Amid the COVID-19 outbreak, general practice has been forced to reshape its daily routines and adjust to a new reality, with surgeries moving fast to online triage and consultations in just days.
PCN leaders have also reacted to the unfolding situation by making plans to ensure their additional roles staff are ready to play their part in the COVID-19 response.
One PCN director in Newham, London, told GPonline she has ‘completely changed’ the role of her clinical pharmacist, making them the link between general practice and community pharmacists to manage drug shortages.
Another PCN leader is inducting and training staff hired through the Additional Roles Reimbursement Scheme (ARRS) virtually, via webcam, as he prepares to welcome two new employees.
Primary care networks
GPs have called for PCN workforce planning for next year to be suspended until the pandemic is over, arguing that box-ticking and work on recruitment are an unacceptable distraction at this time.
But how can those who have already hired additional roles staff, or are due to welcome new workers in the coming weeks, deploy their new workforce in the midst of a pandemic?
Clinical director of Newham 1 PCN Dr Farzana Hussain described how she had already adapted the role of the network's social prescriber. ‘I did something a bit different and contacted some of our local charity groups,' she said.
The PCN's social prescriber has effectively been loaned out to local charities - and is contacting people identified as vulnerable, working with them to identify support they need.
'Our social prescriber is working directly with them, ringing round some of their vulnerable people,' said Dr Hussain. 'He's currently working with a charity that deals with homeless mums and their children and a food bank.’
Dr Hussain said that allowing her link worker to operate in the community had made him ‘really useful’ during the outbreak. ‘He is doing that link worker thing of working with the people in the community. But that took a bit of inventive thinking and a bit of the connection with community groups,’ she said.
Newham 1 PCN has also adapted the role of its clinical pharmacist to fit current needs during the pandemic.
‘Rather than doing our audit like she had done in the past, she's become our link between us and community pharmacy, because community pharmacy is absolutely overwhelmed with people understandably panicking, and over-ordering their medications,' Dr Hussain said.
‘She is a very good link to help us and is able to help the pharmacists with our prescribing because that's what GPs need, we need help with our repeat prescribing. It’s still not fully happened yet but that's the plan - her job has completely changed.’
Clinical director of Whitewater Loddon PCN near Basingstoke Dr Tim Cooper told GPonline that he was looking to use his social prescribers as the bridge between primary care and the local community during the pandemic.
‘At the moment, with the challenges and everything that is going on, we haven't got the headspace to really focus on that kind of community response and there's some great bits that are happening locally.
‘So what we can hopefully do is kind of utilise those social prescribers to help reach into that, and then work out how that fits into our structure of what we're doing.’
He added that social prescribers could be used to conduct ‘comfort calls’, checking on vulnerable people in the community, who have been instructed to practise social distancing for three months, seeing if they have any unmet care needs.
Clinical director of Central and Thistlemoor PCN in Peterborough Dr Neil Modha is has two new staff members starting in April: a pharmacy technician and a physician associate. But in the current climate, he explained that his PCN needed to innovate by inducting and training staff over the phone or via webcams.
‘I guess our normal plan would be for them to sit in doctors' surgeries and sit in with the pharmacist. Whereas we're modifying those plans to ensure we are giving them enough training so that they can be supervised doing tasks.
‘It's going to be a different type of induction and a different kind of role for the first four weeks than what it would have been had the coronavirus pandemic not been around. So, we're definitely having to think through alternative ways of training induction and development.’
Dr Modha also revealed how he could deploy his incoming physician associate, he said: ‘They'll be doing a lot more of the admin-type functions under supervision, so helping us with letters and all of those tasks. That workload hasn’t gone down, we're still getting a lot of communications from the hospital, from out-of-hours services and NHS 111 - having an extra pair of hands for that will be really helpful.’
Clinical directors have argued that PCN structures had allowed them to respond quickly to the coronavirus pandemic in a way that may have been more difficult as larger organisations, such as CCGs.