Blog - Can general practice learn from the COVID-19 pandemic?

Over the last 2 years, concerns raised by local residents about GP services has been the number one reason why they contacted Healthwatch Barking and Dagenham - accounting for a third of all the reasons why we are contacted by the public.

Before the COVID pandemic, services at general practices in the borough were a cause of concern for local people when needing to access the services, and having to face barriers to get to them. Despite the local positive messages of how the services were working well to serve local people – the reality from patient experiences indicated that was not often the case.

Since then, the formation of Primary Care Networks (PCNs) has enabled groups of practices to access streams of public money, with which to run better services for local people. So what has been learned with those changes in place, during the COVID pandemic?

“A relaxation of regulation allowed GPs to use their initiative to a greater degree, with the aim of creating improved ways of working” - BMA GP England committee executive member Krishna Kasaraneni.

It’s clear from the last 15 months that COVID-19 is a horrendous virus – thousands have been seriously ill or died, millions have been shielding and tens of millions have gone without seeing loved ones during the whole of that time. It’s also clear, with the emergence of other variants of the virus, that this is not over yet – we don’t know if COVID-19 will be around for months, years or decades to come! For general practice, and the whole healthcare system, but especially the public; this is a daunting thought.

For GPs, the prospect could have made it hard at these times for them to keep motivated, to see any positives and to even look for the light at the end of the COVID tunnel – such is the human impact, irrespective of the professional one.

According to the BMA (British Medical Association) one of the things that is helping GPs through this is to focus on those positives that individuals are experiencing - personal perspectives: health; family and friends and starting to think about planning for when the worst is over and the impact subsides as immunity via the vaccination programme keeps people safer and protected.

The view of one GP: “Professionally, for me as a GP, the positives have been around practices rising up to the challenge and innovating at unprecedented pace. Another one is practices working closely together in a collegiate and collaborative way; we’ve been afforded some freedom to use our professional and clinical judgement to ensure the way we operate is appropriate for our locality and practice teams and for our patients; we’ve benefitted from some relaxations in bureaucratic processes and regulation; and we’ve successfully managed patients in a different way, using remote consultations and reconfiguring our practices.”

“Many (including me) will look back and think ‘Wow, that was a lot of hard work – changing systems and ways of working in such a short space of time, educating our patients around this new way of operating, and halting a load of work so we can concentrate on providing services to our patients.” “At the moment when I look back, I am astonished at how we worked pre-COVID – how we tried to manage unmanageable patient demand with face to face consultations for all; the huge amount of additional form filling we had to go through every day; the constant red tape we have to deal with just to do the jobs we trained for years to do. One of the things I really want to ensure is that we pull the positive elements we’ve experienced out of COVID with us.”

It seems that many of their colleagues agree… According to the BMA,

66% of GPs said that they have experienced a greater sense of team working, and 55% say they felt less burdened by bureaucracy.

95% said they are currently providing remote consultations to patients, although over 50% said their ability to provide this had been limited by internet speed/bandwidth, hardware and software, and IT infrastructure.

82% of GPs said that they need to retain the reduced paperwork/bureaucracy in the long term.

From a Healthwatch Barking and Dagenham perspective, what has been the impact of the lessons learned and positive changes for local people using GP services?

The service has been under stress for some time - years - and that has affected people looking to use the service through lessons learned. It’s positive to educate the public, but it’s not enough if their reality is, they can’t access the service when they need to. With autonomy in decision making, the quality of services can vary greatly within the borough, depending on how central to services patients are placed by their practices and how well their systems stand up to meeting the health needs of their local communities.

We might not see many positives from the current pandemic, but there is hope we can start to see and experience as patients, the innovation shown by general practices. The positive changes they can work towards with their practice systems, from what has been learned from this time of COVID-19. With GPs being able to work across boroughs and share good practices, we can reasonably expect to see improved services for local residents.

Author: Richard Vann, Healthwatch Barking & Dagenham.