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GPs go forth

‘Dad’s Army’ to the coronavirus rescue? How about a real plan?

Dr Sean Morris

The big Government battleplan to rescue the NHS from coronavirus (Covid-19) has been released, with proposals for former doctors to be brought out of retirement to fill the inevitable staffing gaps.

This is despite the increasing mortality rates the older you get: approximately 4% aged 60-69, and 8% aged 70-79. Apparently there’s a whole batch of retired doctors ready to jump at this unique opportunity to put themselves at risk. I can’t see it somehow. What worries me is that normally Governments leak their best ideas for a good headline. Is a ‘Dad’s Army’ of the NHS the big plan? Let’s hope not.

In the spirit of hope, I thought I’d share a few ideas which will actually help and can be implemented quickly. There are three strands to the plan:

1. Protect the staff we have;

2. Maximise the appointments we have;

3. Support staff willing to work extra shifts

The first issue is we need to protect the staff we’ve got. The more staff who catch Covid-19, the more gaps we have to fill in the NHS at the very time demand is highest.

The Government needs to roll out proper personal protective equipment (PPE) to GP practices, and fast. We need a ready supply of appropriate masks and clothing. Currently, we’re sitting ducks with every cough and cold presenting a risk.

Suspend online booking, let us screen all patients for symptoms, and prevent them entering surgeries where they can pass on the virus to staff and patients alike.

Italy is already suffering from the number of GPs having to self isolate - let’s learn from their mistakes.

If we’re going to take the pressure off hospitals in these unprecedented times, risks must be taken

The second thing we need to do is maximise the staff time and appointments we already have. We need to free up GP appointments for the inevitable increase in demand. Abandon QOF and other targets this financial year. Payments should be be made either based on last year’s results, or current projections, whatever’s higher. The last thing we want in March is a scramble for hypertension checks when a pandemic takes hold.

Furthermore, we should suspend CQC inspections with immediate effect. We don’t need practices reviewing pointless protocols to satisfy tick box CQC exercises. Let’s use that wasted time to help patients.

And whilst we’re at it, let’s get the CQC inspectors in practices working. As the CQC always says, they’re committed to ‘high quality care’, so I’m sure they’d be happy to loan their staff to practices struggling to fill rotas due to quarantine and self-isolation.

Finally, if clinical staff are willing to work more, the Government need to make this as easy as possible. Scrap the pension annual allowance taper with immediate effect.

I know plenty of doctors who are having to refuse extra Covid-19 shifts with the 111 service, due to fears over large tax bills if they breach certain salary thresholds. At a time of crisis, this is madness.

Bring in a Covid-19 indemnity scheme, so that staff who work extra shifts aren’t penalised with extra indemnity payments.

This would be similar to the previous winter indemnity scheme, so easy to set up and not as costly as previous systems, due to the state backed indemnity scheme already present.

And, finally, we need to support the difficult decisions doctors will inevitably have to make. Can we safely treat a patient at home? Is the patient safe to self-isolate? Mistakes will be made.

Despite our best efforts, cases of sepsis will be missed. These are unprecedented times, and if we’re going to take the pressure off hospitals, risks will have to be taken. Italy is admitting over a third of patients with Covid-19, and China built hospitals in under a week. Get the GMC to support doctors in these challenging times, and not haul them in front of disciplinary panels.

Whilst ‘Dad’s Army’ won’t save the NHS from Covid-19, the current army might have a chance if we’re given the help we need.

Dr Sean Morris is a salaried GP in London

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Readers' comments (14)

  • sensible advice but will be ignored. which is interesting in itself.

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  • Have you forgotten to mention scraping the pointless and extremely expensive waste of resources known as appraisal?

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  • ''I know plenty of doctors who are having to refuse extra Covid-19 shifts with the 111 service, due to fears over large tax bills if they breach certain salary thresholds. At a time of crisis, this is madness''

    I beg to differ. Even at at time of non crisis it is fucking madness. But ladies and gentleman I give you the Tory party...

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  • Good ideas - we need to keep them coming. Someone needs to see some sense.

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  • I checked the GMC register against the names of my classmates who graduated in 1981, having recalled the names of about half the class . I am the only person with a current licence to practice who is not currently in work ( all the others with licenses are connected with a Responsible Officer in a care provider ). Half of my sample has relinquished registration and a quarter has no license . A big logistical challenge to overcome . I’d be happy to step into any medical school role to free up my colleagues there for clinical work anytime !

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  • got email for mask fitting from local ooh service 1 month ago replied no answer yet-supposedly only 2 people in whole of Grampian can teach mask fitting mmm

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  • Far too sensible. It will spoil the plan to get the old doctor's pension when they see patients with zero protection.

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  • ....As the CQC always says, they’re committed to ‘high quality care’, so I’m sure they’d be happy to loan their staff to practices struggling to fill rotas due to quarantine and self-isolation......

    Excellent point, sadly you forget the sort of people who do the government's dirty work for them behind the facade of the CQC, are the sort of clinicians who either cannot cope with, or no longer wish to do the useful clinical work they were trained for and instead opt for an alternative career of bullying and harrassing their hard working colleagues on the front line.

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  • I agree with scrapping QOF, but not short term, but for good. Three quarters of preventative medicine is not cost effective and based on weak, if any evidence.

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  • Sean you are much more sensible than Nikita Kanani, and much more useful to patients...... asking to triage already booked appointments is sheer stupidity...... as what happens if you can't call back/ patient doesnt answer?...they turn up at the practice. I would be curious to know what your colleagues think about NHSe current stance? Does your team support what NHSe is doing? I dont know anyone who isn't critical of them over the ability to turn off online bookings... it must be a hancock technology fetish thing......

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