Coping with COVID-19 in Haslemere

Dr Marcus Panchaud, Senior Partner at Haslemere Health Centre:

General practice acts as the front door of the health service. Like many businesses COVID-19 and lockdown restrictions have significantly affected how we are able to operate and see patients. From the outset we agreed that a team based approach was imperative and instigated daily team briefings to discuss and implement changes to our service, protecting our staff and patients.

The impact started on 28th February when we were informed by Public Health England that a patient seen at the health centre had tested positive for COVID-19. The health centre was forced to close immediately for deep cleansing, reopening the following day. This created considerable media interest which the Practice had to deal with, having no experience or support in this area.

Following this we saw a drop in consultation rates and by the time lockdown measures were announced on 23rd March they had fallen significantly, but consultations were taking much longer as so many new procedures were in place. I am glad to report that over the past couple of months they have returned to pre- COVID-19 levels, but the process of seeing patients face to face remains much slower with the need to wear PPE.

Types of consultations have also changed. In February, and prior to this, face-to face consultations were the norm, outnumbering telephone consultations by at least five to one. Since then, telephone consultations have completely outnumbered face-to-face, with an increase in video and online consultations as a direct result of the restrictions.

RCGP data for June revealed that seven in ten routine consultations were conducted remotely, a marked change from the past. Throughout the pandemic we have continued to offer face-to-face appointments and home visits when it was clinically necessary, and provided support to our Care and Nursing homes.

We used the initial period of reduced demand proactively providing check-up appointments for patients with long term conditions and redeploying our excellent Practice nurses to support the Community nurses with home visits for vulnerable patients. We look forward to the time when more face to face consultations can take place without the need for PPE.

Thanks to the dedication of our Practice team and the use of new arrangements including the introduction of Footfall to the Practice website utilising online consultations, patients concerns can now be dealt with more efficiently. We have recently noticed that the proportion of appointments booked in advance has dropped with an increase in the proportion of appointments booked and dealt with on the same day.

We have also experienced delays in getting staff and family tested if they develop coronavirus symptoms, we have secured a number of laptop computers enabling our staff to work from home whilst awaiting a test or self-isolating to minimise any disruption to our service.

Thinking positively and going forward we need to develop some understanding of what went well and what didn’t go so well to help shape the future of GP through understanding the experience of our patients and staff.