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Covid-19: Helplines

Volume 802: debated on Thursday 19 March 2020


Asked by

To ask Her Majesty’s Government what plans they have to establish a COVID-19 specific helpline in addition to NHS 111; and whether any such helpline could be staffed by retired medical and nursing professionals.

My Lords, as part of its coronavirus response, NHS 111 has already trained an additional 1,000 call-handlers. NHS England has been clear that investment will increase as demand continues to rise. As part of the health system’s wider response to the coronavirus, the GMC, the NMC and other professional regulators have written to professionals who have left their registers within the past three years to ask them to return to support the coronavirus response.

My Lords, I first acknowledge the Lord Speaker’s demonstrable leadership in deciding to work from home. We need to remember that we are televised and we need to model the behaviour we are asking of the rest of the country. I thank the Minister for his response, but draw his attention to the fact that there are many retired professional health workers who wish to contribute to the NHS and social care needs of our population in all four countries of the UK but who have their own health concerns. Many, like myself, are fit enough to return to clinical practice and are of course willing to do so. However, utilising others by quickly teaching them a specific algorithm for the Covid-19 virus could relieve anxiety and provide advice to our population and, in particular, relieve NHS 111 to deal with other concerns. We are very worried that, even in the short term, people with perhaps severe problems who should be ringing 999, but do not know that until they have rung 111, will have to wait a disproportionately long time. I wonder whether we could see how quickly we could get a specific line using the expertise of the people I referred to.

The noble Baroness, Lady Watkins, reflects the feeling of all the House in her comments on the Lord Speaker, and I entirely endorse her comment that we must all respect the guidance and advice given to us by the Government. I pay tribute to the Lord Speaker for his comments on that subject.

In terms of 111, she is entirely right that the NHS is under acute pressure, which is particularly felt on the front line in the interaction with concerned people who are understandably phoning 111. The 111 system is recruiting a large number of new handlers. In addition, we have put a letter through the GMC, NMC and other professional bodies and there will be a registration page on the front page of those bodies’ websites—it will be going up very shortly, either tomorrow or very soon afterwards, I believe—for recently retired professionals to register their interest in rejoining their local NHS health authorities in some way. Those applications will then be passed on to the local authorities and triaged, and the applicants will be allocated suitable responsibilities. I pay tribute to all those who are thinking of returning or have returned to active service, often putting themselves in danger and taking risks in the service of the NHS to look after patients. The skills of the recently retired may range from those who are younger and active and can be on the wards through to older people who may have desk-based tasks, but it is up to the local authorities to decide where best they can conduct their services.

My Lords, will my noble friend join me in congratulating the Lord Speaker on the leadership he has given? I declare my interest, as in the register: I work with the Dispensing Doctors’ Association. Can my noble friend address the question of professional indemnity for those wishing to return to practise as recently retired nurses, doctors or other medical professionals? Can he also address the question that I have written to him about regarding the severe shortage on the front line of PPE, which is apparently in warehouses? It really needs to get to the front line.

The question of indemnity insurance is addressed in detail in the coronavirus emergency Bill. We are fully aware of the concerns of anyone returning to work, and indeed anyone who might have indemnity insurance in one area of practice but who will be asked to take on exceptional duties required as part of this emergency—the surgeon, for instance, who takes on respiratory support duties. Those indemnities will be thorough and will cover all work. In terms of the warehouses for PPE, it is incredibly important that there is load allocation according to the need for the PPE, not necessarily the demands of local authorities. There is therefore an active allocation of PPE to those areas that have the highest incidence of the virus. That is being managed centrally in a thoughtful and professional manner.

My Lords, I direct the House to my medical and other interests in the register. I have no doubt that NHS 111 and other helpline medical professionals and health professionals will give the best advice. But Professor John Ioannidis at Stanford University has pointed out that we are making major changes in the way we run society, on necessarily limited evidence for what happens with this virus. Can those working on NHS 111 and any other advice lines also take epidemiological data on the length of time and types of symptoms and, particularly, geographical spread, and feed that data back to research institutes inside and outside the NHS, so that we can get the best handle possible, as soon as possible, on how this virus operates?

The noble Lord, Lord Alderdice, is entirely right: one of the features of this virus is its extremely unpredictable nature. The way in which it reacts in different people at different times is extraordinarily diverse. Some people appear to be completely knocked out by it; some have the lightest possible symptoms. There seems to be an alignment with age. We are all enormously thankful that the young and very young seem to be blessed by having the light symptoms. We are all extremely concerned about the old, but it is not even as simple or as linear as that. A huge investment is being put into understanding the virus better. I am pleased to report to the Chamber that international co-operation on that is extensive and positive, and that British researchers are at the leading edge of pulling together that data.

My Lords, this is a question on co-ordination. Yesterday, I saw the script that 111 is using right now; it was perfectly intelligible and sensible. However, it was out of step with what was on Public Health England’s website. I am sure that is a timing issue but it is rather important, because it will increase anxiety. Moreover, the digital exclusion of the elderly and vulnerable is a really serious problem because suggesting to people that they should go online in the first instance is entirely inappropriate for people who can manage a phone, but that is about it. Many of us are probably related to people in that position, so having plans to deal with that—as suggested by the noble Baroness, Lady Watkins—is very important.

The noble Baroness, Lady Thornton, is right that the Government have moved incredibly quickly, particularly in the last two weeks. The pace of the virus has been faster than initially expected. The response by some of our international partners has in part conditioned our response, and we are working extremely hard to ensure that all parts of the machine keep up with each other. There will inevitably be occasional glitches, but I pay tribute to the NHS, Public Health England and, in fact, the entire Whitehall machine for moving incredibly quickly and, under the circumstances, demonstrating a relatively high level of consistency in the advice as policy has changed.