COVID-19 and Life in a GP Surgery

I'm Claire and I'm the Practice Manager of a medium sized GP Surgery in Cambridge, located very near to Addenbrookes Hospital.

Life as a Practice Manager is never easy - GP/Staff shortages, funding cuts, ever increasing patient demand, and more and more red tape and hoops to jump through all make every day a challenge - but that has been nothing compared to the rollercoaster ride of the last few weeks!

The impact was relatively small to begin with - the initial outbreak in China just caused lots of talk and rumour about what may happen, but all seemed like it was far removed from us here in the UK. Then, when it hit Europe and the news about the frightening scale of things in Italy, everything started to feel a little more real.

There were never-ending email updates, calls for us to make sure business continuity plans were updated and ready to be implemented, worried staff and patients but still little actual effect. Then the first cases hit the UK and everything ramped up a notch.

Over the space of 2 weeks our whole working practice (along with that of every other GP Surgery in the country) changed - from being a busy practice with full waiting rooms with 150 + patients being seen face to face each day we suddenly went to having to cancel all GP appointments and replace them with telephone triage - only those who really needed to be seen were invited in for an actual appointment and only after being very carefully screened to ensure the safety of staff and other patients.

All but the most essential nursing services (such as baby immunisations) have been put on hold. Our front door is closed - only opened to let those with an appointment in. Equipment and software to enable video consultations was procured very quickly by our CCG and implemented overnight. Hundreds of extra laptops suddenly appeared to enable home-working where possible. A 'hot' room had to be created for those patients who need to be seen but also have potential Covid symptoms - they have to wait at the back door and call when they arrive to be greeted by a GP in full PPE (Personl Protective Equipment) and escorted to the room which has to be thoroughly cleaned afterwards, with the GP careful removing the PPE and disposing of in clinical waste.

The first weeks under the new guidance of self-isolation with symptoms of cough or temperature had a big impact as at one point we had almost 50% of our staff in isolation - either because of their own symptoms or that of a family member.

The amount of phone calls received from patients each day went through the roof as did the number of repeat prescription requests as patients began to panic when lockdown began. They were a TOUGH few weeks... Things have slowly started to settle as we get used to a 'new normal' and enter what feels like a limbo phase - the number of cases and deaths in Cambridge is still relatively low but on the increase, and when the peak hits us we expect yet more changes again.

However, one thing this situation has proved is what a fantastic team of staff we have as a practice and how everyone has pulled together and supported each other to get through this - and we WILL get through this, however long it takes. Some of the changes that have happened will actually be for the long-term good - the implementation of video consultations had been due to start next year and was widely perceived as an unpopular move - but in reality, clinicians have got used to it very quickly and actually like it.

It has made us think about how we can change systems for the better when this is over. Undoubtedly it proves that whatever is thrown our way, we will always manage to cope.

---