Greetings to my Danish colleagues
I am very much looking forward, hopefully, to joining you in October. It's been a very strange time in Scotland as we try and deal with our patients who have symptoms of covid-19, and those who don't. In many ways I think this will be a watershed for medicine. Covid-19 is likely to exacerbate health inequalities as well as putting extreme pressure on both primary and secondary care, both dealing with covid-19, and dealing with the aftermath of physical and psychological harm.
There may also be opportunity to get rid of some of the more ridiculous bureaucracy we deal with and which causes so much frustration for patients and doctors. Although I do worry that much of the goodwill towards the NHS - people out clapping on the streets, for example - may evaporate as people wait longer for planned surgery, or whose diagnosis and treatment for serious conditions is delayed because of the stress on the health service.
The impact on health and social workers is also likely to be substantial. What might help us navigate our passage? There are two things I think might help. The first is reassessing what we do on the basis of evidence - if we don't think something works we have a duty either not to do it, or to investigate whether or not it is useful. We should be critically minded of restarting things that covid-19 has put on ice if we are not pretty certain that it is useful. But the second thing is to plan services around what we know already works - but often seems so hard to do in practice.
One of these is continuity of care. To deal with covid-19, understandably, a separate service to see patients in 'hot' clinics was created. But of course this has also created problems, not least fragmented care. Yet continuity, I feel, has has helped where we have been using phone or video consultations for most of our patients - if a patient already knows their doctor, it is hopefully easier to continue a relationship using technology. As we consider what kind of health service to rebuild.
I hope that the values of relationships and continuity of care will be considered essential to shape this new era.
I hope to see you in October.