yes i saw that too access has to be easier and more flexible - ThreadSky

mancunianmedic.bsky.social • 1 day ago

yes
i saw that too
access has to be easier and more flexible

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Access is for vaccs is something that takes concentrated effort for left-behind folk, and the NHS struggles to fund those any longer.

I think the mass vacc of COVID made it worse where one-size-fits-all mega sites were seen as the best choice, all about numbers rather than who actually comes.

1/3

stevensenior.bsky.social•1 day ago

Also on the COVID point - massively underrated point. At every single stage we found a far higher proportion of COVID jabs were being done by PCN sites and far fewer at mass vaccs sites (which were slower to set up too) than we'd been told was the plan.

stevensenior.bsky.social•1 day ago

Side note: I distinctly remember a while where planning for COVID-19 vaccines did not include GPs at all. Presumably that was until someone who understands vaccines delivery managed to get into the planning meeting and said 'you're going to ask the GPs to do this, right?'

mancunianmedic.bsky.social•1 day ago

they were fixated in outsourcing it all to contractors with zero relevant experience

mancunianmedic.bsky.social•1 day ago

see also - if we had not relentlessly cut public health grant and local gov funding they could have left the contact tracing/isolation work to experienced local public health teams (as happened in other countries with good responses)

Ideological obsession with contracting out to private sector

craig.nikolic.co.uk•1 day ago

Well, to be fair, most of the really big numbers came from GP Federations who were subbed the work as "PCN sites" 😜

Our main COVID vacc site was a genuine true collaboration between us, our council, PHE folk, and local college.
e.g. https://www.barkinganddagenhampost.co.uk/news/health/20907881.107-year-old-woman-receives-covid-19-vaccination-barking-centre-celebrates-50-000th-jab/

stevensenior.bsky.social•1 day ago

Yeah, that was mostly true for us too (plus some pharmacy input, plus practice/PCN delivering some of the pop ups). It varied I think but feels like an argument for not over-specifying the form of these things.

craig.nikolic.co.uk•1 day ago

We provide weekend and weekday evening clinics as practice core hours often don’t suit working age folk. We allow self-booking at a site and time they choose. We have people of their culture talking to them. We do pop-ups with the council. And on.

Most were suggestions from local folk.

2/3

craig.nikolic.co.uk•1 day ago

Self-booking has gone down well with tech savvy young families. Reduces DNA rates massively when they can pick their location and date/time.

That also frees up our admin/call centre folk to go chasing those who can’t use the tech or don’t want to.

Flexible access is more a mindset than task.

3/3

stevensenior.bsky.social•1 day ago

Agree. I'm keen we don't lose sight of the policy choices that make this stuff easier or harder - funding cuts, payments for vaccinations not keeping pace with inflation and not reflecting inequalities, removal of local imms leads to regions, underfunding primary care etc.

danspicer.bsky.social•1 day ago

Agree with all of this. I think the Covid programme is also an issue in that a narrative has taken hold, at least in some places, that it was an *NHS* achievement. Whereas my view of it, and especially where it connected with inequalities and poorly served communities, was that it was…

danspicer.bsky.social•1 day ago

…a product of NHS, local gov, community partners, and communities themselves. Really making a difference in those spaces requires everyone working together and the capacity that makes that possible is being actively reduced

mancunianmedic.bsky.social•1 day ago

at the other end of the spectrum
my own parents and their friends (early 80s, retired public sector professionals) feel digitally excluded and frustrated/bewildered by everything being pushed on line

mspottingshed.bsky.social•1 day ago

Our GP has started using the message service on the NHS app lately. I find this a pain as it means I have to log in to see the message, do 2-factor authentication thing, etc. This isn't for core stuff tho'. They still use text messaging re: stuff I need to phone them for, vaccinations due and so on

craig.nikolic.co.uk•1 day ago

NHS App is free to message. SMS and anything else has a cost. The cost used to be covered by NHSE, now it's not beyond a text or two per year for GP practices.

More and more NHS services will move to NHS App because of cost pressures.

craig.nikolic.co.uk•1 day ago

One thing we do to counter that is that we have a list of folk who we know we can't get using digital/tech. Including what they planned care they need, their first/preferred language, etc.

Anytime we get a DNA in a nurse appt, the nurse takes the next name on the list and calls them.

mancunianmedic.bsky.social•23 hours ago

the fact that you do that locally does not mean it is everyone's experience when trying to access services or information though

and considering that both age, disability, socioeconomic deprivation are big predictors of healthcare needs and service use

makes no sense to exclude people

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