Dr J – GP experience

Dr J is the senior partner at a two-surgery GP practice. She found the pandemic ‘draining and exhausting’… ‘strangely different but still busy.’

The doctors in her practice had to quickly change how they worked, with rapid use of telephone and video consulting; and the location where they worked. Home working, and multi-practice based working at hot and cold sites, within a Primary Care Network ‘mega-rota.’

Dr J also had to work out how to protect staff, some of whom were off shielding, considering infection control and availability of PPE, with guidance on safe working changing regularly.

Generally working through this initial phase of the pandemic was tiring just being ‘human,’ looking at the lack of control around the world, as the virus took hold, and attempting to understand some of the science and the projections. ‘We're all members of the public as well as professionals….wondering what will be happening next.’

On a day to day basis, everything took much longer to do - using the technology, putting on PPE, measuring temperatures, meeting and greet patients differently. ’It all adds up,’ she said.

Although there were fewer face to face consultations, consulting with patients took more time too. ‘A normal consultation was split into three - a telephone call explaining the symptoms, an examination in person if needed, then a feedback telephone call with the patients in the car or back at home – but the three ‘thirds’ added up to longer than the whole.’

Like many GP practices, they had had a long history of difficulty in recruiting new doctors, and were already stretched for manpower. As a result, she says ‘we entered this quite tired.’

Before the pandemic, she tended to use newly qualified or recently retired doctors as locums to fill the gaps in the past.

She believes the positive of the pandemic is potentially more young doctors choosing to become salaried GPs, because of the team spirit imbued.

She explains, ‘Over the last few years because of challenges in recruitment for leaving GPs, we have been thin on the ground and we try and work as a team, rather than as individuals.

‘There are silver linings in the pandemic. It might mean that people rethink their career plans and think they need to commit to one particular practice rather than going from one place to another. We rely on locums who have their many strengths but their flexibility is to themselves.

‘We filled a post or created a post for one of our former trainees, who's now doing some regular salary work for us, but also going out to do locums in the area. She gets to experience how other practices work. We are happy to be creative.’

Another big shift has been the changing nature of conversations with patients to determine if they need to be seen, not by whom. She says, ‘before COVID-19 we had already been doing “what is the problem, who is the right person for you to see? The nurse practitioner rather than the GP?” It was turning it around with COVID-19 thinking actually, “what would we gain by seeing you [at all]?”

The government’s message of only contacting doctors if symptoms were getting worse ‘turned everything around.’

She says if that message continues to have force in the months to come, that will be a very novel way of working to most winters.

She is unlikely to see it, though. She had intended to retire in Spring 2020 after three decades in the NHS but postponed her leaving date because of the need during the pandemic and particularly because retired doctors were being asked to come back into the workforce.

‘I'm retiring to give myself a breathing space, but watching - and I might well be back if a second wave comes.’