Exclusive A ‘hot’ respiratory hub has been closed in North Staffordshire despite rising demand, Pulse has learned.
GP leaders told Pulse that the closure was due to the Covid funding that backed it ending.
But the CCG has denied the claims, saying the hubs in the area were closed because they were not being used.
Starting in April 2020, GP-led ‘hot hubs’ were set up around the country to diagnose and advise Covid patients not in hospital, keeping infectious patients separate from others attending their GP practice.
But Pulse has learned that the hubs are closing across the country, meaning that Covid symptomatic patients are now presenting at practices.
North Staffs LMC secretary and BMA GP Committee policy lead on NHS England Dr Chandra Kanneganti said that North Staffordshire’s hub was decommissioned at the end of June because the CCG said the Covid funding backing it has ‘finished’.
He told Pulse: ‘The CCG says those are clinics [backed] with Covid funding and the Covid funding finished, and the practices should make their own plans to have red zones to see Covid patients. So there [have been] no hot clinics from 1 July in Staffordshire.’
He added: ‘The 18 slots when the hot clinic was there were always full, so there is definitely a need there. Now the cases are going up there is much more need, but unfortunately it’s closed now.
‘They find funding for secondary care anytime but when it comes to primary care, nobody finds funding for us.’
And Dr Kanneganti said that ‘a lot’ of hubs have closed elsewhere in the country, in some cases also due to funding issues.
He told Pulse he is concerned that some small practices may not have the space to implement their own ‘red zone’, as well as about the ‘burden’ if staff are infected and forced to isolate.
He said: ‘We are taking a risk but we have to see these patients and as you know the Covid-positive cases are going up. My worry was more about the impact if a GP catches the virus and has to self-isolate for ten days – in a small practice that’s a huge impact.’
Practices are having to pay for higher-grade PPE that’s not eligible for reimbursement to protect their staff as they are not permitted to triage any patients to 111, Dr Kanneganti added.
He said: ‘There is no other way around at all. We can’t triage them to any other place except single practices now so that’s where we’re exposed. And my staff – some of them become Covid-positive, they have to isolate and we have to get them covered.
‘My worry is the GP colleagues – if [there are] two GP partners in a 4,000 patient surgery, if you just have one [due to isolation] and you can’t get a locum, then it’s a very big burden on the GP. That’s the problem.’
The BMA said that practices must be given any additional funding needed to operate either hot hubs or implement ‘red zones’ in their practices.
BMA GP committee chair Dr Richard Vautrey told Pulse: ‘The withdrawal of the national SOP for general practice means practices and their staff will decide if it is best to stop operating a hot hub model, and instead to care for suspected Covid-19 patients through each practice while maintaining appropriate infection, protection and control measures.
‘Should practices require additional funding to safely do this – such as funding for equipment, IT or premises adaptation – that must be made available to them.’
And an NHS England spokesperson told Pulse on background that CCGs are responsible for securing safe general practice services for their populations.
They added that commissioners have scaled hot hubs up and down according to current infection rates and that NHS England expects CCGs to continue with this approach while community transmission remains or if it creates a barrier to in-person access to general practice.
A spokesperson for the Staffordshire and Stoke-on-Trent CCGs told Pulse that the six hubs in the area were closed because they ‘weren’t being used’.
They said: ‘Only around 30% of GP practices were referring anybody to them – they’re across Staffordshire and Stoke on Trent so we’re not just talking about North Staffordshire. We were getting less than a hundred referrals a week – that’s an area with a population of 1.1 million.’
The spokesperson was unable to confirm the capacity of the hubs but added that they were ‘well below capacity’.
‘They were all tying up clinical resource and especially with the demand on primary care at the moment there was just far better use for the people who were working there’, they added.
Meanwhile, Leicestershire Partnership NHS Trust has re-commissioned a Covid virtual ward following a rise in Covid admissions across the area.
The virtual ward at Glenfield Hospital in Leicester was originally launched in late 2020 but stepped down in April 2021 amid a reduction in Covid cases. It was reintroduced from 26 July.
Deputy cardio-respiratory lead at Leicestershire Partnership NHS Trust Alex Woodward said: ‘Due to a significant increase in the pressure on the local healthcare system we had to restart our Covid virtual ward to support the flow of patients through the system.’
It comes as the Government is considering relaxing infection control guidance for GP practices.
The BMA has said that any new or updated GP infection control guidance must reflect ‘high Covid levels’ and the size and layout of practice buildings.
In February, almost 20 healthcare bodies, including the BMA, wrote to Prime Minister Boris Johnson calling for stronger PPE guidance amid emerging scientific evidence around the transmission of Covid-19.
It followed findings that coughing generated at least 10 times more infectious aerosol emissions than breathing or speaking – and recommended FFP3 masks in Covid hot zones and similar locations to reflect this.
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With the imminent licensing of possibly 2 antiviral treatments, there is likely to be huge demand from patients for F2F services to dispense the antivirals to symptomatic cases, which will need significant levels of availability of hot hubs if we are to avoid spreading infection in the green waiting rooms!
Does anyone believe what a CCG says? How naive.
CCGs / PCNs are why I resigned partnership. Best decision I made. ICSs are even more dysfunctional structures.