It has been a long hot summer, I feel we’ve gone back to the 70’s or 80’s when summers were always hot and sunny, we had hose pipe bans — and an amazing Royal Jubilee, Kate Bush was in the charts and we were all wearing floaty long dresses or starting to put shoulder pads in everything. We also had the winter of discontent when so many industries went on strike — and it’s starting to feel like we are in for another cold hard winter just like that one — but with the after effects of the COVID-19 pandemic overlaid onto it. People making a choice between heating and eating — especially our frail elderly population; we may well see increases in homelessness as people fall behind with spiralling mortgage costs. This being the case how do we continue to provide care for these our most vulnerable of patients?