The ‘COVID-19: Preparing for the future, looking ahead to winter 2021/22 and beyond’ paper from the Academy of Medical Sciences also argues that primary care services should be ‘adequately resourced’ to ensure they can ‘safely deliver’ anticipated levels of care in the coming months.
It recommends that GP practices should be allowed to pause non-emergency, non-clinical work amid ongoing COVID-19 vaccination efforts, more coronavirus patients being treated in the community and an expected surge of flu and other respiratory illness.
Report authors also said that Point of Care Testing (POCT) should be rolled out in GP practices to help primary care teams test patients quickly, identify their illness and deliver targeted care.
NHS services must be offered ‘sufficient temporary funds’ to allow for increased workforce over the winter, according to the report, which encourages health services to offer a balance between remote and in-person consultations.
The report explained that low levels of influenza over the past two years is likely to have ‘diminished’ population immunity. It predicted that an influenza epidemic could be between 1.5 and 2.2 times the magnitude of a ‘normal’ year if restrictions are fully lifted - increasing the burden to healthcare systems.
It added that more cases of coronavirus would be dealt with in the community following the COVID-19 vaccination campaign, with more people being treated by primary care than in hospitals. It also predicted higher levels of long COVID over the winter if cases of coronavirus continue to rise.
The report said: ‘We expect the pressures on primary care to intensify this autumn/winter, not least due to its ongoing role in the vaccination effort, including the delivery of influenza vaccinations this autumn; as more COVID-19 patients are treated in the community as delayed treatment causes worsening of chronic conditions; and with the additional uncertainty of increased respiratory infections.
‘To safely deliver the anticipated levels of care this winter, the governments and NHS bodies in all UK nations must ensure that primary care is adequately resourced, particularly as new work is transferred from secondary care. It is essential to allow current resources to remain and an increase may be needed.’
It added: ‘To further reduce pressures, the governments and NHS bodies in all UK nations should consider additional measures to allow primary care to focus on the delivery of clinical care. Options might include pausing non-emergency non-clinical work, such as CQC inspections.’
Last month NHS England revealed it had no plans for the QOF to be suspended for 2021/22, or for a repeat of income protection despite intense workload pressures. The CQC has also this week started to carry out monthly online checks on GP practices as it moves away from a temporary model of monitoring services adopted during the pandemic.
BMA GP committee chair Dr Richard Vautrey warned that GPs had already seen a ‘resurgence' of respiratory viral infections as he predicted a tough winter. He said: ‘The winter pressures that would normally be there will be clearly there again this year. And, also potentially further prevalence of other respiratory illnesses and flu that was suppressed last year.
Respiratory viral infections
‘[This] will resurge again this year particularly if a large portion of the population are not using masks or social distancing, which helped to limit respiratory illnesses over the past 12 months.
‘We have already seen a resurgence of respiratory viral infections, particularly in children, at the moment and that is one of the factors adding to our workload pressures and we fear that that's going to be just a sign of what's to come in the winter.
‘Practices are anticipating an extremely difficult winter. If we have a high prevalence of COVID-19 on top of that it's just going to make matters even worse.'
In recent weeks cases of coronavirus have surged, with cases in the UK now reaching over 40,000 a day and rising - the highest level seen since January.