In the latest of a regular series, Dr Raja Murugesan, our clinical lead for respiratory disease in primary care, answers questions about the Covid-19 pandemic.
Q: When did you first become aware of Covid-19?
A: Early new year, 2020, and then that getting reinforced when we were seeing pictures of lockdown in China on social media.
Q: Do you remember when you first realised this would be the first worldwide pandemic in over 100 years and change your working life for months?
A: The fourth week in January, when we had our first potential patient with Covid present to the walk-in centre that I work in and the challenges were obvious, but the scale was only apparent after it hit Italy the way it did.
Q: What has been the most challenging aspect of working in your area during Covid-19?
A: The initial challenge of seeing your first Covid patient, the thoughts that go through your head, like whether you should go home, dying alone, what will happen to your children, family and overcoming those thoughts and still being a doctor was very hard. The other challenge was spending long hours and weekends constantly creating and re-writing pathways, guidelines and SOPs (standard operating procedures) for managing Covid and to see whether they actually work in practice.
Q: Has there been a low point during the pandemic professionally and if so, what was it and how did you overcome it?
A: The way the pandemic affected India was a low point, and the resurgence of Covid again in the UK was a deja-vu which wasn’t welcome, and we wanted this to be done and over with.
Q: Are there any positives you can take from the pandemic professionally?
Collaborative work carried out across different providers, commissioners, and within the network on managing acute Covid, oximetry at home and long Covid were highlights.
The relief and gratitude we saw in people's faces after recovering from Covid, or being acknowledged when they are suffering from long Covid kept us going.
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The Diabetes Network supported this year’s Diabetes Week by raising awareness of the programmes available to support people in Greater Manchester to self-manage their condition.
The Network ran a week-long social media campaign from June 14-18 to highlight online support such as Digibete and the NHS Low Calorie Diet programme, using the hashtag #DiabetesStories.
We heard how Digibete is helping young people like Alfie from Salford with type 1 diabetes understand his condition better and keep in touch with his local clinic (see image above).
We also heard how Robbie, newly-diagnosed with type 2, is being supported with putting his diabetes into remission through the new NHS Low Calorie Diet programme and how Dorothy was able to lose weight through the NHS’s Healthier You programme and reduce her risk of developing type 2 diabetes.
If you would like more information about the work of the Diabetes Network please email england.diabetesmyway@nhs.net
Join the team!
The Diabetes Network is looking for a diabetes prevention clinical lead and seeking expressions of interest from suitably qualified or experienced clinicians to support the work of its programme.
The role will focus primarily on diabetes prevention and engagement with primary and community care across Greater Manchester in order to support delivery of Long Term Plan commitments.
The role will involve up to 1 pa per week and you will work with the SCNs’ diabetes clinical lead, clinical director and programme manager.
For further information and details of how to express your interest, please contact Ewan Jones on ewanjones@nhs.net or 07710 152896.
One of the SCNs’ clinical leads, who has tirelessly advocated for patients’ voices to be heard, is retiring this summer.
Professor Steve Ball is a consultant endocrinologist and clinical lead with Manchester University NHS Foundation Trust, as well as an honorary professor of medicine and endocrinology with the Manchester Academic Health Science Centre. He has also worked for many years as clinical lead with the SCNs, focusing on diabetes.
His clinical focus has been on improving health outcomes through engagement, service transformation and working across professional boundaries. He led the development of the Greater Manchester transition model for children and young people with long term conditions in 2019 and has a long and successful track record in service redesign to improve patient outcomes.
A tireless advocate for keeping patients at the centre of all strategies and ensuring their voices are heard, he has been an inspiration to work with.
Dr Peter Elton, our clinical director, said: “Steve has brought a wealth of clinical experience to the SCNs and its work with children and in the field of diabetes.
“More than this though, Steve brings an inclusive and engaging style to our clinical leadership team which has been instrumental in bringing people together to secure clinical consensus and build new, better ways of working. We wish him a long and happy retirement.”
Steve’s commitment to better healthcare along with his wit and enthusiasm will be greatly missed.
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The Local Maternity System has circulated new guidance around the importance of reducing caffeine consumption during pregnancy.
Having caffeine drinks during pregnancy may lead to miscarriage and stillbirths. A mug of coffee each day roughly doubles the risk of having stillbirths.
There is no known safe level of caffeine whilst you are pregnant.
During pregnancy, all drinks with significant levels of caffeine such as coffee, cola and energy drinks should be avoided. It is best to switch to decaffeinated drinks or drinks without caffeine.
The image above shows an edited version of the guidance. Download the full version.
Launch of new maternal medicine hubs
The Maternity Network is involved with plans to launch maternal medicine centres in the North West.
The team was represented at the inaugural North West Maternal Medicine Network Board meeting held this month, which plans to develop a regional network of centres in Manchester, Preston and Liverpool.
These hubs will provide regional clinical leadership – on the identification, referral and management of women with medical conditions, including co-developing guidelines and referral pathways.
When established, the network will be responsible for ensuring that all women in the network’s footprint with significant medical problems will receive timely specialist care and advice before, during and after pregnancy.
All constituent providers within the network will be responsible for agreeing and upholding shared protocols on the management and referral of women with medical conditions, including reviewing guidelines and referral pathways.
Critically, in order to address inequalities in maternal outcome, the North West Maternal Medicine Network will need to ensure that pathways are in place to ensure equal access to specialised care for all women, and that referral criteria reflects the increased vulnerability of women from ethnic minorities and those who are socially deprived.
NHS England has announced it will be supporting the ongoing provision of long Covid treatment and care by injecting £100 million into health services across the country.
Over the next few months, our Respiratory Network will once again play a pivotal role, working alongside Greater Manchester system leads in the planning, co-ordination and delivery of long Covid care.
Our Respiratory Network clinical lead, Dr Jennifer Hoyle said: “This is welcomed news and will complement the assessment services now established across Greater Manchester. It also gives us the opportunity to rethink how we provide long Covid treatment and recovery.”
Greater Manchester’s plans are expected to be submitted next month.
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