July 19th has been listed in various places as “Freedom Day”, when a lot of restrictions across England will cease. In response to a number of queries about what this will mean for general practice and when things will return to the way things worked pre pandemic, it is hoped that the information below will be useful.
So – when will things return to the way they were pre pandemic? When will you be able to see your GP face to face again?
Well, firstly, lets’ put the myth that we have not seen any patients face to face firmly to bed. As a practice, we have seen patients for face to face consultations, on every day we have been open. However, these consultations are now decided based on clinical need, in order to keep all parties, patient, Clinician and staff as safe as possible. There are many other ways that patients’ needs can be met, which include text responses from eConsultations, telephone calls and video calls to give further examples. (On average between 25% and 30% of GP consultations remain face to face.)
These changes have been driven from a requirement to pass every contact through clinical triage. This is being used for several reasons;
· There is an initial triage to redirect patients to the appropriate service – things which are urgent/life threatening are not appropriate to general practice (we are not and never have been an emergency service) so they will be redirected to 999/A & E. Slightly less urgent matters may be directed to 111. Minor issues may be directed to a community pharmacy. Where appropriate and patients can make self referrals, they will be directed to do so.
· The general practice workforce has expanded and diversified in recent years. If you wind the clock back a few years, patients would have seen a GP or a practice nurse. There was nothing else! Now, we have GP’s, Prescribing First Contact Nurse Practitioners, Practice Nurses, Phlebotomists, Health Care Assistants, Physician Associates, Prescribing Pharmacists and the list continues to expand on a regular basis. Much of the workload that GP’s used to do is now dealt with by other clinicians. Clinical triage enables appropriate cases to be passed to the most relevant Clinician to deal with that particular aspect.
· The GP’s who carry out the triage of the eConsults that are appropriate for general practice will allocate to the right clinician, who will in turn decide how to deal with the matter and the urgency/timescale that it is dealt with in. Anyone who has attended A & E or minor injuries clinics will be aware that cases are dealt with in terms of clinical urgency rather than arrival time – it is now no different in general practice.
So, in order to meet these requirements, we ask that patients:
· Make all clinical requests via eConsult, if they have access to the internet.
· Those who do not have internet access, can call the surgery, however, the staff will need to complete the clinical triage form and may redirect calls to other healthcare settings as above. Long wait times continue to be reported, this is not due to staff not answering the telephone (the practice has invested in additional incoming lines, additional staff dedicated to answering the phone, carried out a reconfiguration of the system to allow more calls to present to a greater number of extensions and much more) but the main causes of the wait times are as simple as the excessive demand the surgeries are under combined with the average length of call having gone from 2 minutes, to just under 10 minutes, to complete the clinical triage form. So, if you can complete the eConsult, you will be helping yourself avoid a long wait and free up the lines for those who really do need to use the phone.
· We know there are things that eConsult cannot do – so for nursing or phlebotomy (blood test) appointments, please continue to telephone your normal surgery.
· For all prescription repeat requests, please use the NHS App.
Comment was made by a patient recently, that the telephone system says we are operating “normally” – but clearly we are not! Yes we are – the issue is that “normal” has changed… So, the doors will stay closed and patients will be asked to contact via the intercom, to be admitted for appointments etc (after screening for covid symptoms).
As per the announcement by the Government earlier this week, the requirement for masks in healthcare settings will stay after 19th July. So please continue to wear masks if you visit the surgery. Social distancing measures will also remain in place.
Finally, we know that the last eighteen months has been an uncertain and challenging time for everyone. There has been massive change in the way we work and at times, communication could perhaps have been better. Our ability to continue to provide appropriate service to our patients has always been at the forefront of the changes, balanced against ever changing requirements and directives placed on us from above. Hopefully, we are now on a pathway to a more settled time. We know the systems are not perfect – we will continue to review and adapt as time goes on and strive to make improvements where possible.