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Secret Diary – Normal (Or the “Next Normal”) Service to be resumed

So, with the number of first dose Covid Vaccines reaching more than half the population, and many having had their second doses, we must prepare to resume some level of normal service.

This is going to be as challenging as the covid vaccination programme itself, and we need to start looking ahead to factor in the normal flu season 2021/2 and a possible 3rd vaccine booster dose.

Despite asking several questions about the cohort of 50–64-year-olds not on any registers, I cannot get a definitive answer as to whether primary care will be offering this, and whether we will get reimbursed as last year. We are looking at opening our doors and allowing patients in, but not certain as to how we are going to be able to socially distance patients as, like most Practices, our waiting area is not that large.

Notwithstanding the recent ‘notifications’ from the NHS (ie “by the way, I know it’s a Thursday evening, but we expect you to open up again to everyone on Monday? OK, thanks, bye”), we’re still going ahead with keeping F-2-F consultations as minimal as possible until we have more information on the latest variant.

(To start with, I’m not spending any more of my own evenings and weekends ringing staff to re-arrange rotas, bargaining with holiday times, or dealing with more locum agencies for extra GPs and ANPs when we’ve been given little warning of the next edicts from on high!)

So, we are looking at going down the road of total triaging over the phone and online, and then bringing patients in at staggered times.  There are several triaging packages around and I think that the difficulty is going to be selling it to the patients as being the best way forward. 

We have seen several models where it has worked very well, but the key to its success is ensuring that everyone buys into this new way of working - in particular the GPs, as they will be expected when in a triaging clinic, to complete a lot of the problems, making space for patients to come in with more complex issues.

We would look at simple prescription requests, sick notes, blood results, test results and minor issues etc to be dealt with at this stage. We must remember that the NHS is insisting that we go down this road and I would hope that the NHS can support surgeries with a press campaign to explain the reasoning behind this new way. However, I am not convinced they will, and they will leave us to sort out the patient’s reluctance to this.

Patient Complaints 

So, like most of the managers I have spoken to, we are already facing a large increase in complaints, and we are braced to see even more, as we bring in this new way of working. It is still incomprehensible that patients are expecting us to be ready to open our doors to everyone when we’ve had 2 working days’ notice from the hierarchy that we’re supposed to see everyone’s lovely faces – a hastily written notice on our website, a script for our receptionists to deal with any calls, an A4 laminated page on the doors was a start, but we’re expecting a few additional complaints around this.

In the main though, complaints go across the spectrum, from one person trying to sue us for not allowing them in the surgery without a mask as they refused to say why they were exempt, to patients claiming the GP was rude on the telephone consultation or the promised return phone call was not returned at the time they wanted.

Despite us having the CCG-provided telephone system, it does not record calls which makes responding to these types of complaints exceedingly difficult. So yes, hopefully, we are over the worst of Covid, for the time being, but we should not let our guard down and be mindful that the road ahead, will be rocky for primary care.

The pressures ahead will change in nature, but I wonder if we will ever go back to life before Covid. As we roll out total triaging I will report back on how it is going and things to look out for.


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