Failure to involve GPs in COVID-19 test and trace 'a disaster and a national shame'

GPs and primary care teams should have played a key role in the UK’s efforts to test, track and trace coronavirus, according to a leading global health expert who has labelled the current system ‘a disaster and a national shame’.

COVID-19 swab test (Photo: Hollie Adams/Getty Images)
COVID-19 swab test (Photo: Hollie Adams/Getty Images)

Speaking at an online RCGP conference, University College London's Professor Anthony Costello questioned why primary care had been ‘bypassed totally’ in the government’s strategy to tackle the virus, and labelled its reliance on private contractors as ‘crazy’.

GPs’ ‘flexibility and innovation’, he said, made them well suited to take on a key role in responding to the pandemic - insisting that the government should have mobilised GPs instead and given them suitable funding.

Professor Costello argued that patients would prefer to speak to a GP if they tested positive for COVID-19, emphasising the importance of strong relationships between practices and their communities.

Test and trace mess

GPs have previously criticised the government’s unwillingness to tap into the expertise and experience of primary care in its response to the pandemic. Some clinicians have argued that practices should be able to carry out swab tests - or to hand out self-testing kits.

A total of £10bn was allocated by the government to spend on a national test and trace system, with private contractor Serco handed a leading role. But Professor Costello pointed to falling rates of contact tracing - with just 59.6% of close contacts of patients who tested positive for coronavirus successfully contacted and told to self-isolate in the week to 14 October.

He suggested that general practice should instead have been given £2.1bn - around £300,000 per practice - to lead the pandemic response, working hand in glove with local authorities who would also have been offered additional funding.

Professor Costello said: ‘The thing about GPs is that, as long as you give them the resources and you are not overloading them, they are fantastically innovative at making things happen because you have the flexibility to move in the directions you want.

Enhanced GP role

‘[COVID] is a health problem, if someone is identified as a case or a contact, the first thing that I would want to do if somebody told me that would be to contact my GP and discuss it with them. A lot of people will be scared and will want to know that their symptoms are being monitored.

‘Bypassing [the primary care] system by outsourcing [test and trace]… it’s crazy; I don’t know why we ever dreamed that up.’

He continued: ‘Clearly resources had to be made available so GPs were not overloaded. But, if they’ve got the right support - I would argue that with staff who are helping them to contact their patients, contact their household contacts, and work with public health and were resourced properly to do that - I think they could do a fantastic job.’

Professor Costello asked how the country may have responded if the government had set up COVID secure testing sites through primary care and sent samples to molecular virology labs.

Contact tracing

He also said that GPs would not have to take on 'all of the work' if the government had employed new staff to contact patients and follow up all cases, and hired enough local contact tracers to liaise with patients.

‘This is a disaster actually and a national shame. And if you compare to other countries now the situation, you can see that the UK and others like France are surging now. We know that the proportion of people testing positive is going up, hospital admissions are going up… and so are deaths.’

A Department of Health and Social Care spokesperson, said: 'This is an unprecedented pandemic and we have taken the right steps at the right time to combat it, guided at all times by the best scientific advice, to protect the NHS and save lives.

'General practices continue to play a vital role in our response to COVID-19, offering proactive care to at-risk patients and continuing to be there for all of us when we have health concerns.

'We are committed to supporting the NHS and primary care services to respond to the pandemic and have provided £31.9 billion in additional funding, with £3 billion specifically to support the NHS during winter.'

GPs recently warned the government off a PCN-led test and trace system, insisting that they were overworked and did not have the funding they needed. The government previously denied plans to make GPs 'gatekeepers' of the struggling COVID-19 testing system as top GPs warned about a lack of capacity.

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