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The waiting game

One in four GPs has seen Covid-positive patients with no PPE

A Pulse survey of 675 GPs has revealed that one in four have seen Covid-19 patients face-to-face without PPE, while more than half feel unsafe as a result of the lack of PPE.

The survey, conducted between April 17 and 21, also found that more than three-quarters fear for their health or life. 

GPs are continuing to struggle with PPE supplies, with only one-third receiving adequate facemasks, and only 13% and 12% say they have received adequate eye protectors and gowns (aprons) respectively.

Many of the GPs who have seen Covid-positive patients with no PPE said this was when travel history (ie, patients who had arrived from Italy or China) was – wrongly, in hindsight – being used as the main risk factor.

But a number of GPs said that they have seen patients who have been asymptomatic, but later found to have been positive at the time – which is indicative of the fact all patients should be considered potentially Covid-positive.

The survey found:

  • 74% of GPs fear for their health/life;
  • 26% of GPs have seen Covid-19 patients without PPE;
  • 52% of GPs feel unsafe as a result of lack of PPE;
  • Only 33% of GPs say they have received an adequate supply of facemasks; only 13% and 12% say they have received adequate eye protectors and gowns (aprons) respectively;
  • 61% of GPs say they are adopting a ‘no PPE, no see’ policy;
  • One in five GPs say they have had confirmed or suspected Covid-19;
  • 28% have had to self-isolate, increasing workforce pressures.

Public Health England changed its guidance to advise doctors to reuse PPE in certain situations. In the long term, health secretary Matt Hancock has announced that he is working with overseas factories, and that he has engaged 159 UK manufacturers to step up production. He said that around ‘one billion’ items a month were needed.

Pulse has reported on GPs relying on donations from dentists and patients for PPE.

Dr Tracey Turpin, a salaried GP in Durham, said: ‘We have no gowns, just plastic mini pinnies. My kids wear better protection for painting. We have eye goggles but only because donated by a school.’

There are also concerns that secondary care is struggling to obtain PPE, which will mean GPs will be less likely to receive equipment.

Dr Emily Armitage, a GP in NHS Vale of York CCG, said the CCG requested whether they could give some of the practice’s gowns to secondary care. She said: ‘We sourced some gowns (not many!) via a contact in our PCN and claimed the cost from the CCG. So knowing we had some, the CCG asked us this week if we would send them back to be used in secondary care - who are obviously in great need - which we have done.’

Dr Zishan Syed, a GP in Kent and a member of the LMC, said that the PPE guidance prioritise medics performing aerosol generating procedures (AGP)’. He adds: ‘[This] creates a divide between primary and secondary care with arguments of AGP being done predominantly in secondary care and not in primary care. This means that hospitals are prioritized for provision of FFP3 masks etc.’

Dr Nick Grundy, chair of GP Survival, said that Mr Hancock’s calculations are off: ‘A billion items a month would mean 166 million patient contacts all using two gloves, apron, mask, visor. This equates to 5.5m/day, which seems unlikely. Anyway, why are the government only discovering this now when it’s their job to know how many items/month they’d need in a pandemic?

‘Of course primary care is behind secondary care in the queue - but the fact that there is a queue is inexcusable, and the health secretary saying ever-larger numbers doesn’t get around that.’

Six GPs have tragically died with Covid-19.

Readers' comments (15)

  • GPs Practices are independent contractors, so it's not entirely clear why the NHS should be supplying PPE, or what is stopping Practices buying PPE should any be available.
    Of the sadly deceased GPs, the youngest was 57 years old and all were male; perhaps the best way of protecting GPs would be to stop face to face consulting for all male GPs aged 55 years and older.

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  • Stelvio.
    Independent GP practices (even in networks) do not have the financial or political heft to identify sources of PPE, bulk purchase and arrange delivery to themselves in good time to meet clinical demand.
    At present he least worst option seems to be for NHSE et al to do the procurement.
    Better the idiot one knows than...

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  • what is the right PPE for patients who are asymptomatic? N99 masks gloves and eye protection?

    im thinking alot of spread happens from surfaces in surgeries. i have been spraying door handles, computers etc with a antiviral spray. Probably pointless?
    but i was wearing masks on tubes in January so maybe it helps - who knows?

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  • Ivan Benett

    This is a shocking indictment now at least 4 months since knowing C-19 was on its way. Speaks to lack of preparedness, complacency and incompetence. It’s no good waiting until it’s all over and an inquiry. They could be years away. Need action now. Probably need to wait before reopening.
    As Boris would say “ Si enim hortus et in bibliotheca es in omnibus indigetis”. Or something like that :)

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  • Does the NHS have a "duty of care" to protect GPs, or as we are self employed, can they wash their hands of blame?

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  • Where's Optimus?

    Will only get worse with NHS England authorising NHS 111 .. access to direct booking appointments..

    Seen some places operating normal sessions mixed with CCAS sessions.. with ?? No full clean out inbetweeners..
    The virus could be on surfaces... thus putting the next staff or oblivious next locum at risk..

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  • Where's Optimus?

    Plenty goggles for sale on amazon...
    Body suits available..
    Masks more difficult

    As a locum you're on your have to look after yourself
    You cant rely on CCG or NHS England....
    Or practices for that matter.

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  • Roger - under Section3 subsection 1 of the Health and Safety at work etc Act 1974:
    (1)It shall be the duty of every employer to conduct his undertaking in such a way as to ensure, so far as is reasonably practicable, that persons not in his employment who may be affected thereby are not thereby exposed to risks to their health or safety.

    I take this to mean that the NHS has responsibilities not just to its employees but also its Contractors.

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  • Somehow typical of the Brits, in the middle of a crisis to start squabbling over who is to blame. That will definitely help

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