The far-reaching impact of the Covid-19 pandemic has been well-documented, and while front-line resources have found themselves stretched, other medical services have also fallen victim to its effects.
Some key services and planned treatments have been reduced or delayed as a result of the lack of staff caused by health workers being redirected to support the front-line against Covid-19.
The issue prompted renown oncologist Professor Karol Sikora to take to Twitter this week, warning that “coronavirus tunnel vision” had caused the “biggest cancer crisis” of his lifetime and that the disruption to diagnosis, treatment and research “will cost countless lives”.
While cancer services and others have felt the pinch, one provider of diagnostic and post-diagnostic services for individuals with neurodiversity, Chester’s Axia ASD, were determined not to allow the Covid-19 pandemic to put a complete halt on provision.
Leadership in Focus
Axia ASD's educational lead, Sue Power, explained that the service had to restructure and change to deal with the effects of the pandemic.
Speaking to The Parliamentary Review, Power said: “The Covid-19 pandemic and social distancing guidance has meant services have had to temporarily redesign their ways of working. We and our clients consider neurodevelopmental assessments to be an essential service and have therefore adapted how we work within the current climate, rather than postponing assessments.”
By implementing a combination of virtual appointments, social distancing and increased hygiene, it has allowed Axia ASD to continue carrying out neurodevelopmental assessments and post-diagnostic support through the height of the crisis.
Power added: “Specialist neurodevelopmental input is essential for the biopsychosocial, and educational, wellbeing of individuals who have suspected or confirmed neurodevelopmental difference. Having access to knowledge and understanding about how and why people experience the world the way they do can be crucial to their health, wellbeing, and opportunities, and we had to continue with this.
“Poignantly, as the Covid-19 lockdown was announced, we received several concerned phone calls from individuals and families, citing fear that if their appointments were cancelled, the risk of self-harm and suicide would escalate.”
Power was concerned that if neurodevelopmental assessments were delayed like other essential health services, the impact on the lives of patients could be detrimental.
“Overall, deferring neurodevelopmental assessments could clearly be extremely detrimental to the lives of many individuals and families, both in the short and longer term. Further, without timely assessment then the financial cost to health and social care services could be larger, as people may be at risk of going into crisis.
“For these reasons we have continued to operate our business as usual, with some slight structural adjustments and adaptations.”
Although those who use Axia ASD’s services have had to adjust to the changes, Power explained that the new system has been largely well-received by those that have used it.
There were also many people who came forward to make use of the new services, whose issues would have gone unaddressed had services been halted.
She said: “Between the announcement of lockdown on March 23 and early June, we assessed 113 individuals face-to-face and 116 individuals via Skype. One hundred and forty-five people received diagnoses of autism spectrum disorder during this time, and seventy-five people received diagnosis of ADHD. We saw 163 children and 66 adults.
“We saw six for follow-up appointments by skype or phone, and zero for face-to-face appointments. We had 18 DNAs.
“The service user experience of the adaptations has so far been assessed informally by verbal means and Facebook. We have had lots of positive verbal feedback about continuing to offer a service in the current climate. People have commented how essential and timely the assessment was, in reference to preparation for education re-opening in September.
“Our usual quality indicators highlight that people continue to experience a positive service from us. There have been no complaints since our current offer has been in place.”
It is testament to Axia ASD’s ability to adapt that local neurodevelopmental services have not fallen into a perilous state and added to the growing health crisis.
Former US vice-president Joe Biden has warned that peace in Northern Ireland must not become a “casualty of Brexit” and that a US-UK trade deal depends on a hard border being avoided on the island of Ireland.
The Democratic candidate tweeted: “We can’t allow the Good Friday Agreement that brought peace to Northern Ireland to become a casualty of Brexit.
“Any trade deal between the US and UK must be contingent upon respect for the Agreement and preventing the return of a hard border. Period.”
Foreign secretary Dominic Raab has travelled to Washington this week in an effort to reassure US politicians over the Internal Market Bill, while back in Westminster prime minister Boris Johnson has agreed to amend the legislation to ensure that MPs must consent before the powers outlined in the bill can ever be invoked since it would breach international law.
US secretary of state Mike Pompeo said that he trusted the UK to “get this right”, while US speaker of the House of Representatives Nancy Pelosi had fired a warning last week that no UK-US trade deal would be approved by Congress if the Good Friday Agreement were to be undermined.
Pelosi said after a meeting with Raab that Brexit could not “imperil” peace in Northern Ireland, vowing that the House of Representatives would defend the Good Friday Agreement as a “beacon of hope for peace-loving people throughout the whole world”.
Meanwhile, the EU has insisted that it has conducted trade negotiations with the UK in good faith, after Boris Johnson recently suggested the contrary.
During talks on Wednesday evening with the Liaison Committee, the prime minister said “I don’t believe they are” when asked by Labour MP Hillary Benn whether he felt that the EU was negotiating in good faith.
Since that exchange, the Telegraph has reported that the European Commission’s chief spokesperson Eric Mamer, has declared: "I can point to our hundreds - literally hundreds - of international agreements signed with very, very different third parties of all kinds.
"And I think that they testify to - as I think you say in English - a rather splendid track record when it comes to carrying out negotiations in good faith, and indeed even concluding them.
"So, what I would simply do is ask you to go and talk to those third parties with whom we have signed these agreements and further they will testify to the quality of our negotiation.
"And I think that Michel Barnier showed in the context of the negotiations on the Withdrawal Agreement that even on extremely complex and politically sensitive issues the Commission and indeed the EU negotiate in perfectly good faith."
Leadership in History
September 18 is a landmark day in the history of leadership. Going back to the year AD 96, this date saw Nerva Proclaimed Roman emperor following the assassination of Domitian.
On this day in 324, Constantine the Great decisively defeated Licinius in the Battle of Chrysopolis, establishing his sole control over the Roman Empire.
In the year 1066, Norwegian king Harald Hardrada landed with Tostig Godwinson at the mouth of the Humber River on this day, beginning his invasion of England.
On this day in 1180, France celebrated the coronation of a new king as Philip Augustus ascended the throne at the age of fifteen.
In more recent times, September 18, 2014 saw Scotland vote against independence from the UK, by 55 per cent to 45 per cent.