By Chippenham GP Dr Nick Brown

As the public starts the gradual process of trying to return to normal, I thought it was important to write about what this now means for local health services.

Unfortunately, at least for the next few weeks, it is unlikely that there will be any significant change.

The frantic preparation for the unknown but feared consequences of a Covid-19 epidemic largely managed to cope with the first wave. By cancelling all non-essential work, our local hospitals expanded their urgent and intensive care capacity to respond with what turned out to be a lower incidence of infection than was seen in most other areas of the country. Local Minor injury units closed to allow redeployment of staff into other community services. The Nightingale Hospital in Bristol was created but has yet to receive a patient. The private hospitals have been commissioned to help deliver core NHS services.

GP surgeries, in order to increase their 'same-day’ response and reduce the risk of cross-infection by minimising face to face contact, have moved to a daily triaged service using telephone, IT communication and video consulting. Some GPs have been working remotely and effectively and these developments may be here to stay.

Many areas have separated the ‘Non-Covid’ and ‘potentially Covid’ services.

Chippenham set up the new road surgery initially to serve the residents of Chippenham, Corsham, Box and more recently, Calne, Devizes and Salisbury have also set up dedicated clinics and this has allowed appropriate assessment of patients including efficient use of our PPE and increased protection for our staff.Now we have to wait and see whether the easing of the lockdown actually causes a second wave of coronavirus infection as this seems highly likely. Health services must, therefore, maintain their high level of vigilance and preparation whilst the working public emerges from isolation.

Meanwhile, a backlog of ‘non-essential’ work is building up and all health providers need to address this. This is our lockdown challenge, which also needs to be eased. So, for the time being, we need our ‘hot’ clinics and Nightingale hospitals in order to give our service providers the chance to ease their lockdown in more routine areas and try to move, like everyone else, towards ‘business as usual’. However, that might take some time and some services will evolve and others may not return.