Patients 'will die from non-COVID-19 illness' as NHS shifts focus to outbreak

GP practices have been warned to maintain vaccination campaigns and other essential work during the COVID-19 outbreak to limit the risk of preventable deaths from other causes as NHS staff focus on tackling the pandemic.

(Photo: Daniel Leal-Olivas/AFP/Getty Images)
(Photo: Daniel Leal-Olivas/AFP/Getty Images)

Guidance set out by the RCGP and the BMA highlights key work that practices must maintain throughout the outbreak - and spells out what practices can drop or consider suspending.

Key services such as routine vaccination for flu, shingles, childhood vaccination and pneumococcal jabs must continue to avoid a surge in preventable disease following the pandemic, the advice for practices warns.

RCGP guidance warns practices: 'Past experience has shown that patients will die from non-COVID-19 related illnesses in addition to COVID-19 itself as we divert all of our health care resources towards it.

Population health

'General practice has a huge role to play in maintaining the underlying health of our population in an attempt to prevent this. It is vital that we continue to provide care to all patients if we have the capacity, with workloads stratified to ensure that those at greatest need are prioritised.'

Guidance from the RCGP lists postnatal checks, long-term condition reviews for high-risk patients, acute home visits, wound care and other services among work that should continue, but emphasises that self-care should be encouraged and consultations carried out remotely where possible.

For medication problems that cannot be managed by community pharmacists, remote consultation 'should be the norm' - and work should be diverted to primary care network (PCN) pharmacists where possible.

The guidance warns that a rise in pregnacies could result after a prolonged period of isolation, and urges practices to 'consider extending pill prescriptions for low-risk patients without review'. GPs are advised to keep contraception services going 'if capacity allows' - and to consider issuing standardised responses to any complaints during the COVID-19 outbreak until a full response can be offered.

Non-essential work

RCGP experts have also warned that although guidance for practices aims to balance maintaining services 'essential to maintain public health' with dropping work that is 'unlikely to cause harm if delayed for approximately a short number of months', practices must continue to use their own judgment in individual patient cases.

BMA guidance sets out non-essential work that can be suspended by practices, including travel vaccination, minor surgery, phlebotomy and over-75 health checks - along with work such as routine medication reviews and all data collection work apart from in cases linked to COVID-19.

The advice follows clarification from NHS England earlier this month that practices' QOF pay would be protected and that practices would be allowed to suspend much of their routine work as they shift to tackling the growing coronavirus outbreak.

The guidance comes as prime minister Boris Johnson announced on Monday that the UK was moving into full lockdown, with people told to remain at home apart from to exercise once a day, to help vulnerable people or collect food or medicine.

On 23 March 6,650 cases of coronavirus had been confirmed, with 335 deaths.

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