What is the workforce need?
While we hear that the staff in hospitals are run off their feet with the workload from Covid-19 patients, the proactive approach taken by practices across the country has meant that GP surgeries are managing well, and there isn’t an immediate demand for additional manpower. Indeed, many GP locums are reporting that their work has “dried up”. However, the two sectors that are still keen to recruit doctors just now are the Out-of-hours services and the new 111 Covid Clinical Assessment Service (111-CCAS). Both of these are opportunities for doctors who, for reasons of health or age, are keen to avoid direct face-to-face contact with patients, as much of the work is telephone/video based.
Over the next few months, the situation will change, and as the lockdown lifts the demand for additional workforce in primary care is almost certain to increase as:
- The backlog of patients with important urgent conditions who have been avoiding seeking medical help present late to primary care
- GPs pick up the post-discharge management of patients who have been severely ill with Covid-19
- The backlog of patients with non-urgent conditions returns to present in primary care
- General Practices deal with large numbers of patients with anxiety, depression and other mental health problems many of whom have been seeking to self-manage their conditions through the Covid-19 crisis
- GPs and practice-based nurses who have been deferring annual leave so that they can work through the crisis eventually do take some leave to rest and recuperate.
So your expertise and contribution to supporting the NHS will be welcomed over the next few months in different ways.
What are the different roles and settings that I could undertake?
Most doctors returning or moving to work in primary care during the next few months may be doing:
- Telephone and video consultations, either of cases triaged to be likely Covid-19 patients, or general primary care work.
- Some may be doing face-to-face work, either in surgeries, hot hubs or on home visits
- Some may be doing “back office” work – dealing with prescriptions, pathology results, hospital communications (e.g. letters and discharge summaries), medication reviews
- Some may be working in a Medical Support Worker capacity under the close supervision of other primary care staff.
A fuller description of different roles can be found on the RCGP website.
What is a Medical Support Worker?
In the last few weeks NHSE has introduced the new post of Medical Support Worker, for GPs who have been out of practice for several years but have been granted a Licence to Practise by the GMC, and who can work in General Practice under the supervision of other GPs. MSWs have to be on the Performers List which they can apply for via the Fast Track process.
These are examples of tasks that MSWs could undertake:
Medical Support Workers (MSWs) |
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Direct Patient contacts (under close supervision) |
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Consultations performed face-to-face, or by telephone or video but should not include dealing with undifferentiated clinical presentations |
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Call handling and service enquiries, e.g. supporting receptionists by speaking to patients demanding explanations |
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Clinical measurements and procedures (e.g. BPs, ECGs, urinalysis, phlebotomy, IM injections) |
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Care of vulnerable/shielded groups |
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Proactive identification vulnerable patients |
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Shielded patient support and management reviews |
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Telephone follow up of LTCs e.g. Depression reviews |
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Back Office tasks |
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Medication Reconciliation |
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Medication reviews with patient |
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Actioning Lab results and clinical correspondence |
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Completion of official documents e.g. safeguarding reports |
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QA and Audit – e.g. incidence statistics and deaths from C etc. |
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Care of patients at End of Life |
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ReSPECT forms and DNACPR conversation |
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Prescribing for symptom control and anticipatory medications |
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Death certification |
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Bereavement calls |
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Communications |
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Liaison with primary care team; social care, and voluntary sector; secondary care |
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Encouraging mutual support within primary care team |
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Covid-19 patients |
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Supporting hot clinics |
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Supporting GPs doing home visits (driving, maintaining supplies of equipment, helping with PPE, taking calls, planning visit route, liaising with ambulance service etc.) |
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Keep COVID19 info up to date as advice etc changes, distil key messages |
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Telephone follow up if requested by 111 CCAS |