Reflections from the frontline

“We have a unique chance to force change, we shouldn’t let the opportunity pass”

Sam Barke Covid DocDr Sam Barke, OW & Whitgift School Sports Doctor
Usual Job
: Sports doctor & Orthopaedic Surgeon
Covid-19 Role: Redeployed to Intensive Care

With organised sport and elective operating cancelled early on in the crisis, I was available for redeployment and was asked to go to NHS Nightingale North-West in Manchester for the first weeks of its existence. Like most Nightingale hospitals we ended up receiving far fewer patients than we’d prepared for. This is obviously a positive thing as it means the NHS has been able to manage cases within its existing resource.  Since mid-April I have been back in London and am working in an Intensive Care Unit (ICU).

Last week I wrote to a group of colleagues asking them how their working lives had changed during COVID. Many of the responses were as you’d expect – long hours, high stress, disruption of normal routine – but every reply also highlighted positives. Processes that have been needing change for years that have now been rushed through, camaraderie in the workforce and the appreciation from the general public of the work that healthcare professionals are doing.

For me, the biggest take-away when this is all over will be what can be achieved when “needs must”.  People will have seen much in the news about how quickly the Nightingale hospitals were built but what has been far more impressive is how quickly working practices have been conceived and implemented across all NHS hospitals in a situation that we had no blueprint for. Healthcare workers have had to adapt quickly and have been required by necessity to work out of their comfort zone and deal with situations that many have not felt prepared for.  I have felt great pride in seeing my junior colleagues – many who are only a year or two out of medical school – take on responsibility that is usually reserved for far more experienced doctors and doing so with great professionalism.  This is a credit to them but has only been possible because of a flattening of hierarchy and the return of feeling truly part of a team and being supported.

While much of our work has been upsetting – the mortality rates in intensive care units is well documented – it has also been rewarding. I feel hugely privileged to have watched patients talk to their families (via FaceTime, of course) after weeks on a ventilator, see them take joy in eating for the first time in over a month, and clap them as they are discharged from the intensive care unit.  But, as hard as it has been, I also feel privileged to have been able to care for the dying.  To pass on messages of love from their loved ones who can’t be by their side, to hold their hand in their last moments, to be there to say goodbye.

It looks like we will shortly be starting to reopen non-emergency health services and I will await the call as to when I can return to orthopaedics. It is becoming increasingly clear that there are indirect health issues that have been created from delays in access to treatment during the crisis and it will take significant resource to try and clear that back log and minimise the long-term impact.

There will understandably be a temptation to rush back to “normality” as quickly as possible when this is all over but we have a unique chance to take a moment , reflect on some of the positives that have been seen during the crisis, and to implement change that is long overdue to ensure those positives remain.   We shouldn’t let that opportunity pass.

Reproduced, with permission from