Pandemic Update September 2020

The pandemic has brought all manner of suffering to our patients, including bereavement, hardship, morbidity and anxiety. The practice has had to change considerably, and will continue to do so, but our priority remains providing excellent care in Nidderdale.

Why are face-to-face appointments being restricted?

Where a face-to-face appointment is necessary this will always be provided. In order to minimise risk to other patients and indeed to practice staff, we are trying to minimise footfall at the surgery, so if a consultation can be managed remotely, (econsultation, phone-call, video) that is preferred. As well as reducing risk, this system is more efficient for patients and staff and has generally reduced our response times.

I don’t have internet access- does this mean I can’t get a consultation?

No. Plenty of patients do not use the internet and we will always cater for this. The efficiencies afforded by some patients using the internet improve the service we can offer to all patients: thanks to the high use of econsultations etc, the wait for other appointments has reduced.

Why can’t we use the waiting room as usual?

A crowded waiting room could allow cross infection and for vulnerable patients that could be fatal. Somehow therefore we have to learn to operate without more than three or four patients in the waiting room at once. This has been just about possible so far thanks to the large volume of “remote consulting”, but as demand increases (inevitable over the Autumn but actually already is at its highest for many months) and the weather gets worse we recognize that it will become increasingly challenging. Please see below.

How can you expect us to wait outside in the cold?

We don’t want anyone waiting out in the cold. If it is cold or wet and there are already people in the waiting room, (we are trying to avoid having too many parallel clinics) please let us know if you would rather wait in your car. As soon as possible we hope to have shelters built at the various entrances.

Do GPs still do visits?

In Nidderdale the answer is yes. Video-consultations often provide an alternative so there are fewer visits required than before, but if a visit is necessary it remains an option. As well as taking time, home-visits carry a risk of spreading COVID, so are only made when strictly necessary.

Why do you have a triage system every morning?

Even before the pandemic, triaging has been a useful way for us to prioritise. This is needed because there is limitless need but limited resource.

Why is there sometimes a longer wait for an appointment for a nurse or health-care assistant?

Even when we are fully staffed, there are fewer appointments available currently because we have to change PPE and clean rooms/equipment between patients and cannot allow accumulation of patients in the waiting room. This is also true for Nurse-Practitioners and GPs.

What are all the doctors doing when not seeing patients?

Nowadays GPs have very many ‘phone calls, video consultations, econsultations as well as the face-to-face work. On top of this there are home visits, results to interpret and file, investigations to organise, referrals to make, hospital letters to read, training other Drs, answering medication and dispensary queries, infection control, learning together, supporting the staff and, (for some) running the business.

I'm worried I've got cancer but don't want to go to the surgery/ hospital due to COVID-19

Please do get in touch if you are worried about cancer, (e.g. a new breast lump, changing skin mole, blood in your stool or urine or a change in your bowel habit over the age of 60, unintentional weight loss, coughing up blood etc). We have systems in place to minimise COVID risk, and it is essential that cancer diagnoses are not delayed. We have continued to do smear tests for high risks patients throughout the pandemic and have added extra smear clinics in the last few months to work through our waiting list of patients due a routine smear who have never had a previous abnormal smear. We would encourage you to attend for your smear as normal and to book this with us.

Is the practice focussing too much on protecting staff?

The Pandemic could still present an existential threat to the practice: should our staffing levels fall sufficiently, we would be at risk of having to close. Minimising footfall at the surgery reduces this risk, but of course there is a balance to be struck. Staff are having to keep distant form each other and in some cases work from home to reduce the risk of having to quarantine in the event of a colleague testing positive. Like all businesses, we have had high levels of absence over the pandemic, and there is no prospect of this improving any time soon.

When is it going to go back to normal?

The pandemic is on the rise so none of our safety measures can logically be relaxed as things stand. One or two patients have pointed out that pubs are managing to provide “business as usual” and ask why can’t General Practice do the same: the reason is that by definition, patients are more likely to have infections and more prone to become seriously ill or die than those who are entirely fit and well. On top of this we carry out infection-prone procedures (which would be very out of place in public houses), so our infection control procedures are naturally rather more involved.

Is Nidderdale Group Practice going to merge with the town practices?

We continue to resist merging with the town practices as we feel Nidderdale is unique and benefits from a dedicated local practice.

 

In Conclusion

Despite having fewer staff, higher demand, and considerable constraints on our way of working, we have manged to keep all three sites open and are dealing with most problems more quickly than before the pandemic. Patients and staff alike are understandably stressed, anxious and frustrated, but we are all in this together and the practice is here for its patients. Many thanks for your ongoing patience. Here’s hoping for an effective vaccine soon.