How covid-19 unleashed the NHS

ACCORDING TO SHELAGH O’RIORDAN, a consultant in geriatric medicine, patients often experience the National Health Service (NHS) as a conveyor belt. “You feel ill, you call this number. This number calls an ambulance. That ambulance tells you that you should go to hospital. You go to hospital. And then, if you’re frail, you might not come out.” Her job, as she sees it, is to help people off the conveyor belt, and even on a quiet Sunday morning the telephone keeps ringing. Most calls are from nurses, paramedics or care-home workers. After a quick chat, each is given a set of instructions about the care of the patient to whom they are attending.

Dr O’Riordan set up this home-treatment service at the start of the pandemic, spurred by the need to keep patients out of hospital. The service offers acute care at home: diagnosing, assessing and looking after frail locals who wish to avoid hospital. Operating from a nondescript office on the edge of Ashford, a town of 75,000 in Kent, by the start of November it had treated more than 2,000 patients, around a third with covid-19. In the first wave of the pandemic it was unable to replicate the care received in hospitals, with people needing to head into an infirmary for oxygen or dexamethasone (a cheap but effective steroid). Both are now available at home.

The pandemic has put the...