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GPs go forth

RCGP's 14 May letter to the health secretary on Covid-19 testing strategy

The full letter from RCGP chair Professor Martin Marshall to Matt Hancock 

As we move to the next stage of tackling the Covid-19pandemic and begin to ease lockdown restrictions, there will inevitably be a focus on testing, tracking and contact tracing as we work to avoid a second wave of infection over the next few months.

Now that testing capacity has increased, it is essential that we move away from a focus on hitting targets, to having a comprehensive testing strategy that has the confidence of both the medical profession and wider population.

We should be taking a joined-up approach across the NHS, social care and community care including care homes. Any testing strategy should support the existing national effort to contain the virus, support key workers and prevent a second wave of infection, to keep the entire UK population safe and healthy.

It therefore must continue to ensure that the right people are tested at the right time to protect key workers and vulnerable patients. It should help us understand the virus and its spread better through test, track and trace. It should deliver timely results that patients and healthcare professionals can have confidence in.

We are aware of concerns among healthcare professionals regarding the accuracy of some test results. It is crucial that healthcare professionals have adequate guidance and transparent communication from government about testing so that they can interpret and act upon results.

Additionally, we know that the distances that tests are travelling to labs and the wait time for results is undermining confidence in the process and results themselves. Any testing strategy must therefore commit to building confidence in the process, including a commitment to improving the sensitivity and specificity of the tests.

The crisis of the infection rate in care homes has put them on the front lines of this pandemic. In the absence of a clear strategy and with delays in social care planning, patients have been left vulnerable.

GPs and their teams are doing their best to continue to give care, but it is essential that any forthcoming approach enables them to have access to testing to protect their patients. I am sure you will agree that now is the time to move beyond an arbitrary focus on numbers and targets and ensure that our loved ones in vulnerable settings are given particular protection.

Over the last few weeks, we have been involved in discussions with NHSX and others about the forthcoming NHS Covid-19 App and we appreciate that its success will be an important component of ensuring that the R value remains below.

However there needs to be transparent public communication about the importance of test, track and trace and how the NHS Covid-19 App is an innovative and experimental way of doing this.

We need reassurance and clear explanation that there will be other measures in place to support effective testing, tracking and tracing. A comprehensive testing strategy would be bolstered by making testing kits readily available for those recording symptoms and the provision of clear guidance for GPs on how to assist their patients with accessing a test.

Continuity of care could be secured by ensuring pathology labs update GP records with testing results, which would also help to trace positive COVID-19 cases. Whilst there have been clear strides to improve testing capacity, and whilst we recognise the work of Government and a range of stakeholders, we do not believe that there is sufficient clarity on a joined-up comprehensive testing strategy to prevent a second wave of infections and to secure the overall health of the population.

As we ease lockdown over the coming weeks and months it is essential that the profession and patients have full confidence in the approach to test, track and trace. I would be happy to meet with you and colleagues from Public Health England to discuss further.

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