role: GP, Surrey

 

Alongside my work with Return2Play I also work within rugby with Saracens as their match day Doctor and with the RFU as team Doctor with the England U18 and England U20s sides. The COVID-19 pandemic has abruptly halted the season and whilst we wait to see what will happen with the rest of the Premiership and European rugby season, the June U20s Junior Rugby World Cup in Italy, the U18s stand-alone fixtures and Six Nations Championship 2020 have now all been cancelled for the season.

As a result of these postponements/ cancellations at the beginning of March, I returned to work in General Practice full time during the COVID-19 Pandemic. It has been fascinating and rewarding to see how much we have changed in the space of a few weeks. Changes that may have previously taken years have been brought about in a short space of time and many things will be here to stay. For example, all patients are now triaged by a Doctor on the day and if possible their problems or issues are often dealt with via telephone or video consultation, something that patients find convenient and we find efficient!

Name: Dr Miles Bogle
Return2Play Role: Match-Day Doctor
COVID-19 Role: GP, North London

 

As a GP we have seen a complete change to our way of working. New technology made available to us since the crisis begun has allowed us to conduct video consultations which has helped us reduce our face to face contacts from over 75% of consultations prior to COVID-19 to less than 5% now. This has reduced risk to both staff and patients, has largely been well received by patients who prefer video to attending the surgery and is likely to change how we work going forward after the pandemic is over.

In one of my other roles working in the Urgent Care Centre at North Middlesex Hospital all the GPs have been redeployed to the A&E where we screen all patients arriving for COVID. Those with signs or symptoms of COVID-19 get assessed at the front door, and if they are well enough to not require admission, we discharge them quickly from there – preventing those who are potentially infectious having to wait in the department exposing other patients and staff to the virus.

Name: Dr Juan Rosales
Return2Play Role: Match-Day Doctor
COVID-19 Role: A&E Senior Registrar, London

 

My regular job is in A&E as a senior registrar and I continue to work in the same role during the COVID-19 crisis. Over the past weeks I have welcomed multiple redeployed colleagues from different specialties who have enriched and reinforced our emergency team. It’s been a unique opportunity to exchange skills and perspectives.

It has been impressive to see how the Health Service can adapt to changes quickly. We had prepared ourselves to cope with a high number of patients but fortunately we have seen fewer cases than expected, both COVID and non-COVID related.

I’m proud of my team because the care of patients has always been at the top of our priorities throughout this pandemic time. Being there in an emergency is what we do best and we will continue to do it in every setting. We thank everyone for their support given to us as healthcare practitioners and for keeping themselves safe and at home.

Name: Dr Tom Axon
Return2Play Role: Match-Day Doctor
COVID-19 Role: Acute Medicine SHO, North Middlesex Hospital

 

In the Pre-COVID world I was a GP trainee undertaking a placement in Paediatrics. Since the outbreak I have been working on an emergency COVID rota at my local hospital. Even though this period has been emotionally challenging and there have been many difficulties, the collective team spirit within the NHS has been incredible. From unbelievably supportive senior staff, to mentoring newly graduated doctors fast-tracked from medical school, to bonding with new colleagues over donated food in the mess – the positivity shown in these scary unprecedented times has been staggering.

 

From everyone at Return2Play, a huge thank you to all of our doctors who are currently working on the frontline! 🙌

 king on the frontline! 🙌