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Secret Diary of a PM : Re-Opening Practices After Lockdown

I am writing this a few days after the announcement about the easing of the lockdown from July 4th, 2020. In that same news conference, a journalist asked, “when will GP practices get back to normal by fully reopening?”

It was evident that whilst the Prime Minister responded saying he saw no reason not to go back to how it was as soon as possible, Professor Chris Whitty (Chief Medical Officer), was far more honest - “the NHS will never go back to what it was, and changes already made so far, will form part of new norm going forward”.

That is how I see it and we will never get an opportunity like this to modernise the service delivery model.

We do need to use modern IT such as video and telephone consultations, along with the normal face to face appointments, but we should also be mindful that we need to take our patients along with us on this journey and not force them, accepting we could meet some resistance even as the last 4 months has shown us how changes can be made.

Before coronavirus, we were all worried about the rise in the online doctor services, offering 24/7 consultations, and perhaps we were feeling threatened by them.    If the last few months have taught us anything, it is, that we can compete, and even beat them,  as they seem to want to cherry-pick part of the services, whereas we can offer a full service including tests, prevention, and monitoring, etc.

Opening for Business

Most of us will be putting plans in place to reopen for more patients to return to practice, doing risk assessments, ensuring safety for staff and patients alike. From early July we are resuming some of the outside clinics we house, and whilst some services have been keen to restart, others have been more hesitant and delaying the restart. It will be a steep learning curve and our plans will be under constant review, we will need to be ready to restrict entry into the building if patients are symptomatic, but at the same time, start to bring more patients into the building as not everything can be done remotely.

How we bring our patients with us on the new journey is going to take explaining, understanding, and time, along with hopefully some backing from NHS England. There are several packages out there that will allow patients to submit online details of their problems 24/7 and can expect a response within 24 working hours.  These packages can include a facility to take pictures of say rashes, and submit, at the same time there are also ways to have face to face consultations online. We are working with one of these providers to create a package that is tailor-made, and fit for purpose, and we see this as an exciting move forward.

It is being said that these new methods could stop doctors diagnosing other conditions and whilst I can see this point, not everything is diagnosed even in a face to face consultation. We must also remember that not everyone has access to online and for them, they will need to come in as before. Every surgery will have their issues and problems and thinking out of the box may help.  We have limited waiting space and so we are looking at pagers to control the flow of patients. More about this if we go ahead.

CQC Restarting Inspections

I am shocked to see that CQC visits are going to resume in the Autumn.  It is said this is being done following several whistleblowing incidents from staff about the COVID response. It then says CQC will only inspect good practices without any concern (which makes no sense at all!) Practices with concerns should be investigated of course, but too inspect other practices as a normal visit in a time when we are from working in normal times shows a lack of understanding as to how we work. 

This autumn is going to be very tough, with COVID probably continuing, and a flu vaccination programme that is going to probably be wider than previous years, and with a possible shortage of vaccines, as the uptake is bound to be higher, we do not need a CQC visit that takes us away for quite some time for preparation from our duty of care to patients. We should be lobbying our LMC and BMA to try and delay any visits.

A Final Thought

Before I finish, I wanted to share something that I heard recently from a colleague;

I have decided that the best thing is to accept that the previous normal is not going to return. Then I can get on with adapting to the new normal – whatever it turns out to be.“ 

Wise words and worth reflecting on.

 

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