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