GP practices should have been 'jewel' in NHS track and trace system, says US health expert

Leaving GP practices out of the NHS COVID-19 track and trace system is a mistake that has left the UK government operating with 'three layers of mittens on', a leading US health expert has warned.

Professor Don Berwick (Photo: Boston Globe/Getty Images)
Professor Don Berwick (Photo: Boston Globe/Getty Images)

NHS COVID-19 track and trace systems should have been built around GP practices because registered patient lists are a 'tremendous resource' that could have been used to deliver far better surveillance and contact tracing systems, according to health expert Professor Don Berwick.

Professor Berwick, brought in by the UK government in 2013 to help embed findings from the Francis review into the NHS, said primary care could have played a pivotal role in contact tracing during the pandemic - and could do so in a second wave of COVID-19 or in future pandemics.

The US healthcare professor argued that using regional health structures was key to successful surveillance and contact tracing.

COVID-19 pandemic

Speaking at a Royal Society of Medicine webinar, Professor Berwick said: ‘To track and trace is a community-based effort - you have to get out to where the case is and be able to do the correct investigation.

‘One of the great things you have in the UK, that you don’t realise how special it is, is "empanelment",' he said. 'The idea that you actually can tie every single person in your nation to general practice. That’s a tremendous resource.

‘One of the whole problems in case tracking is that you don’t know where the people are - empanelment is a jewel of a lever for proper public health.'

Professor Berwick stressed that using local NHS organisations ‘would have really helped’ to better manage the UK test and trace programme. He said the government had been working with ‘three layers of mittens on’ by bypassing local systems - and suggested that the UK could involve GPs in track and trace systems in the event of a second COVID-19 wave.

GP public health role

He said: ‘You could have, if you had chosen, set up a GP system in the country which could be called into play for the preservation and improvement of public health, including surveillance and contact tracing or at least exchanging data. But you didn’t do that.

‘You can correct that, you can correct that any time you choose and get ready for the next pandemic, much better, with one of the strongest primary care systems in the world.

‘The general practices of your country are a public health tool… but only if they are trained to do that, and resourced to do that.’

The government's failure to involve primary care in its test and trace programme has previously been described as ‘baffling’ by GPs, who argue that number 10 has manufactured a ‘blind spot’ in the system.

At present GPs are unable to swab patients or directly book them in for tests even if they suspect a person has coronavirus - patients must request the tests themselves through an NHS website.

A DHSC spokesperson said: 'We rapidly built from scratch a large-scale testing programme and have carried out more than 13.5m tests.

'GPs have an important role to play in curbing the spread of coronavirus and helping to save lives. Local authorities will continue to engage with a range of local bodies, including primary care and general practitioners, to develop plans and ensure that anybody who needs a test can get one.'

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