One in three single-handed GPs are at high risk from Covid-19, potentially leaving hundreds of thousands of patients without access to face-to-face appointments.
In a report, the Health Foundation called on CCGs to identify potential gaps in care and plan with practices and primary care networks how they will ensure patients have access to face-to-face appointments without endangering GPs.
NHS England wrote to GP practices in June asking them to complete risk assessments for at-risk staff. More recently the government announced it would fund a £2.1m study into the effects of Covid-19 on black, Asian and minority ethnic healthcare workers.
Research by the charity found that 32.7% of England’s 639 single-handed GPs are at high risk of Covid-19 due to factors such as age and ethnicity. The figure, which the report authors said was likely to be an underestimate, compares with 8% of GPs at high risk across England as a whole.
If they follow NHS England guidance and stop seeing patients face to face, it could leave around 700,000 patients limited to seeing their GP only by phone or video consultation, the Health Foundation calculated.
The impact would be felt most sharply in deprived areas where GPs are more than three times as likely to be in the high-risk category further widening health inequalities, the report warned
Figures show that single-handed practices run by a GP at high or very high risk from Covid-19 are more than four times as likely to be located in the most deprived areas of the country with London having the potential to be particularly hard hit.
The charity pointed out that in general single-handed practices – which serve almost 2.5 million patients – are particularly vulnerable to disruption should the GP fall ill or die of Covid-19. Locums who could provide cover make up 17% of GPs at high risk, the research also showed.
‘Our analysis suggests that a significant number of GPs would be at high personal risk from Covid-19 if they continue to consult face to face,’ the Health Foundation report concluded.
‘Doctors who are unable to see patients face to face may continue to consult via other means, including telephone and video consulting. Some higher risk GPs may decide to continue to see patients “as usual”. But surgeries need to plan for how to cover gaps in the provision of face-to-face appointments.’
Dr Rebecca Fisher, GP and senior policy fellow at the Health Foundation said unless urgent action was taken this could become another way in which poorer communities become further disadvantaged
‘It’s particularly worrying that GPs at higher risk from COVID-19 are far more likely to be working in areas of high deprivation.
‘Those are precisely the areas with the greatest health need, the biggest burden from Covid-19, and an existing under-supply of GPs relative to need.’
BMA GP committee chair Dr Richard Vautrey said: ‘As this data shows, some GPs working alone are at a higher risk of becoming ill from Covid-19 and therefore, potentially not able to see patients face-to-face. If needed, locum GPs can be recruited to help these practices, but surgeries need financial support to do so, as well as adequate space in their practices to accommodate another practitioner.
‘This research therefore not only highlights the need for more GPs in the system, especially in deprived areas, as well as the continued provision of effective PPE, but also free access to comprehensive occupational health services to support clinicians with risk assessments.
‘Patients should not be left to worry about being unable to see their doctor in person, but neither should GPs be put at risk or feel unsafe. Following significant pressure by te BMA the Government has finally released funding to support the additional costs of responding to the pandemic for general practice, but we now need CCGs to provide the necessary support to those working in isolation, both for their own health and that of their patients.’