The warning over pressure on GPs comes as the government eased most pandemic restrictions from 19 July - with masks becoming voluntary, the ‘rule of six’ abandoned, and the ‘one metre plus’ social distancing direction scrapped as the country prepares to ‘live with the virus’.
However, family doctors have warned that they are having to treat more cases of coronavirus in the community, including among patients who are fully vaccinated with two doses of COVID-19 vaccine, placing additional pressure on weary staff with no additional support.
Surrey GP Dr Dave Triska, a partner at the Witley and Milford surgeries, told GPonline that many fully vaccinated patients who develop coronavirus symptoms are failing to get tested because they are unaware that they can still contract COVID-19.
COVID-19 cases
Although GPs say these patients are unlikely to require hospitalisation, many are contacting surgeries to ask about symptoms and require support. The RCGP has warned that general practice remains ‘under intense workload and workforce pressures’.
Evidence shows that cases of COVID-19 among vaccinated patients are rising. Data from the ZOE COVID study at King’s College London estimated that there were 15,537 new daily symptomatic cases in partly or fully vaccinated people based on PCR test data up to 11 July - almost in line with an estimated 17,581 cases in unvaccinated people.
The study suggested cases among vaccinated people could outweigh those who are unvaccinated 'in the coming days'.
Dr Triska told GPonline that he had treated at least 20 people who had tested positive for coronavirus after receiving at least one jab, with many assuming the vaccines were a ‘bullet-proof vest’.
Reduced hospitalisations
He said: ‘We’ve had lots of coryzal symptoms; runny noses, sore throats, headaches, myalgia muscle pains, and coughs…they've often not had a test - because [it seems] no one is getting tested - and we have to see them to exclude other illnesses and then send them away again to get a test.
‘These patients aren't having to go to the hospital, but they are pretty unwell. Most people have been left in bed - one young person has been ill for a fortnight, so it can be extremely debilitating.
‘To make a reasonable assessment of some of these people we are having to [conduct] home visits which, when we're absolutely at full tilt, there's very little time in the day and it's not like there's been a resource pushed out to do this.’
He added: ‘When people were being hospitalised there were huge resources thrown at the hospitals - and now it seems that [when we’re treating] lots more people in the community there's no cavalry coming there, there’s no extra resource and COVID funds are stopping.’
Rising workload
Warnings from GPs about rising workloads created by more coronavirus cases come as academics recommended that non-clinical work for primary care should be suspended to let teams focus on patient care.
RCGP chair Professor Martin Marshall suggested that GP services could be affected by workload and workforce issues as cases surpassed 50,000 a day last week. He said: ‘In the coming weeks, we are likely to continue to see more patients testing positive for COVID-19, including fully vaccinated patients.
‘This is why the continued use of masks, and other appropriate infection control measures, remains critical in general practice settings post-19 July.
‘GPs and our teams are working under intense workload and workforce pressures. It’s vital that public health information about COVID-19 and advice for patients on how to behave if they have symptoms – including when partially or fully vaccinated - continues to be prominent, and is kept up to date as our understanding about the virus changes.’
NHS England announced last month that it has no plans for the QOF to be suspended for 2021/22 or for a repeat of income protection for practices despite intense workload pressure on general practice.
GP practices in England delivered 100m appointments from March to May this year, according to official data. But the true figures are likely to significantly underestimate true levels of GP workload, with telephone triage and home visits not recorded properly.
