June Health Matters – Covid, Memory & 111

Four Issues in this month’s Health Matters

• Covid Update
• Memory & Forgetfulness
• 111
• Nurses taking over from Doctors!

1. Covid Update

If you remember last month I reported that the cases per 100,000 were bouncing around in St Albans District – a peak; a new trough etc. But when we recorded last month’s edition we noted that cases had just dropped like a stone – from 2,348 on APR 28^th to 279 last month – and guess what ….. they’ve stayed low! As at the date of this recording they were down to 226. And that is in spite of the fact that they are rising again generally. Against our 226, the Hertfordshire average is 275 and the London average is 423!

Hospitalisation is down significantly on last month from 85 people in Watford to 28 and from 73 in the Lister to 34.

The Omicron BA1 variant has once again become the most common variant in St Albans, accounting for over 75% of cases. And I just saw this morning that there are around 4,000 cases of Long Covid in the St Albans-Harpenden area – that’s certainly higher than I was expecting.

2. Memory & Forgetfulness

Have you ever experienced the embarrassment of forgetting to do that important thing we promised someone we would do. You may well have done everything you could to remember, yet it still slipped your mind.

New research has shown that, however hard you try to remember your plans, whether you remember or forget, it’s simply down to  luck.

In the morning you decide to call your friend in the evening. During the intervening time, you also decide to buy groceries for dinner, pick up the kids from afterschool club and many other things. Psychologists say we can’t keep all these intentions active in our working memory all day.  Working Memory is the type of memory involved when you maintain some information in your mind for a relatively short time

Working memory is limited, both in its capacity and in the duration of time we can hold information. That’s why people need long-term memory to store their information for a longer period. Long Term Memory is a store of information maintained by the brain outside the conscious mind.

As we go about our lives, we hold several intentions for the future at the same time. To walk the dog after work, buy a fruit salad for lunch, to take medicine after dinner, and to call a friend in the evening as promised. In fact all of these intentions are in a race, competing to get across the finish line in working memory.

Think of each of these intention s as individual horses in a race. And it’s mainly luck whether the horse wins or loses.

But you can increase the odds! For example an intention to take your yellow pill the moment you have swallowed your last bite of dinner has a better chance of making the finish line than remembering to take a pill later!

3. The 111 Service

I thought it was about time we had a reminder of the 111 service; and we’re very lucky in Hertfordshire as our 111 Provider is frequently ranked as one of the best in the country!

We all know (I hope) that we can call 111 if we’re concerned about our health & wellbeing 24 hours a day, 7 days a week. Calls are answered by a Health Advisor who will ask a series of questions in order to assess how urgent it is that you are seen by a clinician. But our 111 service is made up of far more than the person on the telephone; there are different levels of Nurse Practitioners, Doctors and Dentists and paramedics who can address our needs – and that means we may not need a GP appointment.

111 can now even make an appointment for you to see your Doctor! They have access to your Surgery’s appointments list and can book you in based on a qualified assessment of the urgency with which you are treated.

111 is also providing an excellent recommendation at the moment if the patient really needs to be seen to confirm the 111-assessment.– they recommend that you go to the Pharmacy and provide any feedback they give you to your Surgery. And that, in effect, does the triage for your Surgery!

Finally – before going to A&E (unless it’s life threatening) or to an Urgent Care Centre (for example at Hemel Hempstead or Welwyn) call 111 first! They can again make an appointment for you, and you’ll spend much less time waiting!

4. Nurses Taking Over From Doctors

You may have seen the Panorama Program on Monday (June 13^th ) highlighting that Nurses were taking over the work of Doctors. What exactly was happening and is this a bad thing?

First of all, we know there is a critical shortage of GPs in our area – so anything that can be done to make GP time more productive is great for everyone – as long as it is safe! And the tendency to allow Nurses to take over some of the less challenging situations frees up GP time significantly. So that means that the more challenging cases receive a better service.

But what level of service does the less challenging patient receive? Well that depends on what level of healthcare professional is actually seeing them! According to the Panorama Programme, people were being seen by Physician Associates – and technically, they are not Nurses. As they are trained like a Doctor in an intense 2 year masters degree. They clearly won’t get the full doctor’s training but they are effective as part of a multi-disciplinary team, So whether it’s good or bad really depends on the operating practices within the Surgery and the degree of supervision they receive.

Alan Bellinger
15^th June 2022