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The waiting game

GP practices must not ‘feel closed’ to sick patients, says NHS England

GP practices must make sure that they do not ‘feel closed’ to sick patients that need them during the coronavirus (Covid-19) pandemic, NHS England has said.

NHS England medical director for primary care Dr Nikki Kanani told GPs in a webinar last week that although practices must ‘absolutely’ remote triage patients and protect their staff, they still need to ensure that those who are ill ‘can get through’.

She said: ‘People are finding it hard to make sure they get help. We've had a number of children sadly die with non-Covid symptoms and I think it's really important that we try and make sure that our surgeries don't feel closed.’

The ‘problem’ with staying at home and complying with the Government’s social distancing rules is that ‘people are not necessarily accessing healthcare when they need to’, Dr Kanani added.

NHS England is working on public messaging to ensure that patients know they still need medical help for certain sets of symptoms not associated with coronavirus, such as stroke symptoms, she said.

However, she added that she was ‘asking for some help’ from practices.

She said: ’I know it's difficult because we've all changed operating model so quickly.’

NHS England’s latest standard operating procedure for general practice reiterated that all patients should be triaged remotely and practices should use remote consultations ‘where possible’, but that practices must maintain access to both urgent and ‘essential’ routine care ‘for all patients’.

Some face-to-face contact with symptomatic patients may also be necessary, so practices should designate areas and staff to the management of coronavirus patients or designate certain practices within their PCN as ‘hot hubs’, it added.

The guidance added that practices or PCNs must set up a dedicated home-visiting team for ‘shielded’ patients, unless a designated site has been set up for this.

Meanwhile, NHS England has committed to providing GPs with IT solutions including laptops to enable them to work remotely during the pandemic – amid criticism from GPs that their remote working was disrupted by IT issues.


Readers' comments (11)

  • Is this the same NHSE who asked GPs to review 1000s of letters overnight? The same NHSE who have micromanaged GPs to extinction over the past several years. Maybe it's time for NHSE to support rather than unload. I wonder how many GPs will walk away or reduce commitment once this crisis abates. Thanks once again NHSE.

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  • Vinci Ho

    I am sorry , Nikki , while I am fully understanding where you are coming from , the track record and credibility of NHS England in last few months leading up to this historic crisis of Covid-19 has been very poor . Fine , the passing of the Coronavirus Bill virtually have granted you and your organisation the full power to impose anything on our GP colleagues . You can even blame GPs are not doing enough to help the hospital situation and we should be altogether in this war .
    Question is , do you think you have done enough to help us(GPs) to help you ? The criticism on the government in PPE is unequivocal. Hospital colleague who died of Covid-19 had already alarmed the system way before . The fiasco of rushing GPs to pull ‘lists’ of patients needing shielding is beyond shambolic.
    While I am prepared to stand up to tabloid headline like ‘GP folded up their arms doing nothing to save Coronavirus patients ‘ , are you prepared to stand in front of your mirror to face another headline ,’ NHS England and GP leaders failed to protect frontline colleagues from dying ‘?
    I have said before that I fully respected collectivism in the middle of a national disaster but this can only be applicable in the presence of empathetic , understanding and sensible leadership. 😑

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  • They don't want to come in, they don't want to go to hospital, they dont want to get covid. Plus if they go in and deemed to have too much co morbidity they are sent home to die . They are terrified. Catch up NHSE, you are way behind and out of your league. Why aren't you demanding the PPE, demanding an immediate review of care home deaths. Immediate review of health care staff deaths. You are our employer. You are meant to protect us. When employees buy their own equipment and set up their own systems to manage does not speak well of you. Constant demands and criticism are signals of a bad employer. You will reap the consequences when this is all over.

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  • The only people that feels closed are NHSE who creates extra work for GPs to justify their existence. I certainly have no feelings of being closed. Just busy in a different way. Ears burning.

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  • I got a call from our local deputy GP CCG lead that my emails firmly rejecting or criticising the bullying & harassing torrent of emails from NHS & local NHS/CCG to have coded and reviewed shielded patients (despite no searches and our own computer system not due for required update until night of 15th - 1 day after supposed deadline), and to continue referring as normal (despite the CCG's own Referral Management Team having sent out email that the are not accepting non-urgent referrals for 4 weeks), amounted to "not being a team player".
    Local CCG does not have a duty to pass down instructions from NHS if those instructions are physically impossible to do, that at best just wastes my time and at worse is adding to my stress of being bullied.

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  • My dear Dr.Kanani,
    When all this is over would you be able to look yourself in the mirror and say ''Did I really dish out all that patronising garbage?''

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  • No reflection!

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  • Do not put children's deaths on our conscience. That is cheap. I WOULD LIKE PULSE AND THE COUNTRY TO KNOW AN OXYGEN TANK IN LONDON COSTS £79 OF A GPS OWN MONEY TO REFIL on top of the annual subscription. That is HIS/HER OWN SALARY. And NHS can't even supply us with that centrally. Or the mask, or tubing or emergency drug box. They'll make you see the sickest patients, give you nothing for it amd shaft you at the end.

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  • Firmly agree with all the comments made by colleagues above who have wise heads and probably been in the game for a while. Furthermore this is probably the reason I will look to reduce my clinical session in the future sooner than I wanted to. After first hand experience with NHS england ,don’t expect any compassion, empathy , but rather passive aggressive approach to an endpoint.

    Just take the comments from the article above , ‘ practices should not feel closed’, if your phone lines are busy and surgery door is open with clear message about triage , what more can we do ? But you can feel the undertone and insinuation, ie children have died due to non COVID....which is generally how NHS england works, no solutions just dictatorship.

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  • Personally speaking, i am reviewing all my patients every day. I give them all a phone call first, then drive past their door in PPE from Amazon. I have prioritised everybody as Urgent class 1 Priority. I am also transporting all discharges from hospital to their home and setting up high dependency units in every house. And care home. I am delivering piping hot fish and chips to the elderly. And of course I am reading every document from NHSE, DOH, HmGOV and CQC. without these, I wouldn't have a clue what to do and would just be sitting in a cardboard box somewhere. Please, more guidance - especially the anonymous ones like those from NHSE, I suspect these are actually from God but can't prove it yet.

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