Dr Tim Noble: GP’s View

How did our GP surgeries work together during lockdown? What role did the Canterbury Mosque play? What changes will we notice when we consult our medics in future? Dr Timothy Noble of the University of Kent’s Medical Centre gives his personal account. 

When I was first asked to write an article about my experience of COVID-19 I was in two minds. I thought it would be a very angry piece and not show me in a good light. The daily news briefings were still occurring and the continuing sophistry and obfuscation by the ministers raised my hackles; figures plucked from thin air, empty promises, “Protect the NHS” (not being the same as protecting the nation’s health), the numbers who had “sadly died” with no acceptance of some responsibility and always being “guided” by science.

However… so much negativity is not good for one. Focus on the positives doctor.

“Adversity does not build character, it reveals it”. We have seen this both in the scramble for loo rolls and flour bags, but also in those volunteering to help in many different ways — food banks, grocery shopping and, from my point of view, our staff working above and beyond what had been expected of them.

Team working whether it is at a practice level or all the Canterbury GPs working together has been magnificent. Local practices have been grouped into Primary Care Networks for some time working closely in developing services and in very successful multidisciplinary teams to look after our frailest patients. When the pandemic started to take off we very rapidly worked together to build and staff a Primary Care Treatment Centre with the support of our local NHS Commissioning Group as well as the University of Kent who provided and adapted facilities to help with requirements. We called it the “Hot Hub”— we were expecting to see, by appointment only, patients with covid symptoms who needed to be physically examined to assess if they could be managed at home. We could not have run it without the support of volunteers as marshals and the Canterbury Mosque who provided refreshments for all. Thankfully the numbers predicted did not realise and we have been able to close the facility. Practices have now had time to begin to “zone” their premises so that these patients can be seen in their own surgery moving forward.

Embracing new technology. We went from seeing 30 patients a day to zero almost overnight. The majority of consultations are now done, at least initially, by telephone. All the local practices are  using “econsult” — you will see this on the front page of their websites — you enter your details and your query/request/list of symptoms and then the practice will respond ideally before the end of the day, or next working day — perhaps by phone call, SMS text or email. This avoids phoning and being held on hold for what can seem like forever in the morning. Photos can also be uploaded on the system which can be useful for some problems.  We are also beginning to use video consulting. I think these approaches will become the new normal. We will want to avoid crowded waiting rooms as social distancing continues. Consulting remotely this way means that one will not need to take time off work for an appointment so I think people will like the convenience of this approach. Not everything can be done remotely and it will continue to be necessary to see and examine people — as part of new presentations of illness or for routine health checks and screening — some services such as childhood immunisations have continued since lockdown. All the health care professionals are becoming used to this new way of working but I think we all miss the face to face contact and the extra information this provides. I think we are all nosey by nature, or should I say curious.

Doctor and Practice Nurse appointments will be different — contact time will need to be kept to a minimum — we will most likely be in PPE (scrubs, gloves, mask, apron) and patients will be expected to bring and wear a mask, you shouldn’t arrive more than five minutes before your appointment and, with obvious exceptions, come on your own. You should let the surgery know if you have a new cough, fever or lost your sense of taste and smell between booking and the appointment timeWhen you come in there won’t be much time for small talk. Remember we are all still open and seeing patients — don’t be worried about contacting your practice.

Moving forward I think there will be some polarisation of society — those, like me, who will continue to keep stick to 2 meters social distancing and lots of handwashing, those under say 25  years of age (I know it’s a bit of a generalisation) who will want to live as they were before lockdown, those currently shielding or very anxious who will be reluctant to expose themselves to risk, those who economically have little choice but to put themselves at risk and some of those over 70 years of age who would rather not spend their remaining years locked down with little contact with friends and family. Or the search for an effective long-lasting vaccine is quicker than we think.

Remember stay alert, keep your distance, wash your hands, and if you do read The Guardian everyday try to balance it with other news sources (that last one is for me).re? Dr Timothy Noble of the University of Kent’s Medical Centre gives his personal account. 

When I was first asked to write an article about my experience of COVID-19 I was in two minds. I thought it would be a very angry piece and not show me in a good light. The daily news briefings were still occurring and the continuing sophistry and obfuscation by the ministers raised my hackles; figures plucked from thin air, empty promises, “Protect the NHS” (not being the same as protecting the nation’s health), the numbers who had “sadly died” with no acceptance of some responsibility and always being “guided” by science.

However… so much negativity is not good for one. Focus on the positives doctor.

“Adversity does not build character, it reveals it”. We have seen this both in the scramble for loo rolls and flour bags, but also in those volunteering to help in many different ways — food banks, grocery shopping and, from my point of view, our staff working above and beyond what had been expected of them.

Team working whether it is at a practice level or all the Canterbury GPs working together has been magnificent. Local practices have been grouped into Primary Care Networks for some time working closely in developing services and in very successful multidisciplinary teams to look after our frailest patients. When the pandemic started to take off we very rapidly worked together to build and staff a Primary Care Treatment Centre with the support of our local NHS Commissioning Group as well as the University of Kent who provided and adapted facilities to help with requirements. We called it the “Hot Hub”— we were expecting to see, by appointment only, patients with covid symptoms who needed to be physically examined to assess if they could be managed at home. We could not have run it without the support of volunteers as marshals and the Canterbury Mosque who provided refreshments for all. Thankfully the numbers predicted did not realise and we have been able to close the facility. Practices have now had time to begin to “zone” their premises so that these patients can be seen in their own surgery moving forward.

Embracing new technology. We went from seeing 30 patients a day to zero almost overnight. The majority of consultations are now done, at least initially, by telephone. All the local practices are  using “econsult” — you will see this on the front page of their websites — you enter your details and your query/request/list of symptoms and then the practice will respond ideally before the end of the day, or next working day — perhaps by phone call, SMS text or email. This avoids phoning and being held on hold for what can seem like forever in the morning. Photos can also be uploaded on the system which can be useful for some problems.  We are also beginning to use video consulting. I think these approaches will become the new normal. We will want to avoid crowded waiting rooms as social distancing continues. Consulting remotely this way means that one will not need to take time off work for an appointment so I think people will like the convenience of this approach. Not everything can be done remotely and it will continue to be necessary to see and examine people — as part of new presentations of illness or for routine health checks and screening — some services such as childhood immunisations have continued since lockdown. All the health care professionals are becoming used to this new way of working but I think we all miss the face to face contact and the extra information this provides. I think we are all nosey by nature, or should I say curious.

Doctor and Practice Nurse appointments will be different — contact time will need to be kept to a minimum — we will most likely be in PPE (scrubs, gloves, mask, apron) and patients will be expected to bring and wear a mask, you shouldn’t arrive more than five minutes before your appointment and, with obvious exceptions, come on your own. You should let the surgery know if you have a new cough, fever or lost your sense of taste and smell between booking and the appointment timeWhen you come in there won’t be much time for small talk. Remember we are all still open and seeing patients — don’t be worried about contacting your practice.

Moving forward I think there will be some polarisation of society — those, like me, who will continue to keep stick to 2 meters social distancing and lots of handwashing, those under say 25  years of age (I know it’s a bit of a generalisation) who will want to live as they were before lockdown, those currently shielding or very anxious who will be reluctant to expose themselves to risk, those who economically have little choice but to put themselves at risk and some of those over 70 years of age who would rather not spend their remaining years locked down with little contact with friends and family. Or the search for an effective long-lasting vaccine is quicker than we think.

Remember stay alert, keep your distance, wash your hands, and if you do read The Guardian everyday try to balance it with other news sources (that last one is for me).

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