GPs must demand strong voice in COVID-19 public inquiry

General practice must ensure its voice is heard as national inquiries into the initial handling and longer-term impact of COVID-19 begin in the UK and around the world - and ensure lessons are learned and shared internationally, according to a leading GP.

Professor Michael Kidd speaks at RCGP conference

Delivering the 11th John Hunt lecture at the 2021 RCGP annual conference in Liverpool, Australia's deputy chief medical officer Professor Michael Kidd - a GP and former president of the Australian RCGP - said the response of UK general practice to the pandemic had been 'extraordinary but not at all surprising'.

General practice teams demonstrated their dedication and insight into communities the profession serves through the pandemic, Professor Kidd told the conference - and had shown that primary care is a 'fundamental part of public health'.

He urged GP leaders to continue to lobby government to remind them of the essential contribution of the GP workforce in the pandemic response - and to underscore how fundamental the profession's contribution will be in managing the 'long tail' of morbidity and mortality likely to continue for years in the wake of COVID-19.

Public inquiry

GP leaders should 'advocate strongly now for inquiries' into the handling of the pandemic and into its likely medium- and long-term impact, Professor Kidd told the conference - and should press politicians to ensure that the GP voice is 'involved and heard' in these processes.

A UK public inquiry into COVID-19 is unlikely to begin until April 2022, the government has said - a delay condemned by doctors' leaders who have warned the long wait is unfair on bereaved families and could drive down morale in the medical profession, potentially adding to early retirements.

But Professor Kidd said that as these inequiries begin in the UK and around the world, it was vital that GPs both ensure they are heard and that the profession learns lessons from experiences elsewhere - taking on board what went well and mistakes made.

He set out questions to consider as countries emerge from the pandemic - including how general practice would support its most vulnerable patients, how it would continue to care for those with COVID-19 while keeping other patients safe, how continuity of care could be maintained in the face of intense workload pressures and how the mental health impact of the pandemic could be managed.

COVID-19 protection

He said it was essential that GPs and practice teams continued to receive the same level of protection as staff working in hospitals as countries moved on from the worst of the pandemic.

Professor Kidd pointed out that once large parts of the population were vaccinated, most people infected with COVID-19 no longer require hospital treatment and would therefore be 'cared for by GP services'.

He said it would be challenging to handle this additional workload safely, while at the same time 'ensuring continuity of regular care' and addressing the burden of care missed during the pandemic - both from patients putting off seeking help, and from hospital backlogs.

The success of the UK vaccination programme - with more than 80% of the adult population now 'double jabbed' - demonstrated the 'great value of a strong system of primary care based on general practice', Professor Kidd said.

Vaccine rollout

But he voiced concern for those yet to be vaccinated - particularly those unable to go out to receive a vaccine who may have been missed in the national rollout, newly arrived immigrants who may miss important public health messages, people who are homeless or those in crowded locations including prisons who may be unvaccinated.

He said high levels of trust in general practice would be a vital asset in spreading vcaccination to these populations, and within local communities - but that the profession would also need more resourcing to strengthen an 'ageing workforce', particularly with large numbers of doctors who have postponed retirement through the pandemic likely to leave.

Despite these concerns, he said the pandemic had made clear that 'whatever happens in future, the GP role will continue'.

He highlighted 'exciting transformations' during the pandemic - citing a 'blending of public health and medicine that I don't think we've seen before', and a increased public awareness of public health and emergency response than in the past - along with evidence that trust in general practice had never been higher.

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