GPs ‘concerned over lack of coronavirus guidance’

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GPs are seeking extra advice around treating potential coronavirus patients

Leading GPs have highlighted confusion among family doctors about treating potential coronavirus patients.

The Royal College of GPs (RCGP) said there was confusion about “the appropriate steps that GPs and their teams should take”.

Concerns include a lack of guidance, too little information on local cases and a lack of community testing and protective equipment.

NHS England said protective kits would be delivered to GPs this week.

Patients who have been to a high-risk country in the past 14 days or have been in close contact with someone with coronavirus are being tested for the virus and have been told to contact NHS 111.

But there are concerns around patients who report a fever, cough and shortness of breath – the main coronavirus symptoms – but do not meet those criteria.

GPs said they were having to make difficult decisions about where to see patients, if they could not be managed on the phone, and there was a lack of guidance about what to do for those patients.

Some described measures such as seeing patients in a designated room or at the end of surgery. Others said they were wearing “catering aprons”, due to a lack of equipment.

Doctors also said they had contacted Public Health England (PHE) to find out more details of local diagnoses, but were unable to find out any more information than was already published online.

Two doctors, Dr Jane Wheatley and Dr Shivangi Thakore, both GPs in Islington, London, said they were only aware of a diagnosed case of Covid-19 in a parent of a local school in London when told by other patients.

The NHS 111 service had then asked a child at the school to come to the GP with symptoms of a cough and fever after a telephone triage.

It took three calls to Public Health England to decide what to do – and the child was eventually managed over the phone.

The GPs told the BBC: “We have struggled with deciphering and managing the seemingly conflicting information given by PHE and 111.

“It has incurred a heavy time cost, restricting our ability to practise; several GPs have had to dedicate time to strategic planning and lengthy phone calls to PHE, NHS 111, as well as local infectious diseases specialists.”

‘No online booking’

Prof Martin Marshall, chair of the RCGP, said it was important that everyone in the NHS had “clear, concise guidance”.

“GPs will increasingly be on the front line of dealing with Covid-19 – and we’re already hearing from members that they are seeing more patients who are concerned about the outbreak and what steps they should take to protect themselves and their families.”

He welcomed advice issued by the NHS to GPs last week, including the suggestion patients should no longer be able to book appointments online without being spoken to first.

But he added: “We are aware that there is some confusion around triage and the appropriate steps that GPs and their teams should take, particularly for patients who don’t fit all current criteria for Covid-19.

“We are also aware of some concerns around community testing and the information on cases being made available to GPs. We are feeding this information back to NHSE and PHE.”

An NHS spokeswoman said hundreds of protective kits would be sent out to GPs from this week, with larger surgeries receiving repeat deliveries.

She added: “Anyone with concerns about coronavirus can use the NHS 111 online service, and while the 111 phone line is understandably busy, and people may have to wait longer than usual, all enquiries are being responded to, thanks to hard-working NHS staff.”

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