General practice updates for Covid-19

These past few weeks have been unlike any other time. I cannot recall an occasion in my 30-odd years as a GP when we have worked under circumstances like this – across both primary and secondary care.

There are three things I want to update you on in this blog:

  • Funding for practices to stay open over public holidays
  • PPE
  • A pan-NHS approach to staffing Covid Assessment Centres

You will have received a letter from the Cabinet Secretary for Health, Jeane Freeman, and myself this week, requesting that all GPs keep their practices open over the upcoming public holidays as long as it is safe to do so. This is not a request we have taken lightly: practices and out of hours services are working under more pressure than ever during this pandemic and I know each and every one of you is willing to put in the extra work required to help the NHS fight this virus.

The Scottish Government announced additional funding of £15 million for general practice as we move into a new way of working for the foreseeable future. This will allow us to cover the extra costs of staying open over the public holidays, pay our staff and all the extra expenses that go with it. We are currently in talks with the Scottish Government to establish further funding to help us as we inevitably come up against other challenges during this time. I will, of course, keep you posted as this progresses.

Additionally, we now seem to be in a better place in regards to PPE – it’s still not perfect, of that I am absolutely clear, but in this past week we are starting to see improvements in the supply and distribution, and with the publication of the new guidance around PPE I am hopeful that everyone is much clearer on what is required. Many frontline staff had anxieties about meeting patients who might not be aware they had the virus and so the guidance that we should now be wearing fluid repellent masks in all clinical contact situations is reassuring.

We are listening to your concerns and taking them to the Scottish Government on a daily basis – we have made it clear to them that it’s not just about having the PPE in the here and now, it’s also about having a solid system in place that will respond quickly and effectively to demand. This is an evolving and fast-paced situation which we are continuing to monitor very closely – if the new arrangements fail to have the desired effect on sustainability of the supply of PPE, let us know by emailing support@bma.org.uk and we will take your concerns forward.

Finally, but by no means the least important part of this blog, is our call for a pan-NHS approach to staffing the CAC hubs across Scotland. We need a wealth of experience working in these hubs, and that means we need a wealth of doctors and nurses from all different backgrounds and areas of expertise: we need GPs, we need specialists, we need consultants, we need juniors – in short, we need everyone’s knowledge.

As many of you know, these community pathways were established with the aim of both enabling general practice to focus on keeping safe and managing as many non-covid19 patients away from hospital, and to allow a streamlining of the assessment and management of patients who are unwell with the virus.

We need these hubs to be staffed by clinicians from across the NHS at both primary and secondary care level. Currently, most of them are being staffed by GPs – and I want to offer my thanks to each and every one of you who has volunteered your time – but this is not sustainable for us to carry on with day-to-day general practice. So we, along with the Chief Medical Officer for Scotland and the Academy of Medical Royal Colleges and Facilities in Scotland, have issued a letter to all health boards, medical directors, primary care leads, NHS board HR directors, all royal colleges in Scotland, and all BMA Scotland members, asking them to consider volunteering some time to work shifts in their local CAC.

This is a huge community response, and we need all hands on deck – for those in more elective specialties, where they find their current workload may be less intense, we are appealing especially to them.

In the meantime, I want to thank you once again for the work you are doing at this time – it is invaluable. Remember to look after yourselves too, with the BMA’s free and confidential counselling service available to you and your dependents 24/7. I would encourage everyone who needs it to use it – it is not a sign of weakness to ask for help at a time like this.

Andrew Buist, chair of SGPC

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