New service will manage patients with COVID-19 who are self-isolating at home

GP practices will not be responsible for looking after patients with COVID-19 in the community, after NHS England unveiled a new service to manage coronavirus patients who are self-isolating at home.

NHS England primary care medical director Dr Nikki Kanani
NHS England primary care medical director Dr Nikki Kanani

A letter to GP practices from NHS England primary care medical director Dr Nikki Kanani on Tuesday said that in most areas the service would be run by the current out-of-hours provider.

NHS England also intends to ramp up plans to roll out online consultations in general practice to ensure 100% coverage, the letter reveals. Health secretary Matt Hancock told parliament yesterday that all GP consultations should be carried out by phone or digitally where possible 'with immediate effect' to improve access during the coronavirus outbreak.

However, Dr Kanani's letter said that only around half of GP practices currently have online consultation systems. 'Rapid steps' would be taken to increase the use of existing systems and set up new systems where practice don't have them, the letter added.

NHS England is also 'taking steps' to review current GP work 'to assess how additional capacity might be released if required'. The letter said that if practices needed to undertake annual reviews with patients for the QOF they could do this on the phone or via online consultations and, providing they were coded as usual, this would meet QOF requirements.

COVID-19 home management service

The new home management service for coronavirus will be available 24 hours a day, seven days a week and will manage patients with COVID-19 who are self-isolating within the community. Until now, all patients with COVID-19 had been isolated in hospitals regardless of the severity of their symptoms.

Dr Kanani's letter said that the new service will provide urgent primary care services to the patients it covers, including treatment for symptoms of the coronavirus as well as any other conditions. Patients will be discharged from the service after they have tested negative for COVID-19 or 'after an elapsed time period'.

GP practices will be kept up to date with details of their patients' health.

Dr Kanani said that in most cases the service would be provided by 'existing local out-of-hours service provider but may also be an alternative provider from a different locality or a digital first provider depending on local arrangements.'

Public Health England has established three new categories of patients with COVID-19:

  • Category 1 – Require immediate admission
  • Category 2 – Home isolation with active health monitoring (for patients at increased risk of complications from COVID-19)
  • Category 3 – Home isolation with health advice

The new home management service will provide care for patients in category two and three. Those in category two will receive daily communication from a healthcare professional working for the service. Those in category 3 will be told to contact the service if they develop breathing problems or have any other health concerns.

The plans come as NHS England also announced that it was expanding the number of people it can test in a day to 10,000, up from 1,500. The vast majority of tests will be turned around within 24 hours.

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