This site is intended for health professionals only

NHSE advises GPs to review Covid-19 outbreak plans including closures and ‘high’ staff absence

GP practices should review their Covid-19 business continuity plans, taking into account potentially ‘high levels’ of staff absences and the full closure of premises in the event of local outbreaks, NHS England has warned.

It said that practices should prepare to ‘maintain services’ if there is a local outbreak of coronavirus in a new update to its GP standard operating procedures, published yesterday.

But practice buildings may be required to shut to allow for cleaning and many staff may need to be off work due to sickness or self isolation as the NHS Test and Trace programme gets fully underway, it said.

It comes as the Prime Minister announced a significant relaxation of the lockdown in England on Tuesday, saying the Government does ‘not believe there is currently a risk’ of a second Covid-19 spike overwhelming the NHS. 

The document said: ‘It is recommended that [business continuity] plans are reviewed to capture the risks of Covid-19 and plans to maintain services. 

‘This should include local outbreak scenarios that could temporarily disrupt delivery of services from practice premises (for example, to allow effective cleaning) or disrupt staff availability (for example, if staff become poorly or are required to isolate) following NHS Trace and Test contact.’

It added: ‘Plans should consider high levels of staff sickness and self-isolation, call handling, staff and patient communication and, ultimately, denial of access to premises for staff and patients.’

NHS England reiterated that arrangements to maintain services could include the use of ‘buddying systems’ within PCNs as well as remote working.

However, Dr Farzana Hussain, a GP in east London and clinical director of Newham Central PCN, told Pulse that networks won’t necessarily solve the problem.

Dr Hussain’s network ‘very quickly decided to buddy up’ to cover practice closures during the pandemic but risk-assessments for vulnerable staff means they cannot be redeployed to high-risk areas during local outbreaks, she said.

Her PCN has 18 out of 19 partners from Black, Asian and minority ethnic (BAME) backgrounds, she added. A Public Health England report confirmed risk of dying among those diagnosed with Covid-19 was higher for people from black, Asian and minority ethnic groups.

Dr Hussain said: ‘It’s going to be very hard unless we do something nationally where we bring in a whole load of caucasians from another part of the country to help. 

‘Hospitals can do that because they’ve got bigger numbers but I can’t see how we can do that in the way primary care is set up as small businesses.’

She added: ‘I’ve been hearing a lot of ‘the networks will sort it, it’s fine – practices don’t need to worry”. But actually a network like mine won’t sort it.’

Meanwhile, Dr Hussain added that she has ‘lots’ of concerns ‘particularly’ around maintaining proactive services because those patients who may require more care are often also those most at risk from coronavirus.

She said: ‘These are real challenges on how we go back to the vast array of services that we were providing pre-Covid, particularly those proactive elements of general practice preventative work.’

The standard operating procedure added that practices may need to ‘prioritise their workload’ using ‘clinical judgement and experience of recent months’.

If services are disrupted, practices should inform commissioners, update the NHS 111 directory of services, follow Public Health England guidance on managing infectious disease outbreaks and communicate any service changed to patients, it added.

GPs have recently voiced concerns they may need to self-isolate for 14 days if approached by Covid-19 contact tracers, because they have no way of knowing whether their contact was with a patient while wearing PPE or someone they met outside the surgery. 

Last week, NHS England said GP practices may need to stop delivering routine services if there are further spikes in coronavirus cases.