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GPs go forth

Routine GP requirements to be relaxed amid 'significant' coronavirus epidemic

Expectations on routine GP services will be relaxed if the spread of coronavirus becomes a 'significant epidemic' in the UK, the chief medical officers have said.

In a letter to doctors, the CMOs of all four UK countries said they 'expect employers, educational supervisors, professional bodies, and national NHS and HSC organisations to be flexible in terms of their approach and the expectations of routine requirement' in the face of such a crisis.

The letter also said a significant epidemic 'will require healthcare professionals to be flexible in what they do'.

'It may entail working in unfamiliar circumstances or surroundings, or working in clinical areas outside of their usual practice for the benefit of patients and the population as a whole.'

BMA GP Committee chair Dr Richard Vautrey told Pulse: ‘As the number of cases of Covid-19 increases significantly nationwide in the way it is expected to, it is likely that demand on GP practices will grow.

‘GPs will need to be able to prioritise their time to care for those who need their expertise most which will mean reducing or stopping other more routine work.’

Speaking to BBC News earlier in the week, Dr Vautrey said this would include routine checks for blood pressure, heart disease and lung disease.

In an information note to GP practices earlier this week, NHS England said it is ‘reviewing current GP services in preparation for any need to release capacity’.

The note said: ‘We are taking steps to review the broad spectrum of current GP services to assess how additional capacity might be released if required. Similar work is also taking place across the other primary care professions.

'Further information will follow in due course should such steps need to be taken.’

But Pulse has heard from GP practices in Glasgow, Manchester, Norfolk, St Albans and Oxfordshire which have already stopped conducting routine appointments. 

This comes as GP practices are being forced to draw up their own emergency plans amid confusion over NHS England advice regarding how to examine and treat patients with respiratory illness.

The CMOs' letter also reiterated the GMC's reassurance that fitness-to-practise complaints relating to doctors during the epidemic will be viewed in context.

They said: 'We need to stick to the basic principles of being a good doctor. All doctors are expected to follow GMC guidance and use their judgement in applying the principles to the situations they face, but these rightly take account of the realities of a very abnormal emergency situation.'

Meanwhile, primary care minister Jo Chuchill has said that discussions are underway in the Department of Health and Social Care to free up GPs to deal with the coronavirus crisis by removing ‘all appropriate bureaucracy’.

GP leaders and cardiovascular experts have called for the suspension of QOF and health checks.

Prime Minister Boris Johnson is expected to chair a Cobra meeting regarding the coronavirus today, which could see the UK's response to the emergency escalated. 

Read the CMOs' letter in full

Readers' comments (9)

  • I will wait until I get a direct letter from the GMC, until then?

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  • How do I get away with not offering routine appointments?? _This could defer my retirement!!!

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  • GMC's reassurance that fitness-to-practise complaints relating to doctors during the epidemic will be viewed in context.

    Dear Dr, following 30 months of due process in context concerning the complaint in context about your practice in June 2020 during the Corona epidemic, we conclude that in context you are not fit to practice

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  • GPs routine work involves seeing those who are ill or who believe themselves to be ill. Covid-19 can present as mild viral rest tract infection or flu like symptoms (myalgia, malaise). There is no way to discriminate between Covid-19 and non Covid-19 without testing.
    I suggest GPs be able NOT to see any viral URTI or flulike illness, as now all these patients need testing - PHE needs to immediately put in place a massive rollout of testing for all URTI and flu like illness, irrespective of cost. This has been done in South Korea.
    Only then will we get a true picture of the problem.
    At the other end of the scale, the ITU bottleneck will be apparent very soon.
    If we are not there already, medics will soon be deciding who gets treated and who dies.

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  • I am intensely relaxed knowing that Charlie Massey's got our backs.

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  • Watch out for the knife in the back from MR Massey though.Charge at the Nazi machine gun nest with no weapons and a commissar at your back with a gun .

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  • Meanwhile, primary care minister Jo Chuchill has said that discussions are underway in the Department of Health and Social Care to free up GPs to deal with the coronavirus crisis by removing ‘all appropriate bureaucracy’.

    Maybe they could prioritise by removing ‘all INappropriate bureaucracy’ first?
    (free hint: CQC, appraisal etc)

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  • Tis article underscores my comments on testing etc.

    A scary but likely true analysis of the spread of Covid-19.

    https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

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  • This is not about patient first anymore. It is about your practice, the team, medicine and urgent patient need first. All practices are immensely powerful units that can dictate their area, and act as pillars to keep people home and reduce spread of this impending catastrophe. Strong decisive triage, reduced flow and clear diagnoses of the trivial and self limiting is key. Forget defensive medicine and say what is right and what is wrong. Let us put our heads high and command this now, because in 2 weeks we'll wish we had.

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