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GPs express concern about practice infection control under ‘Living with Covid’ plan

GPs express concern about practice infection control under ‘Living with Covid’ plan

GPs have expressed concern about the safety of vulnerable patients visiting their practices, as Covid isolation requirements and free testing is scrapped in England.

GPs said cash-strapped patients, without free testing, may attend with no way of knowing they have Covid – thus putting extremely vulnerable patients at risk.

Other GPs said mask wearing must continue to be advised in healthcare settings, with the lack of clarity on guidance putting GPs in an ‘impossible situation’.

It comes as the Government announced its ‘Living with Covid’ plan on Monday, meaning free Covid testing for most of the population in England will end from 1 April, except for the most elderly and vulnerable.

Mandatory self-isolation for those who test positive will also no longer be legally enforceable from tomorrow (24 February).

NHS England told Pulse that continued Covid testing for GPs and practice staff is being reviewed, and will be updated before 1 April.

GPs also remain in the dark over whether new self-isolation rules coming into force tomorrow apply to them.

Writing on Twitter, Lancashire GP Dr Mark Spencer said the news ‘really concerns me… as a GP’, as he ‘may see a patient who quite possibly has Covid but has no way of knowing that, and then the very next patient I see is on chemotherapy’.

He asked: ‘How can I keep my most vulnerable patients safe?’

Chief executive of Lancashire and Cumbria consortium of LMCs Peter Higgins complained that there is a ‘complete vacuum of support and guidance from NHS England at the moment’, placing GP practices in an ‘impossible situation’.

He told Pulse: ‘It sounds like a free-for-all to me. If you are in a practice, you’re dealing with vulnerable people, you need to protect them.’

Dr Higgins is especially concerned about what Living with Covid signals with regards to mask wearing and other IPC measures.

He said: ‘What worries me is that practices will still want to implement control of infection measures and ask about wearing masks where necessary, but some of the public are going to be turning around and saying, “No, we don’t need to.”

Dr Higgins is also concerned about the cost of Covid testing for patients who may wish to attend a GP practice but can’t afford tests.

He said: ‘A lot of people that may not be vulnerable, but they might not be able to afford lots and lots of tests. There needs to be something put in place for people who need to attend or want to attend the practice to have a supply of tests available for them.’

Regarding the plan as a whole, he added: ‘It’s not satisfactory at all. What we need is some leadership and guidance from our secretary of state.’

Meanwhile, Essex LMC deputy chief executive Dr Vaiyapuri Raja expressed that the relaxing of Covid guidance had been too ‘drastic’.

If NHS staff cannot get access to free testing, it will be ‘a disaster’, he added.

‘They are going to be coughing and spluttering right in front of the patients. That’s going to be a nightmare.’

Dr Raja also hopes masks in GP practices will continue to be advised, as otherwise staff will be open to patient abuse if they try to enforce local rules.

He said: ‘Now that the Government has said you don’t need to do anything, there’s going to be some very difficult conversations and that might lead to abuse of staff.’

Birmingham GP Dr Liz Croton, from Doctors’ Association UK’s GP Committee, told Pulse she was concerned the removal of restrictions ‘will cause a greater resistance to the wearing of masks in healthcare settings putting other patients and staff at risk’.

She said: ‘We are very much dependent on people choosing to do the right thing with regards to infection and protecting others and we are not confident that this behaviour will be followed consistently. 

‘Many people who are clinically and extremely vulnerable have co-existing chronic illnesses which require regular attendances at their GP surgery.  With the removal of the requirement to self-isolate with symptoms, there is a real risk that vulnerable people could be put at unacceptable risk at their surgery.’

Dr Croton added: ‘We look forward to some meaningful and pragmatic guidance from NHS England as to how to protect vulnerable patients in healthcare settings and would support the continuation of mandatory mask wearing in these environments.’

Prime Minister Boris Johnson told MPs on Monday that ‘it will be for the NHS itself to determine’ whether healthcare workers continue Covid testing practices. The session also revealed that this would need to be funded from ‘existing budgets.

Following the Government’s announcement, BMA called for ‘urgent clarity’ regarding ongoing testing for healthcare professionals, arguing that this is essential for protecting vulnerable patients.

BMA council chair Dr Chaand Nagpaul said: ‘People visit hospitals and surgeries to get better, and not to be exposed to deadly viruses, and the continuation of testing for healthcare workers is invaluable in protecting both staff and patients.’

Dr Farah Jameel, BMA England GP committee chair, told Pulse: ‘GPs and doctors across the health service will be naturally very worried about what Monday’s announcement means for their most vulnerable patients as well as the safety of themselves and their colleagues.

‘A significant reduction in free testing will mean more people in the community going about their daily business not knowing that they have Covid-19. This poses a particular risk to healthcare settings, where many people are already very ill and at greater chance of becoming seriously ill if exposed to the virus.’

Stressing that Covid ‘has not gone away’, Dr Jameel said there ‘needs to be a strong, clear message from leaders that nothing has changed this week for healthcare settings’.

And she said that ‘with free PCR tests to end for those with symptoms from the beginning of April, practices will want urgent clarity about what this means for the way patients access services, and for infection prevention and control measures’.

‘Furthermore, ministers and NHS England must ensure practices continue to have access to free testing for staff – which is vital for ensuring the safety of our sickest patients.’



Please note, only GPs are permitted to add comments to articles

Azeem Majeed 23 February, 2022 9:56 am

It’s an issues for employers more widely and not just the NHS. In this article for the BMJ, myself, Lara Shemtob and Kaveh Asanati discuss the implications of the ending of the legal requirement to isolate after a diagnosis of Covid-19 in England. Employers will need to think about how they protect the health of their staff and the people who use their services.

Michael Mullineux 23 February, 2022 10:05 am

Do not await NHSE guidance which will be the usual unhelpful tepid whitewash (as demonstrated on multiple occasions during the pandemic)- carry on with infection control measures and risk mitigation that you as clinicians have all become used to or be prepared to become infection vectors with multiple staff members constantly off sick.

Patrufini Duffy 23 February, 2022 2:21 pm

The good old British GP waiting room, akin to the weekly trip to Weatherspoons or the betting shop, is no longer safe nor fit for purpose. Under Health and Safety Law, if you cannot keep your own staff safe (forget the public, that’s not your issue) then you are liable. Legally. Remember that. Your staff come first. I hated it anyway, playing with toys, fiddling with phones and letting their “emergency ill” kid run rampant, gawping at Loose Women on TV and leaving their leaflets on the chairs, whilst complaining why you are running late. Not missed one bit, come if you have a valid reason, otherwise self-care your boredom better. We’ve learnt too much, PTSD amongst staff exists, recognise it.