As the nation steps cautiously out of lockdown GPs across Scotland are managing a rapid return to normal levels of patient contact, as patients who had delayed contacting their doctor during the height of the COVID-19 pandemic now present for care. Added to that the psychological and physical consequences of the lockdown period, including on those who were shielding, is now becoming apparent and increasing the need for patients to consult with their GP and practice team.
I’m sure I’m not the only one who is now noticing an increase in the length of time each telephone consultation requires: as we now undertake full remote consultations as the norm, with all the challenges that that new way of working presents for both patients and doctors, I am now looking at average telephone consultations taking as long as face to face ones. There has certainly been a change in patient demand with lists of issues and concerns and it seems, to me, we are more overloaded with work than we have been for a long time. We may be doing it differently, with less face-to-face contact, but the level of work has increased and I for one find the sheer number and intensity of telephone consultations quite exhausting.
One of the – many – consequences of COVID-19, and the easing up of lockdown, is the mandatory wearing of face coverings in shops and on public transport. None of us want to see a resurgence in the number of COVID-19 cases and I support the move on wearing face coverings to minimise the risk of the disease spreading rapidly once again.
However, things like this do not come without problems: not everyone can wear a face covering, whether that is due to a physical or mental health issue and I would encourage members of the public to be compassionate and understanding towards those who find it difficult to wear a face covering for the reasons above. In this situation, people can wear a badge that explains they are exempt from wearing face coverings. The important thing to remember here is that this is self-certified.
We are now hearing of private companies – such as airlines – refusing to allow people to enter their premises, or travel with them, unless they are wearing a face covering. Anyone who cannot wear a face covering must present a medical certificate outlining why they are exempt. And of course, we all know who will be the first port of call when a person wants a medical certificate: general practitioners.
Private companies can make their own policies: if they want everyone to wear a face covering, that is entirely up to them. However, it is not appropriate to expect GPs – or any doctor for that matter – to provide medical certificates to prove exemption. Practices are exceptionally busy providing care to patients and doctors should not feel under any obligation to do this.
In saying that, of course, you are free to do it if you please – you can charge a fee for a medical certificate as it is not NHS work – but if you decide to decline it is entirely within your right to do so and no GP should be placed under any pressure from private companies to do otherwise.
We are facing a very long road out of COVID-19 as we attempt to get primary care back on a level footing and turn our attention once again to the implementation of the GP contract to address the retention and recruitment problems we faced before Covid19 struck – in doing so we need to be able to focus on the essential healthcare work that our patients need from us.
Dr Andrew Buist, chair of SGPC
Photo credited to Gordon Terris/Herald and Times Group
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