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How GPs worked together to innovate in the face of COVID-19

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08 Jul 2020

How GPs worked together to innovate in the face of COVID-19

Dr Shikha Pitalia, Chair of Wigan GP Alliance
How GPs worked together to innovate in the face of COVID-19

While the spotlight on caring for people during the pandemic understandably has been on Intensive Care Units, GPs across Wigan and Leigh have also been on the frontline, treating people with symptoms of the virus in pioneering new ways.

Wigan GP Alliance is shaping how patients across the borough are looked after while also preventing the spread of the disease and keeping its clinicians safe. The close co-operation between health professionals has allowed our organisation to be at the leading edge of this in Greater Manchester.

The Alliance is a confederation of more than 60 GP practices across Wigan and Leigh, which look after around 330,000 patients. It was established five years ago and its main role has been to deliver pre-bookable appointments for patients who need to be seen in the evenings or at weekends when surgeries are closed. It also provides doctors to deal with emergencies out of hours and on bank holidays to reduce the need for patients to go to A&E.

But when the pandemic struck, Wigan’s Clinical Commissioning Group (CCG) asked the Alliance to set up new services to help practices across the borough deal with the crisis – and we quickly stepped up to the mark.

In one of the fastest responses seen across the city region, within two weeks of the request the Alliance had set up bespoke new services. This includes ‘hot clinics’ for patients who either have symptoms suggestive of COVID-19 or are self-isolating with someone who has the virus, but need to be seen for another co-existing illness.

These patients have to be assessed away from their usual surgery for the safety of other patients and staff. The Alliance quickly expanded an initial service to three hot clinics across the borough so all patients and practices could easily access them.

These facilities, which are not advertised to ensure access is strictly by appointment only so as to not compromise infection control, have taken a great deal of pressure off GP surgeries across the borough.

At the same time, as more patients were asked to shield themselves at home, the numbers of GP home visit requests increased.

To protect doctors from exposure to the virus, strict personal protection equipment (PPE) requirements have to be followed and so, to make the best use of the borough’s supplies, the Alliance set up a dedicated acute home visiting service. This follows strict protocols so patients who are too ill to leave the house but do not need to be seen in hospital, are visited by a doctor wearing full PPE.

All patients seen at the hot clinics or visited at home must have a telephone and sometimes also a video consultation with their own GP or nurse before being referred into these services. The Alliance doctor will then speak to the patient again to agree the most suitable option for them.

The Alliance had to organise high-level decontamination processes for these sites and sourced Hackney Carriage vehicles to transport GPs on home visits to ensure social distancing measures between driver and doctor. The Alliance arranged for all GPs involved to be risk assessed to ensure their safety ahead of potential exposure to the virus and organised enhanced PPE for them.

The Alliance also works in partnership with Wrightington, Wigan and Leigh NHS Foundation Trust (WWL), and was already providing GP services from the Royal Albert Edward Infirmary and Christopher Home.

During the crisis, WWL reached out to the Alliance for help in providing additional daily medical staffing to support the care of patients in their recovery phase at Wrightington Hospital and out of hours cover at Leigh Infirmary. The Alliance team was able to co-ordinate these services within WWL and to recruit more doctors to deliver them, while continuing to provide all existing and the new COVID-19-related community services.
The Alliance is proud to be working with the CCG, Public Health England and WWL and of its unique contribution in providing these bespoke services. Many thanks to our colleagues in GP practices across the borough for their support and co-operation.

It is a credit to the Alliance’s clinical leadership and operational experience that these services have been set up and staffed with such speed and effectiveness, especially during such an intense period when Alliance Board members have been also looking after their usual daily workload in their own GP practices.

It shows how all arms of our NHS can work together to swiftly put in place ground-breaking initiatives to ensure our patients across Wigan and Leigh receive some of the best healthcare, not only in Greater Manchester, but in the whole country.

Dr Shikha Pitalia, Director of SSP Health, has been leading the co-ordinated response of doctors’ surgeries across Wigan to the COVID-19 crisis in her capacity as Chair of Wigan GP Alliance.

The Alliance, a confederation of more than 60 GP practices across Wigan and Leigh, which look after around 330,000 patients, has been busy creating new ways of treating patients in line with the demands the Coronavirus pandemic puts on healthcare.

This has led to the creation of ‘hot’ clinics across the borough for patients who either have symptoms suggestive of COVID-19 or are self-isolating with someone who has the virus, but need to be seen for another co-existing illness. These patients have to be assessed away from their usual surgery for the safety of other patients and staff.

An acute home visiting service was also established, using a specially-sourced Hackney Carriage vehicles, so doctors in full PPE can visit patients in their own home.

The Alliance also co-ordinated extra staffing for hospitals where COVID-19 patients were recovering.

Dr Pitalia said: “It is a credit to the Alliance’s clinical leadership and operational experience that these services have been set up and staffed with such speed and effectiveness, especially during such an intense period when Alliance Board members have been also looking after their usual daily workload in their own GP practices.

“It shows how all arms of our NHS can work together to swiftly put in place ground-breaking initiatives to ensure our patients across Wigan and Leigh receive some of the best healthcare, not only in Greater Manchester, but in the whole country.”

Click this link to read Dr Pitalia’s personal account of the initiative, which was published in the local press.

Dr Shikha Pitalia, Director of SSP Health, has been leading the co-ordinated response of doctors’ surgeries across Wigan and Leigh to the COVID-19 crisis in her capacity as Chair of Wigan GP Alliance.

The Alliance, a confederation of more than 60 GP practices, quickly created new ways of treating patients in line demands that the Coronavirus pandemic puts on healthcare.

This has led to the creation of ‘hot’ clinics across the borough for patients who either have symptoms suggestive of COVID-19 or are self-isolating with someone who has the virus but needs to be seen for another co-existing illness.

An acute home visiting service was also established so doctors in full PPE could go out to see patients and the Alliance co-ordinated extra staffing for hospitals where COVID-19 patients are recovering.

Dr Pitalia said: “It is a credit to the Alliance’s clinical leadership and operational experience that these services have been set up and staffed with such speed and effectiveness, especially during such an intense period when Alliance Board members have been also looking after their usual daily workload in their own GP practices.”

Read Dr Pitalia’s account of the initiative, published in the local press, here.

Dr Shikha Pitalia

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