How the pandemic is changing the face of general practice forever – A GP’s Perspective

Following our conversation with Sue a couple of weeks ago, I sat down with Saima Afseh (my mum!) to understand an HCP’s opinion on how the pandemic is affecting healthcare. Below, she writes about her experiences dealing with COVID 19, as a GP.

My name is Saima Afseh and I am general practitioner, working in London.  I recently spoke with Manahil at Aurora about how COVID-19 has impacted my life as a GP and how it will change the face of general practice forever.

COVID-19 has transformed how GPs work – from having to wear full PPE instead of ordinary clothes, to a huge decline in the number of non-COVID related patients I am seeing. Most consultations are now done remotely and when we see patients face-to-face, we are completely clinical, I look like I did when I was a medical student.

“I want my patients to know I am still here for them”

Fewer patients have been consulting their doctor or nurse for their usual health issues, or new physical or mental health problems during this pandemic, and this is concerning doctors as there may be people out there who need medical advice and whose conditions may worsen if they don’t get it.

Use of video technology for multidisciplinary team (MDT) and clinical team meetings and Medical Boards should be retained in the longer term”

Increased telephone and video consultations, which are proving shorter than standard ones, are freeing up time. They have transformed our day and we are getting through things much quicker. As well as patient contact, surgeries are using video to hold daily practice meetings with staff, and with local nursing homes. Of course, video calls are not always suitable for patients without smartphones — home visits are still happening.

Online working has come with its own territory of issues as the ability to provide remote consultations has been limited by internet speed and IT infrastructure. All of this experience around remote consultations will improve the access arrangements longer term, but to be able to do that consistently we need the ongoing investment in IT that is provided by clinical commissioning groups (CCGs).

In terms of support offered to GPs, there has been lots of information on COVID-19 which was generic and did not tackle the specific needs of primary care. We are frustrated with the lack of clear central direction, or a clinical care model, from CCGs. There is a great need for detail in guidance. and more local nuance, as to whether our specific surgeries are a “hot spot” as well as when to use PPE.

“Taking samples at ‘hot sites’ saves time, improve diagnoses and help to save precious PPE”

It is frustrating that GP practices have not really been involved with coronavirus testing efforts, until quite recently. We are, and increasingly will be, in contact with symptomatic patients and so conducting tests during consultations makes sense, both in terms of not inconveniencing the patient, and not using PPE unnecessarily when there is a shortage.

My whole team has given 110%: working hours have gone out the window, clinicians come in or video call on their day off, our local practices have been collaborating almost daily, and, for the stuff we can control, there’s been some progress in improving the patient and healthcare professional dialogue and patient outcomes, but there’s still so much more to be done. Despite my anxiety towards a second wave, I do look forward to seeing the new face of general practice.

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