In the first of a series of regular updates to keep general practice updated on the 'emerging COVID-19 situation', NHS England director of primary care Dr Nikki Kanani wrote: 'I recognise that COVID-19 is placing a new and increasing challenge on already busy practices, and this will be an area of concern for you, your teams and your patients.'
The letter to GP practices highlights existing safety advice and operating procedures for primary care - and promises that advice and plans on how to 'prioritise work to help manage increased pressure on the workforce, models to care for vulnerable and self-isolating members of the public and staff, and approaches to temporarily increase workforce capacity' will be distributed to primary care 'as required'.
Following warnings from GP practices over a shortage of personal protective equipment (PPE), the letter promises that each practice in England will receive 'an initial stock' of PPE including 400 general use aprons, 300 pairs of examination gloves and 300 fluid repellent face masks from early next week. Larger practices will receive 'repeat deliveries to ensure they have sufficient amounts', the letter confirms.
Practices are advised to 'change face-to-face appointments booked online to triage appointments via telephone or video' to avoid patients with potential coronavirus infection arriving at practice premises. BMA leaders called last month for the relaxation of a contractual requirement for practices to make appointments bookable online.
GPs have also been warned against supporting patients to stockpile medication by changing the duration of repeat prescriptions. The guidance warns that switching to longer-duration repeat prescribing could 'put a strain on the supply chain and exacerbate any potential shortages'. Patients should be switched to electronic prescribing where possible
GP leaders have warned that steps such as the suspension of QOF could be necessary as pressure on GP practices rises through the coronavirus outbreak.
More than two dozen GP practices have been forced to close temporarily in recent weeks after suspected contact with coronavirus cases - with one 20,000-patient practice forced to close for a fortnight after all staff were told to self-isolate.
With just weeks to go until the 31 March deadline for entering QOF achievement data, practices have called for a commitment to pay practices in line with previous years' achievement - a measure that has been used in parts of the UK in recent years when practices have been under pressure.
Dr Kanani said on Twitter that measures such as QOF suspension were under consideration - while CMO Professor Chris Whitty told MPs on 5 March that officials had also looked at the possibility of stopping CQC checks and doubling the duration of GP sick notes from seven to 14 days - although the CQC has said it plans to continue inspections for now.
The letter from Dr Kanani came after confirmation of the first UK death from coronavirus. An older patient with underlying health conditions died at Royal Berkshire Hospital on 5 March after contracting COVID-19.
A total of 115 cases have been confirmed across the UK, with more than 18,000 patients tested.