The past year has been the most challenging we’ve ever experienced in General Practice. Practically overnight, we’ve had to implement new ways of working that enable us to look after our patients in a safe and timely manner. More recently, the NHS in Wales has led the way with vaccination, helped by GP practices like ours who have taken on this mammoth task in addition to our usual duties.
To be clear – we did not close at any point during the pandemic, as most of you will know. We’ve maintained services because our medical team have been triaging all calls by telephone or online via “eConsult” then deciding if the problem can be solved over the phone, by video call, by text, by online response, by face to face or home visit the same day. As you can imagine, when a home visit or face to face consultation is required, this has taken considerably longer with gowning, masking, cleaning and collecting patients from their vehicle or an outside waiting area.
Remember that the surgery is a place where Covid and any potential new variants may appear first (because it’s usually the first point of contact for people who are unwell) but also a place where the most vulnerable may need to attend for medical care. So whilst you may be able to enjoy a relaxation of restrictions in the wider world, we have to be particularly careful in the surgery to make sure that we can see our patients safely and protect our staff. It may look quiet outside the surgery because patients are not coming and going from the waiting room or dropping things off, but inside we are dealing with demand that is unprecedented by phone and online, whilst staggering arrivals of those who need to be seen.
However, as we gradually return to normal we have seen demand for our services sky rocket way beyond normal levels. We have been inundated and working at unsustainable levels as we try to deal with every single telephone call and the less urgent “eConsult” contacts. This is a national trend and GP practices are reporting this throughout the UK. Demand is far higher than normal. This has led to an inevitable prioritisation of more urgent problems and we’re having to look at the current “pandemic” way of working and whether it best suits our patients needs as we move forward, whilst acknowledging that our team (who have been working flat out and beyond during the pandemic) can only see a finite number of patients per day.
The current combination of telephone triage (which includes seeing patients who need to be seen on the day) and eConsults is unsustainable. There is also a need to allow patients to book ahead for review and we are mindful of this. You may, therefore, see some changes in the way appointments are conducted soon. We are looking to implement the My Surgery app to streamline services a little better and we are re-evaluating our ability to triage everything whilst continuing with the sheer numbers of non-urgent eConsults coming in each day.
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