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General Practice in the Time of COVID-19: A Mixed-Methods Service Evaluation of a Primary Care COVID-19 Service

Author

Listed:
  • James Hibberd

    (Islington GP Federation, London N7 8EG, UK
    James Hibberd and Jessica Carter are joint first authors and contributed equally to this paper.)

  • Jessica Carter

    (Islington GP Federation, London N7 8EG, UK
    Institute for Infection and Immunity, St George’s University, London SW17 0RE, UK
    James Hibberd and Jessica Carter are joint first authors and contributed equally to this paper.)

  • Michaella McCoy

    (Islington GP Federation, London N7 8EG, UK)

  • Meena Rafiq

    (Epidemiology of Cancer and Healthcare Outcomes (ECHO) University College, London WC1E 6BT, UK
    RM Partners, London SW1H 0QS, UK)

  • Amita Varma

    (Islington GP Federation, London N7 8EG, UK)

  • Rita Sanghera

    (Islington GP Federation, London N7 8EG, UK)

  • Philippa Matthews

    (Islington GP Federation, London N7 8EG, UK)

  • Greta Rait

    (Primary Care and Population Health Department University College, London NW3 2QG, UK)

Abstract

Primary care coronavirus disease 2019 (COVID-19) clinics were rapidly introduced across the UK to review potentially infectious patients. Evaluation of these services is needed to guide future implementation. This mixed-methods study evaluates patient demographics, clinical presentation, co-morbidities, service usage, and outcomes for the Islington COVID-19 service (London, UK) and from April to May 2020 and thematically analyses survey responses from 29 service clinicians and 41 GP referrers on their service experience. Of the 237 patients booked into the service, a significant number of referrals ( n = 91; 38.6%) were made after the presumed infectious period of 14 days. Almost half of all adult referrals (49%) were dealt with remotely (via telephone/video consultation +/− remote oxygen saturation monitoring). The service was perceived to provide a safe way to see patients; it developed local expertise, learning, and empowerment; and it was a positive teamworking experience. These findings suggest that the management of many patients with COVID-19 symptoms is possible in routine general practice with minimal risk through the implementation of remote consultation methods and in patients who present after the post-infectious period. Additionally, the use of remote saturation monitoring and local GP COVID-19 “experts” can support practices to manage COVID-19 patients. Future primary care COVID-19 services should act as empowerment tools to assist GPs to safely manage their own patients and provide support for GPs in this process.

Suggested Citation

  • James Hibberd & Jessica Carter & Michaella McCoy & Meena Rafiq & Amita Varma & Rita Sanghera & Philippa Matthews & Greta Rait, 2021. "General Practice in the Time of COVID-19: A Mixed-Methods Service Evaluation of a Primary Care COVID-19 Service," IJERPH, MDPI, vol. 18(6), pages 1-11, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:6:p:2895-:d:515530
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    References listed on IDEAS

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    1. Luca Fiorillo & Gabriele Cervino & Marco Matarese & Cesare D’Amico & Giovanni Surace & Valeria Paduano & Maria Teresa Fiorillo & Antonio Moschella & Alessia La Bruna & Giovanni Luca Romano & Riccardo , 2020. "COVID-19 Surface Persistence: A Recent Data Summary and Its Importance for Medical and Dental Settings," IJERPH, MDPI, vol. 17(9), pages 1-10, April.
    2. J. Daniel Kelly, 2014. "Make diagnostic centres a priority for Ebola crisis," Nature, Nature, vol. 513(7517), pages 145-145, September.
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