General Practice Provision during the Coronavirus pandemic.

Many of you will know that General Practices as a whole are experiencing enormous pressures and has been throughout the coronavirus pandemic. There are many reasons for this but more recently as demand for return to a more ‘normal’ service has increased we find ourselves in an uncomfortable position of being stuck between our increasingly frustrated patients and a backlogged general practice and hospital system, with the ever present increased workload associated with coronavirus and a looming further wave of extended flu vaccinations (e.g. to more patients) and booster coronavirus vaccinations. The to-do-list grows and grows.

Our concern is that the messages issued from on high has led to the perception that GP Practices may not have been working to full capacity throughout the pandemic and that we have somehow been withholding services.

To set the record straight and to avoid some of the conflict arising as a result of this misinformation we would like to clarify the following:

1. Were Doctors/Nurses in work providing face to face appointments during all lockdowns and are they continuing to do so now?

Yes – throughout and now via a clinical led triage system.

All practice staff have worked their usual hours plus extra throughout the pandemic. The practice has had to completely change the system of working in order to ensure we keep people safe when visiting the surgery for a face to face appointment. The NHS is still maintaining social distancing in the waiting rooms and extra cleaning is taking place in NHS premises (with general practices undertaking extra cleaning of our consultation rooms between patients).

2. Have GPs/Nurses &/or other members of the practice team ever been furloughed?

No – Far from it.

All members of the practice team have worked throughout. Many members of the practice team have worked longer hours to cover the workload being faced since Covid 19 arrived in the UK and throughout all the lockdowns. Members of the team worked weekends to set up new ways of working so that the practice could function safely.

During periods of social isolation or due to vulnerability, staff who have had to work at home have used/are using laptops and phones in order to keep your surgery functioning as normally as possible.

3. Were local GP practices involved in Coronavirus vaccination campaign?

Yes – We joined with all the other local practices, with the Clinical Commissioning Group (CCG) and other NHS organisations to provide vaccinations through the GP Led mass vaccinations site which was the first mass vaccination site to open in St Helens.

Members of our team, both clinical and administrative staff, worked additional hours or changed their working patterns in order to administer Covid vaccinations. On a rota with other local practices, members of our team acted as clinical leads for the site, vaccinators and admin support. Whilst in the practice staff phoned thousands of patients, ensured text messages were sent to appropriately and dealt with the queries coming in. On some days the practice had to release up to 8 member of staff to support the services at the vaccination centre including GP’s, nurses and administrators plus we had to continue running usual services at the practice.
At any one time, from practices in St Helens, the Saints mass vaccs centre needed up to 12 vaccinators, 14 admin staff, a GP plus support clinician, multiple volunteers to direct patients, clean seating etc. Plus pharmacy and CCG staff. The centre was staffed from 8am-8pm most days and virtually worked non-stop for 6 months.
Hundreds of housebound and nursing home patients were vaccinated by our nursing team (and teams form other practices). Practices even supported each other to ensure that each other patients were vaccinated. Sessions were covered by volunteers (including our very own Dr Hanrahan-retired GP) to whom we are eternally grateful, but the majority of vaccines were delivered by your local GP staff.
We stopped providing services to the centre in June this year when other services were able to completely take on the tasks. However, by the time our practice withdrew from the centre over 115000 vaccines had been administered between January and May 21 at the GP led site.

St Helens is one of the UKs most successful regions for getting the population vaccinated and that is thanks to all the St Helens general practice teams, St Helens Clinical Commissioning Group and others who supported this service from St Helens.

4. Is the practice back to normal especially after 19 July?

No – practices, hospitals and other NHS services are facing a backlog of work that needs to be caught up on.

During the pandemic many secondary care (hospital) services were also moved to telephone and online consultation to keep staff and patients safe and some hospital outpatient staff were moved to Covid wards. General practice helped our NHS colleagues by picking up workload for secondary care by doing requested bloods tests, prescribing medications etc which would usually be done during outpatient appointments in hospital and this is ongoing. Planned operations and procedures have been delayed and new ones scheduled placing extra demand on the hospital and in turn the queries about these delays and requests to expedite healthcare falls to General practice.

Further booster vaccinations are planned and the extent of the practice’s role in providing those vaccinations is still being discussed.

Staff are under strain as the pressures of the last 18 months have taken their toll on staff numbers and morale. Those who remain are exhausted but are expected to continue to work extremely hard. We still have to comply with social distancing measures in the waiting areas so clearly can’t go back to the days of packed waiting rooms. We don’t want to place vulnerable patients and our staff at increased risk in the surgery. Covid is still here.

5. Do I still have to wear a mask when I attend the surgery?

Yes – At this time we will continue to request that masks be worn (unless you are exempt), along with all other NHS services. We also require you to observe social distancing and that you wash your hands – we need to restrict the risk of infection to all patients but particularly those who are most vulnerable and to members of our staff team. Remember that double vaccination, whilst protective, does not fully prevent someone contracting the virus and therefore spreading it. The number of patients able to attend the site is therefore also reduced in line with ongoing primary care infection control guidelines.

We hope that by answering some of these questions directly there will be less conflict between patients and our members of our practice team.

As you may be aware; the practice, is seeing an increase in the abuse faced by all members of the team. We can only assume that these are occurring due to a misunderstanding regarding the pressures we face and the role we have played in supporting the community in the fight against Coronavirus.

Not long ago the NHS was being clapped and cheered weekly. Perhaps General Practice was not in the hearts and minds of those taking part in that. Hopefully this piece will correct that omission and we can come together again as a community of dedicated health service providers and patients supporting each other as we move forward towards the end of this nightmare.

Thank you