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General Practice and the pandemic 

Firstly, in your own words, sum up the last 12 months in General Practice from your experience?

Well 12 months ago was the beginning of life as we now know it, we were faced with Covid and a big unknown. The last year has for everybody been a huge change. We were faced with something we’d never come across before and we were all afraid. We were afraid as we didn’t know what we were doing, we didn’t have the right equipment, we didn’t have the right protection, we didn’t have the knowledge of how we were going to work. Suddenly we were told that we weren’t able to see patients face to face anymore so yes, I think the overriding feeling was fear.

As time went on however, we got more used to it and if anything, we probably got the rest we needed. Patients weren’t coming to us anymore and even though there was lots of public thanks, we were probably a little embarrassed by that as in my experience at least, we were probably having more rest than we’d had in years and had a chance to breathe. In a strange way, it was what we needed.

You were one of many GPs who did move practices during the height of the pandemic. Many others were reticent to do so. How did you find the move, and did it differ in any way to the experience you’d have faced moving jobs pre-Covid?

If I’m completely honest, the induction process didn’t differ too much from how it would have been pre-Covid. We’re typically very busy in General Practice anyway so it’s not like there was more time for additional luxuries pre-Covid. Ultimately, for me it was the right time to change and Covid didn’t affect that thought process.

One thing we’ve seen a lot of is public frustration towards GPs. Both ‘the man on the street’ as well as in the papers, with the misconception that you aren’t seeing patients anymore and therefore aren’t busy. Where do you think this has come from?

Well the public were told to stay at home and by and large, they did. In that sense, we weren’t seeing a lot of patients because they just weren’t coming to us. Also, I think some GPs reinforced that because they were scared themselves.

There was also a lot of confusion about what we could and couldn’t see. At first, we were told we couldn’t see anyone with a cough or a temperature, but then we realised that Covid has a lot of different presentations. As a result, we didn’t always know what we were supposed to be doing so it’s no surprise that the public was confused!

It also varies massively from area to area and I know there’s still some practices who aren’t seeing patients face to face even at this point, so I think patient experience depends on where they are in the country.

For those unfamiliar with General Practice, just how has your role changed over the last 12 months?

The major change is I now sit on the telephone most of the day – one could argue that I’m now just a glorified call centre!

There was a part of me at the beginning of the pandemic though that felt like I’d lost a major part of my role. We as Doctors like seeing people and when that was taken away, there was some feeling of ‘why are we doing this anymore’. However, as time has gone on, we’ve begun to see some of the advantages.

And what are these advantages?

It gives us more control over who we see and don’t see. For example, who can just be spoken to over the phone, if it’s not serious. We have a larger number of patient contacts now, but it allows us to prioritise those who need more time.

When life gets back to how it was; do you think General Practice will go back to how things were too?

We’ll never go back to the way things were. There was already a definite trend towards moving to this model; the triage model before the pandemic arrived.  All the pandemic has done is force everyone into it at the same time.

The workforce simply isn’t there to go back to the way things were before. There isn’t the staff to keep the long lunch hours, the 15 minute appointments, the easy working days.

In a post-Covid world, what are the main challenges you foresee General Practice facing next?

The obvious ones are that of missed disease, the waiting lists, the backlogs. Then there’s the mental health issues and the social aspects too where people have lost their jobs for example. One thing for certain is we GPs are never going to be out of a job.

What does General Practice need to do, or put in place to meet these challenges?

I think there’s going to be a larger role for the likes of Social Prescribers. Medicines are not always going to be able to sort out people’s problems. Ultimately though, it’s the same challenge as it’s always been – more people and a bigger workforce.

Do you think the increase in funded-ARRS roles can help this at PCN level?

I’m not sure. In some ways, I’m maybe a little bit cynical. You can’t really replace a Doctor or a Nurse with someone else. We all have our roles to play. Although having a Physio in house is brilliant and having a Pharmacist in house is brilliant. Too much signposting – one clinician referring on to another that is; will typically come full circle with the end result being the patient still wanting to talk to the Doctor.

Looking back over the last 12 months. Taking into account those GPs who have qualified during the pandemic, or are qualifying soon. What would be your advice to these new GPs?

See your patients. It’s very easy to be part of a training model that encourages telephone triaging everything,  safety netting and making sure your notes are perfect and so on. There is however no shortcut for seeing your patients face to face. That’s how you learn and that’s what I advise – see as many of them as possible.

 

Feature in our series!

Are you a GP, nurse or allied health professional? Would you like to feature in our series of Primary Care Insights? We would love to speak to you and hear about what working in primary care means to you. Do you have advice for others? Let us share your story and expertise. Contact Harriet at [email protected]

You can read other interviews in our series here.

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