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NHS72 - Primary Care in the face of Covid-19

Since the Covid-19 pandemic arrived in Britain, the face of primary care has changed completely.

All initial contact between patients and GP practices is either online or on the phone, in order to assess patients for potential coronavirus, with people invited to face-to-face appointments as necessary.

Video and phone calls have become the norm, with some GPs shielding at home while still seeing patients online.

GP practices have also been making major physical changes to their premises to conform to national social distancing restrictions, and working with other practices and local agencies to establish 'hot sites' - where people suspected of having coronavirus can still go for treatment while reducing the risk of infection to others.

Thanks to local primary care

Dr Lalitha Iyer, Executive Medical Director for the Frimley Collaborative of Clinical Commissioning Groups, has recorded this message of thanks to those working in primary care locally for their efforts.

Coming out of retirement

In 2018 Dr John Rose retired from his position as a GP in Farnham. Little did he suspect that two years later he would not only be back practising on the front line, but doing so as part of the largest medical effort in British history.

And yet as the virus spread at the beginning of the year, Dr Rose’s insight, experience and his continued interest in  his combination of clinical knowledge and accurate reading of the global situation meant that he was ready to help at the earliest opportunity.

Here’s his story:

“In February 2020 the New England Journal of Medicine published an Article by Guan and colleagues which collated the clinical data on over 1,000 patients affected with the newly identified virus, SARS-CoV-2 (severe acute respiratory syndrome - Coronavirus - type 2) which causes the disease known as COVID-19 (a portmanteau for Coronavirus Disease-2019).

“It was clear that this virus was easily spread and with no known effective treatment and no clinically available coronavirus vaccines, I thought a global pandemic imminent. The reported mortality rate of hospitalised cases was quite high, with 1.4 per cent of cases dying.

“Anticipating the illness reaching the UK, I contacted Dr Liz Burrin of The Ferns Practice (in Farnham), a GP colleague with whom I had worked until my last retirement in June 2018, to ask whether I might re-connect with the Practice and do a couple of surgeries to test that I was happy with the hardware and software systems they use. They were extremely accommodating and this was soon achieved.

“I had kept up to date clinically as, after retirement, I had continued doing GP appraisals, reading a lot of other doctors CPD (Continuing Professional Development), and reading medical journals and doing online learning for my own interest. Additionally, one of my daughters was in specialist training in rheumatology, and her fiancee in neurology, and they had lived with me in 2018 and 2019 enabling us to enjoy discussing medical cases.

“After doing a couple of surgeries at the Ferns, I waited to see what the demand would be in General Practice. In the meanwhile, Dr Edward Wernick (the Farnham Covid-19 lead) called me about working in Farnham Hospital in order to build resilience into the local healthcare system in anticipation of increasing clinical demand. I met up with two of the consultants supervising the wards, and then started the job enrolment process to work at Farnham Hospital.

“On the same day that I'd agreed with Ed to work at Farnham, I was asked to work at Alton and Petersfield hospitals, but was limited in what I could offer. I ended up working at Farnham on Monday and Tuesday mornings, Alton those afternoons, and Wednesday to Friday at Farnham Hospital on Bourne ward.

“It has been a very interesting and rewarding time, though at times stressful and upsetting, particularly around the peak time of COVID-19 deaths. The high points were the patients recoveries, the low points the deaths and families not being able to visit the sick.”

Frimley Health and Care