In depth: NHS Games preparations

Health on the starting block – NHS London's Games preparations

Simon Tanner

It is the kind of statement a politician would avoid.

'You are not going to find your operation is cancelled at the last minute because of the Olympics,' says Simon Tanner confidently.

If anyone can speak with certainty about healthcare provision during London 2012, though, it is surely NHS lead on Olympic preparedness Dr Tanner.

'We started planning for the games in 2008,' he says. 'I have been personally living this for the past four years.'

The scale of the task for the NHS in London in the coming weeks is, on the face of it, daunting.

Not only are visitor numbers in the city expected to be high, but the London Olympics bid committee pledged from the outset that free, comprehensive NHS care would be available to all members of the Olympic 'family'.

As families go, it's a big one: an estimated 55,000 people, including athletes, officials, accredited media, sponsors and senior representatives from participating nations.

But, says Dr Tanner, the expectation is that the extra workload for the NHS in London will be similar to that in a mild winter.

'Our assumptions have been based on evidence of games in other places, with a bit of extra modelling thrown in,' the lead regional director for public health in London explains.

Every NHS trust in London has a designated Olympics lead, and those individuals have formed a network for communication and planning purposes.

Three London hospitals have specific roles during the Olympics and Paralympics: the Homerton in Hackney is treating athletes who need secondary care; Bart's in the City is taking accredited media representatives who require hospital admission; and University College Hospital in central London is looking after other members of the Olympic family as necessary.

But Dr Tanner insists there is no question of those trusts - or any other hospital in London - skimping on their usual workload.

They may have planned their timetables and elective surgery commitments slightly differently in expectation of the Olympics - just as they would for an annual holiday period - but overall targets will not be relaxed.

'It's not a case of saying: "The Olympics are on so you can shut down for six weeks",' says Dr Tanner.

He is also keen to point out that the 'vast majority' of Olympic-related healthcare is delivered at primary level, and much of that will be overseen by LOCOG (London Organising Committee of the Olympic and Paralympic Games).

As well as a polyclinic in the Olympic village, LOCOG is providing primary care services in several of the hotels being used by accredited visitors during the games.

These are staffed by volunteer medics appointed by LOCOG in the run-up to the event.

'That's a process that's been going on for a couple of years,' says Dr Tanner. 'Highly qualified people from all over the world want to come and give service to the games.

'They take leave of absence from work, and they have to be temporarily registered with the GMC.'

In spite of the concern expressed in some quarters (see 'PCOs found wanting', right), Dr Tanner says he does not expect GPs to face a large amount of additional work.

'At any one time there are millions of visitors in London, and it's not common to have GPs saying they are inundated by that, so I do not see that as a major issue.'

The 'really important thing' for the NHS in terms of reputation management, he says, is that medical staff are familiar with official Olympics accreditation.

'If it's Usain Bolt you could probably recognise him, but it could equally be someone quite important that's unwell.

'Not that one wants different treatment for anyone, but you don't want prominent people to get unwell, not get treatment, and take [attention] away from what we are meant to be doing, which is looking after the residents of London.'

A significant part of the work done by Dr Tanner and his team has involved preparations for a large-scale emergency.

'We have had a number of exercises that have been fairly specific,' he says. But he also acknowledges there will always been a certain degree of risk. 'You can dream up one thing and another thing can happen,' he says.

And, he adds that 'you don't have to be a genius' to realise that the best-laid plans can go wrong - particularly when transport systems are involved.

Among the NHS London armoury is a piece of computer software that identifies the location of every pharmacy and GP surgery in the vicinity of daily Olympics road closures.

Dr Tanner says: 'We will be able to say to them: "On this particular day you are going to have real problems with your deliveries".'

To help minimise those problems, NHS London has worked closely with the Association of British Pharmaceutical Industries and companies such as Boots.

Some of the restrictions that limit the amount of stock pharmacists can hold will be temporarily lifted at times, to minimise the chance of them running out of certain drugs.

Above all, Dr Tanner is convinced the NHS will cope with London 2012.

'There will be people out there waiting for the NHS to fail,' he says. 'I think actually what we need to do is to remind people just how fantastic some of our NHS facilities are … Some of the doctors who are worried should be more confident about what the NHS can do for people.'

He is, he insists, absolutely not complacent.

'You can't predict every eventuality,' he says. 'But I feel that we are very well prepared, and that's a nice place to be.'

 

PCOs found wanting

GPs will negotiate the Olympics with 'a combination of good-will and muddling through' — and with no thanks to London's PCOs (primary care organisations), says Londonwide Local Medical Committees medical director James Heathcote.

Dr Heathcote says PCO clusters have offered insufficient support to GP practices in the capital in the run-up to the games.

That view was shared by the LMCs conference in Liverpool in May, which backed a motion condemning 'cluster intransigence in failing to acknowledge the level of pressure many London practices will face in terms of increased workload and patient access difficulties'.

The conference also criticised PCOs' 'unrealistic expectations' that practices could deliver all aspects of their contracts as normal.

Dr Heathcote says road access is likely to be a particular problem for GPs, with many routes closed and others congested. Unlike blue-light ambulance drivers, doctors will not be allowed to use the specially designated games lanes in London.

In a briefing sent to practices earlier this year, Greenwich LMC says GPs should lower their threshold for calling ambulances if patients at home are in urgent clinical need and visiting is likely to be problematic.

The document says: 'This may increase [emergency department] activity, which should normally be avoided. However, in extenuating circumstances, such as those you may be faced with during the games, it may be inevitable.

'We expect PCOs to be understanding of this.'

Dr Heathcote says GPs attending a recent meeting of Greenwich LMC were told by the Southwark Business Support Unit (an NHS directorate supporting clinical commissioning arrangements across south-east London) that they would all receive multi-zone parking permits. However, he says, these have yet to materialise.

Fellow Londonwide LMCs medical director Paddy Glackin (pictured) also believes GPs should have been consulted about decisions such as the siting of the Olympics media accommodation near two practices in north London.

'They could potentially find themselves with tens of thousands of additional patients,' he says.

In depth: Olympic and Paralympic Games 2012

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