Having recently joined the rapidly developing CCAS (COVID Clinical Assessment Service), I wanted to share my experience.

Joining

There were several initial challenges in joining the service. The ID verification seemed to require an in-person attendance at a practice, but eventually was sorted remotely. I was given a second NHS.net email account, which was unnecessary and inconvenient (as you have to keep checking between the two for relevant updates). There seemed to be a requirement to repeat lots of in-date mandatory training, but thankfully this too was resolved.

This is not my first time onboarding for a remote clinical GP role, so the complexity was not a complete surprise: half a dozen new logins in rapid succession without understanding what they were all for.

Clearly a process designed for the recruitment of practising GPs and retired returners was going to have its challenges, not least in ensuring superannuation has been set up correctly. That said, the team supporting the onboarding process has been incredibly helpful at trying to fix issues and finding the right person to advise me.

The work

Many clinicians expressed anxiety about their first shifts and indeed my first sessions were bumpy, due to varied IT problems, but the IT team and shift leaders were always incredibly helpful.

The online forum was also fantastic. I have become very resourceful in troubleshooting technical glitches: have I gone through all the logins in the correct order? Should I reboot the computer, as that’s the first thing any IT person seems to say? How many different browser windows should I have up and running (logged in) at the start to feel prepared: the portal, my clinical resources, the forum for asking colleagues questions, CKS, BNF, my email…?

As there was no predetermined consulting pace, one did not have to stress about falling behind. The online forum on NHS futures and the regular daily debriefings provided essential peer and managerial support.

Knowing that somewhere a patient is experiencing a wait due to IT glitches at my end can be unsettling, but they have not had to travel to a surgery and are waiting patiently in the comfort of their home (or work). Also there are lots of remote eyes on your activity, ensuring no patient is left behind.

It has been fascinating to see how the COVID-19 ‘standard operating procedure’ for primary care is experienced in different parts of the system by frontline workers and patients. There is a revolving door feel to it which even nine weeks into lockdown is still very real.

There is a sense of flux in the whole service as demand quietens down, and the service has over 1,000 GPs only recently onboarded. Some retired GPs have noticed they may not be as essential as they may have thought, and are considering stepping back to allow younger GPs in need of income to take up shifts. It will be a challenge to support a remote workforce if a significant number will be redundant for long periods of time and may become disconnected and less confident in this work.

It is also a very restricted scope of work, which presents challenges for maintaining a GP skill set, as one can’t completely rule out a non-COVID problem appearing on our case list. This is not an issue for those of us who do broader general practice elsewhere but if you are recently back from retirement and feeling generally deskilled it could be unsettling.

There is also the danger of monotony of dealing just with COVID.

The new office

As I make the short journey from my bedroom to my home office via the kitchen, it is comforting to feel safe from COVID exposure. Remote coffee rooms have proved essential for clarifying problems and learning from questions raised by others on the same journey. Despite the technical hiccoughs, I am excited by the pace of change and the possibilities of CCAS, and am looking forward to this new role.  

Paula Wright is the BMA sessional GPs committee’s north east representative.