BMA could ask for QOF suspension if coronavirus cases rise

Doctors’ leaders could push to suspend parts of the GP contract including the QOF if coronavirus cases rise.

(Photo: Mike Kemp/Getty Images)
(Photo: Mike Kemp/Getty Images)

The BMA confirmed on Friday that it had called on NHS England to allow practices to ignore a contractual requirement to make 25% of appointments bookable online and shift to a model where all booking would take place by phone.

Calls to suspend online booking came amid fears that allowing patients to book online could prevent triage needed to ensure that patients with potential coronavirus infection do not visit practices.

BMA emergency preparedness lead Dr Peter Holden told GPonline that the association was working with the RCGP and the Royal College of Nursing to revamp pandemic ‘action cards’ drawn up in the 2009 swine flu outbreak for GPs and practice staff.

Coronavirus

Dr Holden said it was difficult to know whether a major coronavirus outbreak would occur - but that if pressure on general practice rose substantially in the coming weeks - when practices face significant workload around QOF data - the framework could need to be suspended.

He pointed out that under the current response mechanism - in which people thought to have been at risk of coronavirus infection face isolation for two weeks - it was essential to avoid as far as possible potential cases attending their GP practice.

‘By some measures, general practice is in permanent crisis,’ Dr Holden said. ‘Around 17 patients per session is the safe limit, but we are breaking that all the time and the work is increasingly complex. If the hit rate from coronavirus gets high, obviously you will have a staffing problem as people go into isolation.

‘The average GP might have 1,100 patient contacts in a fortnight of one sort or another - whether it’s appointments, signing prescriptions, looking at results or writing letters. That’s a huge amount of work - and you can’t lose that without it having an impact.’

Non-urgent appointments

His comments came as The Avenue Surgery in Brighton suspended non-urgent appointments after a GP at the practice who came into contact with a confirmed coronavirus case was ordered to self-isolate for 14 days - leaving it with a single doctor.

A message on The Avenue Surgery website on Friday told patients: ‘Dr Hacking has been in contact with someone who has tested positive for coronavirus. He has been advised by Public Health England to self-isolate for 14 days and therefore will be unable to attend the surgery.

‘Dr Winter is the only doctor available to see patients for face-to-face appointments and therefore we can only offer a very limited service during this time. We have taken the decision to keep the doors closed and can only see urgent pre-booked appointments.’

The message thanked patients for their support ‘during this extremely difficult and challenging period’.

The Avenue Surgery is understood to be one of around a dozen across England forced to close temporarily for cleaning over the past week.

GP practices closed

Two practices in the County Oak Medical Centre in Brighton closed for two days last week, while practices in Somerset, Berkshire, Surrey, Northamptonshire, Portsmouth and London have also been forced to close temporarily for emergency deep cleaning over coronavirus fears in recent days.

Dr Holden said GP practices should be ‘dusting off their business continuity plans and having a look at them’.

BMA warnings over the potential impact of coronavirus came as two MPs were ordered to self-quarantine after attending a conference at which a person diagnosed with coronavirus was also present.

Healthcare staff are working to trace other delegates at the conference, and Public Health England has advised a number of people in the Brighton area to self isolate over concerns they may have come into contact with the virus.

On 16 February the government confirmed that 3,109 people had been tested in the UK of which 3,100 were confirmed negative and 9 positive.

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