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GPs left to make unenviable choices need proper support



Twelve GPs have tragically died from Covid-19. Reading the tributes to them is heart wrenching. Each one of them left a mark on their communities.

Although 12 is a tiny sample size, it is noticeable that 11 of these GPs were from minority ethnic (BAME) backgrounds. Eleven were male. All were over 55.

To their credit, NHS leaders have acknowledged this. And, since I first wrote this for our June print issue, Public Health England has published its review into risk factors.

The PHE report has been released to almost universal criticism. There is nothing in the report that we don’t already know. More importantly, there are absolutely no practical recommendations about what GPs or other NHS workers can do to mitigate their risks.

This follows on from the risk tool developed by a team led by professor of primary care at the University of Leicester Professor Kamlesh Khunti, which again gave no practical recommendations – but was endorsed by NHS England.

For GPs anxious about their staff and themselves, it is difficult to see how these reports will help. By releasing and publishing reports with no proper recommendations, health authorities are putting the onus on vulnerable GPs: it is they who must decide on their level of risk and what actions to take.

Explicitly acknowledge when GPs are at higher risk, with stratified risk scores

This is, to say the least, an unenviable decision. Plenty of practices have predominantly older, male, BAME GPs – many of whom are singlehanders. Even if other practices in their primary care networks can support them – which is highly dubious anyhow – this cannot work in areas such as Newham, in east London, or Rusholme in Manchester, where a high percentage of the entire GP population fits this demographic. Clearly, they cannot all avoid patient-facing roles.

So here is my plea to the UK governments and the NHS. Explicitly acknowledge when GPs are at higher risk, with stratified risk scores. Build up a national picture, pinpointing areas where many high-risk GPs practise, and do all you can to support all GPs – including lower-risk ones taking on more face-to-face work and locums, whose support is needed. This includes providing (note, not just paying for) adequate PPE at WHO standards and funding locum cover.

But most of all, appreciate these GPs. Be honest with them – the NHS is not in a position for all of them to work from home. And maybe next time you think about moving on the singlehanders, remember why they were left with this horrible decision.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk. This article is an adapted version of the editorial that first appeared in Pulse’s June 2020 print issue