Exclusive GP practices are continuing to triage patients remotely against NHS England guidance to protect their staff and patients against Covid, Pulse has learned.
In May, NHS England said that practices must offer all patients face-to-face appointments if that is their preference, while receptions must be open for walk-ins.
But current IPC guidance states that in primary care settings ‘where possible and appropriate, services should utilise virtual consultation’.
And practices across the country – backed by GP leaders – are sticking to the total triage system beyond next week, when all legal coronavirus restictrions will be lifted in England.
Liverpool LMC medical director Dr Rob Barnett told Pulse that the LMC has always advised practices to continue triaging patients remotely to protect patients and staff – and will continue to do so after the 19 July unlocking.
He said: ‘We have been recommending all along that practices didn’t allow walk-ins and patients should be triaged prior to accessing the premises.
‘There were issues at one point with patients saying they’d done a lateral flow that was negative so why couldn’t they just come in.’
Dr Barnett added: ‘We had the LMC meeting [last week] and there was a discussion on what we should be doing post 19 July. There was a general feeling we should be maintaining our current strategy of mask-wearing, social distancing and triage.
‘It was felt there was a difference between opening up shops, where people go when they’re well, and practice premises. We have had discussions with our director of public health and I’m hoping there will be general support from public health locally.’
Nottinghamshire LMC chief executive Michael Wright said that ‘a number of practices’ in his area are also closed to walk-in patients for safety reasons.
He said: ‘We already have a number of practices preventing people from walking in and with rising cases, despite the changes on 19 July, practices still have to safeguard patients and themselves.
‘It’s already very mixed across our area and will no doubt continue to be so past 19 July unless firmer advice/guidance comes out nationally in the meantime.’
Mr Wright added that practices are contractually able to choose how best to ‘meet the reasonable needs of their patients’, including by limiting face-to-face contact.
He said: ‘We will defend any practices who decide to limit face-to-face entry as long as it’s clear how to access them, that they remain “open for business” and that clinical decision-making is at the forefront of how patients will be triaged and attended to.’
Essex LMC deputy chief executive Dr Vaiyapuri Raja added that total triage and other social distancing measures ‘should continue in general practice’.
He told Pulse: ‘We are in the middle of a third wave and all precautions should be taken to prevent the spread within the practices.
‘Total triage of patients, wearing of masks/face coverings and social distancing measures should continue in general practice.’
Both LMCs and the BMA have advised practices that NHS England’s guidance has ‘no contractual force’, and the BMA has warned that many GP practices are ‘not yet safe’ for walk-in patients due to unsuitable reception areas.
GPs have also previously warned that many Covid-symptomatic patients are now attending face-to-face appointments having only had a negative rapid lateral flow test (LFT), putting GPs and staff at risk.
It comes as NHS England has today told patients and staff they should continue to wear face masks and maintain social distancing in GP practices and other healthcare settings after Covid restrictions end in England on Monday.