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Secret Diary Of A PM : Running a Practice In The Pandemic

Since the beginning of the year we have all been watching the spread of Coronavirus across the world. As the government measures were put in place, we too had to rapidly change the way we work and how we treat our patients.

Because of our location, we are probably behind London by about 2 weeks and so we’ve had time to think about further changes we must make during this pandemic.

 

Practice Actions – Dealing With Patient Triage

We are now on total telephone appointments and have locked our doors to stop access to the premises unless triaged by a doctor.  Most patients have been more than happy not to come in, and indeed this way of working is something we could possibly look at once this pandemic is over. Naturally we cannot treat everything this way, but it could help alleviate the wait for appointments in the future by utilising the telephone more.

We don’t use video consultations at the moment as we aren’t in a position where the IT (for us and the patients) will make it an effective triage tool- we feel that in time we will use it, but there is too much going on as it stands. We have been using eConsult as an online consultation tool which seems to work well, but we are still in the process of rolling this out.

Surprisingly, we feel that we are not as busy with patients as normal, but I think this is the calm before the expected storm.  All routine work has stopped and all the extra clinics we run in the community have also stopped.  There is an eerie feeling around as the normal waiting room is devoid of patients.

 

PCN in Action

Our PCN have been working closely together to find ways of handling the crisis and it has certainly bought us closer together and we have developed ways of working across the area. We have Zoom meetings every couple of days and have split the PCN into Hot and Cold Hubs. Our surgery is the Hot Hub and are starting to see patients with suspected Covid-19 and have set aside space in our car park to treat patients, without them getting out of their cars. The clinician, one from across the PCN is in full protective gear at the point of examination and screening.

We have contacted our local council and they have been very supportive in supplying barriers and cones to place in our car park to man the HOT HUB. They have also offered several volunteers to assist a member of our staff to man the car park not allowing normal parking to take place. Our local church has also offered volunteers to help the chemist and patients to ensure they receive their prescriptions. With Easter approaching and the fact that Good Friday and Easter Monday are going to be a normal working day I am sure there will be volunteers to work on those days.

 

Access To PPE 

One of our biggest issues is getting the right Personal Protective Equipment, and the current struggles with getting some are already well documented - we have been sourcing our own kit and made pleas to our patients to donate anything they have. Our CCG have promised to reimburse us for the costs and our appeal for PPE was featured on the BBC News.  Since then, we’ve been inundated with kit and feel we can protect our staff adequately.

 

Remote Working

Working from home is somewhat easier for clinical staff than admin staff and is only really restricted by the quality of the access to clinical packages, which our CCG is working on. However, our policy is to have at least some doctors in the surgery each day.

Admin/ reception staff working from home is something we are not yet doing as we have issues around computer access, kit, and GDPR etc and again we do need staff on-site to handle all the incoming post and telephone calls. As a manager my view is that whilst a Practice Manager could work from home, it does not seem right when our staff need to be in, so I am in every day and I know the staff appreciate the support they are getting.

Just like our patients, our staff have families - of course they will be worried about them and the partners and managers here are being very supportive to them. Two members of our staff have asked to go on 12-week isolation for genuine reasons of age and conditions so we have agreed to this. The other staff have been looked after with biscuits and cake and there is a good feeling of camaraderie; each of us knows the challenges we are facing like no other could - we talk of resilience but until you see it in action at a time like this, you won’t understand how meaningful your work is as a team, and I am very proud of what we have achieved in such unprecedented times. 

No one knows what the future holds and who could have predicted what has happened and its intensity. When we hear of the death of a patient, we cannot help but feel sad and it brings home the realities we are facing. Things will probably get worse before they get better, but I am comforted by knowing the team and staff will do whatever they can to get through this period.

I wish everyone well and hope this surreal situation ends quickly.

 

How has your practice coped with the Pandemic? Let us know in the comments below. FPM Members can access the Pandemic Toolkit for a wealth of information and resources.

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