Routine GP work may be dropped due to coronavirus

The British Medical Association has said that routine monitoring of long-term conditions could stop, in order for GPs to focus on the sickest patients as the coronavirus outbreak worsens.

GPs said they were having to make difficult decisions about where to see patients, if they could not be managed on the phone, and there was a lack of guidance about what to do for them. Some described measures such as seeing patients in a designated room or at the end of surgery, while others said they were wearing 'catering aprons' due to a lack of equipment.

NHS England has said protective kits would be delivered to GPs this week, but there are growing concerns about assessing patients, and supplies of protective equipment like gloves and masks.

Dr Richard Vautrey, chair of the BMA's GPs committee, warned patients with mild health complaints should expect to wait longer to see their GP.

He told the BBC: "We do expect cases to rise rapidly and over the coming weeks. We will need to stop doing much of the routine work that we do week-by-week to enable us to focus on the sickest patients and prioritise those who most need us. Practices that are routinely doing routine health checks, assessing blood pressure, diabetic control, and long term problems with heart and lung disease. Those routine checks will need to stop.

"We'll need to prioritise not only those with potential Covid infections, but also the sickest patients who will need to continue to receive our direct care. It does mean that some patients may have to wait longer than normal to see their GP. It's likely to continue for at least a few weeks, if not months. And it's quite possible that there will be more than one wave of infection."

At the moment, there is guidance around testing patients who have been to a high-risk country in the past 14 days or have been in close contact with someone with coronavirus. However there are concerns around patients who report a fever, cough and shortness of breath - the main coronavirus symptoms - but do not meet those criteria.

As well as equipment shortage concerns, doctors also said they had contacted Public Health England (PHE) to find out more details of local diagnoses, but were unable to find out any more information than was already published online.

Prof Martin Marshall, chair of the RCGP, said it was important that everyone in the NHS had 'clear, concise guidance'. He welcomed advice issued by the NHS to GPs last week, including the suggestion patients should no longer be able to book appointments online without being spoken to first. However, he added his voice to the 'confusion around triage and the appropriate steps that GPs and their teams should take, particularly for patients who don't fit all current criteria for Covid-19'.

The protective kits set to be sent out to GPs from this week will include general use aprons, examination gloves and fluid repellent face masks. Larger surgeries will receive repeat deliveries to ensure they have sufficient amounts.