Can general practice learn from the COVID-19 global pandemic?

A relaxation of regulation has allowed GPs to use their initiative to a greater degree, creating improved ways of working, writes BMA GP England committee executive member Krishna Kasaraneni

Location: UK
Published: Thursday 4 June 2020
Krishna Kasaraneni

It’s clear that COVID-19 is a horrendous virus – thousands have been seriously ill or died, millions have been shielding and tens of millions have gone without seeing loved ones for months. It’s also clear that this is not over yet – we don’t know if COVID-19 will be around for months, years, decades to come! For general practice, and the whole healthcare system, this is a daunting thought.

It’s often hard at these times to keep motivated, to see any positives and to even look for the light at the end of the COVID tunnel. One of the things that is helping me through this is to focus on those positives that I am experiencing. From a personal perspective: I have my health; my family and friends are unaffected (touch wood); and we are starting to think about planning for when this is over.

Professionally, for me as a GP, the positives have been around practices rising up to the challenge and innovating at unprecedented pace. Another one is practices working closely together in a collegiate and collaborative way; we’ve been afforded some freedom to use our professional and clinical judgement to ensure the way we operate is appropriate for our locality and practice teams and for our patients; we’ve benefitted from some relaxations in bureaucratic processes and regulation; and we’ve successfully managed patients in a different way, using remote consultations and reconfiguring our practices.

Many (including me) will look back and think ‘Wow, that was a lot of hard work – changing systems and ways of working in such a short space of time, educating our patients around this new way of operating, and halting a load of work so we can concentrate on providing services to our patients’.

At the moment when I look back, I am astonished at how we worked pre-COVID – how we tried to manage unmanageable patient demand with face to face consultations for all; the huge amount of additional form filling we had to go through every day; the constant red tape we have to deal with just to do the jobs we trained for years to do. One of the things I really want to ensure is that we pull the positive elements we’ve experienced out of COVID with us.

It seems that many of my colleagues agree… 66% of GPs who responded to the BMA’s latest COVID survey said that they have experienced a greater sense of team working, and 55% say they felt less burdened by bureaucracy.

95% said they are currently providing remote consultations to patients, although over 50% said their ability to provide this had been limited by internet speed/bandwidth, hardware and software, and IT infrastructure. Despite these limitations 88% said they wish to retain this for the future – clearly some work for the government, NHS England and CCGs to make sure these barriers are removed.

82% of GPs said that we need to retain the reduced paperwork/bureaucracy in the long term, with 59% in favour of less frequent appraisals and 54% in favour of fewer or no CQC inspections.

I am using this evidence, in my other professional role as executive team member for the BMA GP England committee, in my interactions with NHS England, the Department for Health and Social Care and Government, to try and make these changes for the longer term.

We might not see many positives from the current global pandemic, but I’m hoping we can build on the resilience and innovation shown by general practice and make positive changes to how we work for the long run.

More than 2,600 GPs responded to our latest COVID survey (28 May 2020). The full results to all questions can be seen here