In February I was looking forward to a week away in our caravan in March.
Fast forward a few weeks now and who, apart from Bill Gates, could have predicted what was coming? On the one hand it seems like we have been living in lockdown for months but on the other hand I feel like the last four weeks have flown by.
The first week is a bit of a blur to be honest. It felt like emails were coming in fast and furious. Sometimes the advice changed from morning to afternoon, never mind from day to day. The practice I work in has just over 8,000 patients with a large older population. The first week was probably the worst. We spent time along with reception staff cancelling appointments and trying to make safe plans for dealing with appointment requests. Much as I do not really enjoy doing telephone triage am I ever glad that we have been doing this for years? Guidance was coming in daily regards a lot of the routine work in general practice, cervical screening was put on hold, new protocols devised for near patient testing, guidance on reviews for contraception but more importantly flow charts for screening patients and contacts for Covid-19.
One of our main tasks that first week was to prepare the practice for seeing possible Covid patients. We were fortunate to have two rooms at the end of a corridor not in regular use with a door onto the car park that were quickly identified as the most suitable to use for this purpose. They were stocked with minimal essential equipment so as to make cleaning between patients easier. This worked well for us and patients were asked to only come at their appointed time. If they came by car we asked them to wait in the car until a GP called their mobile and come in on their own where appropriate. This worked well for us. We welcomed the opening of a designated Covid assessment centre a few miles away two weeks ago. This took a lot of pressure away and we, as a practice, are taking our turn of manning this one morning a week. If, however, numbers increase the centre can only see a limited number per day so we need to keep the rooms we have set aside ready as we may, in this situation, have to see possible Covid patients again.
What has been quite amazing is how quickly things have happened that would usually take ages. We got extra phone lines and two computers were fitted with webcams for video calling within a few days. We have been fortunate not to have a shortage of PPE and practices locally have helped each other out if one is running low.
The Covid assessment centre opening allowed us time to plan and complete eKIS summaries for 3,000 of our patients that were frail, elderly, on disease registers or other high-risk groups. I phoned almost 100 patients aged over 90 during this time, mainly as a welfare check but also to update their emergency contacts and ensure they had, for example, arrangements in place for shopping.
The numbers calling triage are much lower than normal so are people self-managing their minor ailments. Will this continue after lockdown? I would love to think so but fear when life returns to ‘normal’ old habits will too. However, I think the increased use of technology phone calls and video calls will continue at least to some extent.
I think GP nurses/practice nurses in Scotland have been well supported during this challenging period by NHS Education for Scotland, and in Glasgow and Clyde we have also been supported by our practice nurse support and development Team and not least by each other.
It has been fantastic to see the kindness and goodwill shown during this difficult time, how quickly people volunteered for a wide variety of opportunities to help, and the cooperation between health and social care, primary and secondary care, and community pharmacies. How good would it be if this united approach could continue?