What have we been doing during the pandemic?
Our aim during the Covid-19 pandemic has been to keep all patients safe and support our practices to continue to provide excellent care. Our priority has been the set-up and management of specific Covid-19 services, via a single citywide primary-care workforce. This has enabled practices to maintain ‘clean’ core GP services.
To do this, we worked in collaboration and partnership with the Clinical Directors of each Newcastle Primary Care Network and a number of organisations. These included Newcastle/Gateshead CCG, Newcastle Hospitals, VOCARE and Newcastle City Council.
With their help we have:
- Set up ‘hot sites’, dedicated facilities for patients with suspected Covid-19
- Established a visiting service for patient homes and care homes
- Launched an online rota system for hot sites
- Provided support through our social prescribing team to patients who are shielding
- Sourced and delivered PPE
- Set up a pilot SATS probe delivery service for patients
Hot sites provide a ‘hot’ face to face assessment service. This is available to all patients registered with GP practices who have suspected or confirmed Covid-19. Three hot sites were initially set up, with the first opening in the first week of April. This was reduced to one – at Elswick Family Practice – as the demand reduced. The hot site and visiting service will continue to operate for the foreseeable future.
The Newcastle Urgent Treatment Centre budget is currently being rediverted to pay for this service.
Our role included developing the Standard Operation Procedure; this mapped the process for booking in and seeing patients at hot sites. We also made sure the estate and facilities were fit for purpose and stocked with equipment including technology and IT. We also managed the rota; on many days members of the NGPS team have also worked at the hot sites as duty managers.
The visiting service was set up to allow patients in their homes or care homes, with confirmed or suspected Covid-19, to be visited by a GP. The care home visits are also supported by NuTH’s specialist care home nursing team, and a team of drivers from Newcastle City Council.
As with the hot sites, we put together the Standard Operation Procedure. We also ensured the right team were in place, procured the necessary equipment and managed the rota.
To support both the hot sites and the visiting service, we set-up a telephone triage service that went live 16 March 2020. This was staffed by a GP, who responded to calls redirected from NHS 111 and other partners. The triage service closed at the end of March after limited use.
New technology in GP practices
Patients have been able to access phone, email, and video consultations at almost all practices during the pandemic. Healthcare staff – both GPs and nurses – have been able to assess patients before either seeing them face to face or referring them for further treatment. Of these practices, 79% anticipate continuing to offer video consultation. 90% expect to continue using emails to support patient assessments.
We worked with a third-party provider to set up an online system for GPs to book on to the rota for our hot site and visiting service. The online tool (Lantum) allows GPs to search and apply for sessions online, submit invoices, and set up alerts so they can be informed of future available sessions.
Our social prescribing team – supporting shielded patients
Our social prescribing navigators and link workers have been continuing to provide a referral service in addition to supporting the Covid-19 effort.
They have made more than 3,500 calls since the pandemic started. They have spoken to both existing patients who have been referred to the service and shielded patients who are at high-risk and self- isolating.
The team has been supporting referred patients on a range of subjects. This has included universal credit, benefits, mental health and wellbeing, employment, debt and food deliveries.
For those shielded patients who need additional support the team have logged them on the national volunteer system where they are matched with volunteers who can help.
Members of the NGPS team have been ensuring that GP practices, and the hot site and visiting service have the necessary PPE. We have coordinated with national and regional suppliers and sourced equipment – including face visors and scrubs – from local volunteers.
Our social prescribing service have also been working with one GP practice to support patients who require SATS monitoring. The team, with medical student volunteers, have been delivering SATS probes to patients in the community. These patients carry out their own monitoring and report the data to their GPs on a telephone or video consultation.
What does the future hold for primary care in Newcastle?
Like many other healthcare organisations across England, returning services to ‘normal’ and being prepared for any future issues with Covid-19 is at the top of our priority list. This will be a phased recovery and won’t happen overnight.
We are currently reviewing how well our provision of additional services during the pandemic worked – primarily the hot sites and visiting service – and what future need we have. These decisions will be made jointly with the CCG.