Dr Poppy Freeman set up the Covid-19 Primary Care Resource website at the start of the pandemic. It has provided thousands of GPs with a easy-to-use toolkit that provides GPs with up-to-date guidance with all the necessary recent clinical and organisational Covid updates. The site will be moving over to PulseToday imminently, and ahead of that, she talks us through her motivations and how the toolkit can be used
What motivated you to set up the toolkit?
In early March I was unsure of what I could do to help, and panicked by the lack of information. Despite lots of conversations and emails I felt there was a lack of clear, usable guidance applicable to primary care.
Within a few weeks the situation had changed, but now GPs were facing a deluge of information. I remember patients telling me that they felt completely confused by Covid-19 guidance. Admittedly I felt exactly the same way.
I found it very hard to track the right information, as multiple government and medical organisations were rapidly publishing and revising very large documents across the internet. The distribution was ad-hoc, and not helped by the absence of a well organised, authoritative resource to refer to. I was reliant on colleagues emails, GP Facebook, WhatsApp, and sporadic webinars to understand what was happening, but these resources were hard to reference when in clinic.
Although these issues felt overwhelming, they didn’t feel new. The pandemic exacerbated what is an ongoing problem for primary care; GPs have to navigate huge amounts of information from disparate sources across the NHS and social care whist busy with patients.
How did you think a website was going to resolve the issue?
I have spent over ten years setting up digital platforms to disseminate information on clinical services and pathways to primary care. In my experience, and when done well, clinically designed websites can deliver information which is usable within real time patient encounters. To achieve this you need well written synopses combined with a good interface and accurate search functions. Ten years ago, I set up the Camden GP website, which acted as one stop web-portal for GPs in Camden, London, providing rapid access to clinical pathways, a service directory, commission updates, training and events information. We had success with this and were pleased that it won several national awards, and was rolled out in to other areas across London.
How did you set up the Covid-19 resource toolkit?
My web-developer colleagues, Shed Collective, and I wanted to contribute to the crisis we were all facing. So we rapidly built a website tailored to store and navigate all the Covid content for primary care. I summarised guidelines for quick access on the site as they appeared and formed a group of key contributors. This network of contributors routinely suggested and summarised good resources, and provided expert responses to questions that GPs submitted through the website. In particular, Dr Sarah Logan and the UCLH infectious disease team, and mental health experts at KCL and South London and Maudsley NHS Foundation Trust, have been amazing at answering GP queries and providing expert opinion.
It’s been a great reminder of what doctors can do quickly when they work together for the benefit of each other and our patients.
Infectious disease consultants rapidly answered questions such as how to interpret skin manifestations of Covid in response to articles in the news which were difficult for GPs to place in context. Queries about interpreting antibody test results were also rapidly answered and then widely shared as soon as we started having our antibody tests done in primary care.
This has been a good example of true integrated care; GPs, specialists and allied health professionals working together. The website has been shared between primary care colleagues and we now have over 4,500 GPs using the website on a regular basis during clinic hours and we have had some very positive and helpful user feedback.
What do you think has been the most useful aspect of the toolkit?
The most looked at webpage on this site is this one on assessing and triaging suspected Covid cases. I think that is because it has been reorganised for GPs and is easy to bookmark and access quickly in clinic. It is a summary of 80 pages of guidance from 5 different sources.
Being able to quickly share recommended resources from colleagues was also key. The fatigue page was looked at by hundreds of GPs during clinic hours weeks before any national guidance was developed and is a summary of great local resources recommended by GPs from across the UK.
How will you manage to sustain the toolkit on PulseToday?
Obviously sustaining this resource voluntarily is hard. I’m really pleased to have found a home for the content in PulseToday. It will be shared with a wider network of GPs whilst remaining free to access. I’m also pleased to be helping Pulse to set up a new clinical toolkit to build on this initiative to support primary care.
I’d like to thank all the key contributors who helped set this resource up:
Dr Sarah Logan, Hospital for Tropical Diseases, University College London Hospital
Dr Vibhore Prasad, Academic Clinical Lecturer in General Practice, Department of Population Health Sciences, KCL
Dr Melissa Heightman, Respiratory Consultant, University College London Hospital
Dr Johnny Downs, Senior Clinical Lecturer and Honorary Consultant Child and Adolescent Psychiatrist, Institute of Psychiatry, Psychology & Neurosciences, KCL
Dr Penelope Elphinstone, GP with special interest in medical ethics and law
Dr Tim Nicholson, Senior Clinical Lecturer and Honorary Consultant Neuropsychiatrist, Institute of Psychiatry, Psychology & Neurosciences, KCL
Dr Jayati Das-Munshi, Senior Clinical Lecturer and Honorary Consultant Liaison Psychiatrist for Older Adults, Institute of Psychiatry, Psychology & Neurosciences, KCL
Dr Stephen Walker, Associate Professor and Consultant Dermatologist, Hospital for Tropical Diseases
Dr Michael Zandi, Consultant Neurologist and Honorary Associate Professor in Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square and UCLH
Mr James Tysome, Consultant ENT Surgeon, Cambridge University Hospitals
Dr Marcus Lewis, GPwSI in Headache and Migraine, Camden
Dr Dana Beale, Specialist GP and Homeless Health Lead for North West London
Dr Siobhan Gee, Principal Pharmacist, Liaison Psychiatry, South London and Maudsley NHS Foundation Trust
Dr Amit Bhan, Consultant Cardiologist, Bart’s Health NHS Trust
Dr Alicia Demirjian, Paediatric infectious diseases consultant and epidemiologist, Evelina London Children’s Hospital and Public Health England
Dr Nicholas Meyer, Consultant Psychiatrist in Behavioural Sleep Medicine, Royal London Hospital for Integrated Medicine, UCLH
Dr Sharon Raymond, GP, Safeguarding Lead and Director of Covid Crisis Rescue, North Central London
Dr Poppy Freeman is a GP in Camden, north London