During the COVID-19 pandemic, healthcare services have had to adapt and change the way that they provide care for patients. We spoke to Dr Mohammed Munshi, regional clinical lead (South) at Virgin Care, to find out how they have continued GP appointments during the lockdown.
“COVID-19 has accelerated digital changes in the provision of patient care,” he explained. “So instead of seeing patients face-to-face, there's an online triage system on the practice website where the patient fills in their details. These are then sent to a doctor and they can prioritise cases. We can call a patient back on the telephone or we can do a video consultation with them. This technology was already out there but there wasn't a massive uptake.”
Before the pandemic, Dr Munshi said, just 20% of the GP practices in Essex that Virgin Care is responsible for had an online triage system. Now they all do. And the adoption of digital has many benefits, for both doctors and patients.
“It has increased accessibility for patients who are housebound because they now also get a video consultation, whereas previously they may not have been able to visit a doctor,” Dr Munshi said. “We get the opportunity to see them in their home environment and they get to see us, so for some people it's actually improved accessibility. For others it's improved accessibility because we can prioritise cases. So a child with a rash is a higher priority than someone with an ongoing knee pain because of arthritis, for example, so we're able to see that child a lot quicker.”
Digital consultations are also more convenient for patients because they don’t have to waste time in a waiting room. Instead, they are at home when the doctor calls them.
However, Dr Munshi said that GPs have seen their workload change dramatically during the coronavirus pandemic. “A lot of patients who we would normally see don't appear to be coming through. There's a bit of concern around a lot of things that are going undiagnosed, in particular the diagnosis of cancer because patients aren't presenting because they're worried about coming in.”
Statistics from Cancer Research UK show that urgent cancer referrals are down 75 per cent in England. Dr Munshi said this was concerning because “the outcomes of cancer will be much worse if there's a significant delay in starting treatment.” He added: “Cancer treatment pathways are still active – they've never been stopped during the COVID-19 pandemic. Referrals are still going through as they would have pre-COVID.”
The impact COVID-19 has had on cancer referrals is difficult to know, because while patients aren’t booking in to see a GP with the initial symptoms, figures are impossible to track. Some estimates, Dr Munshi said, are that up to 30,000 cancer treatments across the UK could be delayed or missed entirely because the pandemic has meant people not getting checked soon enough.
Dr Munshi said: “That would be a significant number. And that would be unnecessary because cancer pathways are still active and we are still referring patients to be assessed by a specialist within two weeks.”
Across the NHS doctors are urging people to keep coming forward, and to speak with their doctor as they normally would about symptoms.
Dr Munshi said that he understands patients’ concern about having to visit a doctor but wanted to reassure them that, in many cases, it wouldn’t be necessary to actually attend a GP practice. And, if it is, they have made sure it is as safe as possible for patients. “We have PPE and we have cleaning procedures. We have clean rooms where we can bring patients into,” he explained. “Child immunisations have continued throughout COVID and it's not caused any concern at all. Patients arrive, they are waiting in their car outside, when the clinician is ready we collect them with full PPE on, bring them in, administer the immunisations and then off they go. It's not caused any concern at all throughout COVID. So we are still functional and there is a lot of capacity to see patients in primary care right now.”
Ultimately, Dr Munshi said patients should ask themselves: “Would I have contacted a healthcare professional before COVID?” If the answer is yes, then you still should.
He added: “General practice is open, 111 is still running – in fact both have ramped up their provision of appointments in anticipation of the increased amount of COVID-related cases. But the demand for other conditions has actually dropped. What we want to do is to encourage people to contact us. There's a lot of anxiety around having to come into the practice or come into hospital – but there shouldn't be because there are all these other provisions for assessing a patient remotely.”
Virgin Care workers are on the frontline of the coronavirus pandemic, working hard to fight this disease. Visit Virgin Care to find out more.
Virgin Group has invested more than £75m to date into Virgin Care’s health and community services and neither Richard Branson, nor Virgin, has taken a penny of profit out of the NHS, nor do they intend to do so. Every penny Virgin Care has received has been used to pay for delivering services, including doctors, nurses and allied health professionals’ salaries, as well as being invested in transformation projects to improve the NHS. If Virgin Care ever does make a profit over and above its investment, the Virgin Group has committed to reinvest 100% of that back into healthcare services.