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Independents' Day

GPs concerned they may need to isolate if contact traced despite wearing PPE

GPs are concerned that they may need to self-isolate for 14 days if approached by Covid-19 contact tracers, because they have no way of knowing whether their contact was with a patient while wearing PPE or someone they met outside the surgery. 

Department of Health and Social Care guidance says contacts when wearing PPE do not count under the test and trace programme.

But GPs are concerned that because they are not told which of their contacts tested positive they cannot know whether they came into contact while in the surgery and wearing PPE or in day-to-day life.

GPs have now warned that colleagues having to self-isolate unnecessarily risks decimating the workforce, with some even expressing concerns that the system could be deliberately misused.

The system launched last month to control the spread of Covid-19 infections means that if someone is informed they have been in contact with a person who has the virus, they must stay at home for 14 days from the date they were last in contact with them.

DHSC guidance has also said that ‘if someone who works in – or has recently visited – a health or social care setting... tests positive for coronavirus, their case will be escalated to local public health experts, who will liaise with the relevant setting to agree on the most appropriate action’.

But Surrey GP Dr Dave Triska told Pulse that his practice has not been contacted by local authorities following one of his GP colleagues being traced and asked to self-isolate earlier this week.

Dr Triska's practice 'assumes' that the contact was a patient, but said they were not informed by NHS contact tracers if this was the case, just told the GP had to immediately begin isolation.

Guidance from the Department of Health and Social Care (DHSC) states that ‘close contact excludes circumstances where PPE is being worn in accordance with current guidance on infection, prevention and control’.

But speaking to Pulse, Dr Triska said: 'One of my partners was contacted by NHS Test and Trace this morning, and had to go home immediately, despite saying she's a GP. 

‘We have to obey the rules, but the initial problem is that we don't know if it's a clinical contact - it might be someone she bumped into in a shop. We can't be confident, as it's all confidential. People generally remember seeing the doctor, so we assume that's the case.'

Dr Triska added: ‘The team who called were pretty adamant, despite hearing that the GP wore PPE. Ideally, the first phone contact should establish this, rather than waiting for the next day or longer, and losing work. I'm flabbergasted.’

Also concerned about the programme, Dr Ankit Kant, a GP in Norfolk, said: ‘This [system of isolating on the basis of anonymous contacts] looks like it could be manipulated by individuals massively. Someone who may have a grievance with a GP surgery, or any business for that matter, could essentially close them down for two weeks.’

Meanwhile, Essex LMCs told Pulse they are currently in discussion with local public health teams about the potential issue.

BMA's GP Committee did not say whether they are concerned GPs may need to isolate unnecessarily, but its chair Dr Richard Vautrey said it was 'imperative' that PPE supplies are 'kept up and where they are limited, replenished, so that GPs and their teams are properly protected'.

A DHSC spokesperson explained to Pulse that they understand that health protection teams would carry out risk assessments of the environment, such as a GP surgery and use of PPE within in, prior to the sending of the notification for someone to self-isolate.

Earlier this month, deputy chief medical officer for England Dr Jenny Harries admitted that the absence of asymptomatic GPs and staff due to the test and trace programme would put pressure on practices, but she added it was especially important for healthcare workers to isolate if traced.

So far, a third of people in England who have tested positive since the tracing programme began have not been successfully reached by the scheme. 

In a further setback for the programme, the Government was forced to halt the planned rollout of its test and trace app last week after realising it was not yet a viable solution.

Readers' comments (14)

  • Vinci Ho

    It is bound to generate many contentious issues : we , GP, are subjected to both clinical(at work ) and non clinical (outside work) exposures . Once being traced , you are to isolate for 2 weeks if PPE was not worn .
    Perhaps , it is a logical argument to test frontline medical professionals twice a week ?
    Otherwise , this matter of ‘recovery’ is questionable where the workforce is to be challenged constantly by at least , the Trace part of the equation. Undoubtedly , the scheme needs to be implemented more consistently among those tested positive .
    After 4th of July , the risk is more about infection among relatively younger population as the vulnerable ones are still in shielding until august . The R rate could go up rapidly but the death rate might remain low . This is the phenomenon seen in Beijing , California right now .

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  • Hi Vinci and everyone - just to clarify, the problem is that the GP won't know whether their contact was a patient or was someone they came across outside the surgery, due to anonymity. Therefore, even if you wear PPE for every patient contact, you are relying on the public health teams to inform you if the contact was a patient or someone you contacted outside of work. If they don't inform you, then you will have to self-isolate regardless.

    Jaimie

  • Easy answer. Wear PPE with all patients. Its still the Standard Operating Proceedure to do so.

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  • I dont think our PPE is proven to stop us catching covid. So does it count as PPE.

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  • Wear ppe and sort your building out so all distanced so the worst outcome is one person working from home for 2w

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  • Why bother? Vulnerable people are not all shielding, and kids are back in school. R number is about 7 on Anglesey; will be higher if any of their kids are at school on the mainland; and government thinks it is better if lots of people die sonner, rather than protect our population and thence the economy.

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  • I wear PPE for all patient contacts, and I have patients wear face covering, but if contacted how do you know if it is a patient when you are wearing PPE or a close contact out side the practice??

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  • GPs went to medical school. Some still want to hug 'their' patients. A successful brainwashing by training institutes. You're doing 1 million consults a day. No other professional is. Don't be a sheep.

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  • The system clearly isn't working, and it isn't the only part of the system that isn't working. COVID is a notifiable disease, so ALL DOCTORS, GPs and hospital doctors have a statutory duty to report ALL CASES,EVEN SUSPECTED CASES.
    But NOIDS weekly reports indicates that only 164 cases of COVID, or suspected COVID were reported last week, and 326 for the week before.
    https://www.gov.uk/government/collections/notifications-of-infectious-diseases-noids

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  • Vinci Ho

    Wait a minute
    Why are the ‘contacts’ of the one tested positive NOT automatically tested but only advised to isolate 14 days ?

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  • Agreed Vinci

    Thought it was called Test and Trace -not enough Testing going on.

    If some of the contacts test positive, their contacts need tracing too.

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