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by Eleanor Philpotts
14 February 2020
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The BMA’s GP Committee has urged NHS England that practices should be able to turn off their online booking systems, amid rising cases of coronavirus (Covid-19).
The online system does not triage patients in the same way as receptionists, meaning it could lead to infected people turning up at practices, it warned.
So far, 2,521 tests of the globally-spreading virus have currently taken place in the UK, with nine confirmed positive.
Meanwhile, 11 GP practices across England have now closed due to the potentially lethal virus, including three, in Somerset, Surrey and London, yesterday alone.
Public Health England has been ‘racing’ to locate patients who may have been seen by the two Brighton GPs who are among the confirmed cases.
Dr Peter Holden, emergency preparedness lead of the GPC, told our sister publication, Pulse, that this outbreak posed a problem with online booking systems.
He said: ‘Patient and staff safety must always take precedence.
‘It is possible that proper triage does not take place with online booking systems, and therefore temporarily suspending this process would be a sensible precaution in order to prevent people who may be suffering from this virus presenting at their practice, and we have made this clear to NHS England.’
The patients affected are receiving specialist NHS care in Newcastle and London, with the capital’s first confirmed case being a Chinese national who arrived at Heathrow over the weekend and is understood to have walked into Lewisham A&E via Uber taxi on Sunday.
GPs have voiced concerns that NHS 111 is still directing patients with flu-like symptoms to consult their GP, without asking whether they have travelled from regions worst-affected by Covid-19. This contradicts NHS England’s official advice, which is that those who may be affected should call 111 and not visit their GP.
At-risk groups include people who have travelled from Wuhan or Hubei Province to the UK within the last 14 days, even if they are asymptomatic; those who visited other parts of China or neighbouring countries in that period and have a cough, high temperature or shortness of breath, even if mild; and those have been in close contact with someone with confirmed coronavirus.
The BMA’s GP Committee raised this issue with NHS England and the Department of Health and Social Care last weekend, and are believed to still be awaiting update.
Yesterday, Dr Dave Triska, whose Surrey practice is approximately ten miles from Ferns Medical Practice, which closed after seeing someone who had travelled from one of the most-affected regions, encountered further difficulties with trying to access a diagnostic swab for the potential patient.
He described how 111 incorrectly digitally triaged the individual, after providing false reassurances that they could not have had any Covid-19 contact.
Dr Triska spent four and a half hours yesterday trying to get a swab for the potential patient, being declined because the potential patient had not personally travelled from the most-affected areas, nor been in close contact with someone with a confirmed diagnosis. Eventually, they were transferred to an isolation pod at Royal Surrey County Hospital.
He told our sister publication: ‘My experience of 111 today does not fill me with hope that clear clinical need for testing is able to be flagged by clinicians.
‘Dogmatically sticking to an algorithm is going to miss potential cases and cause havoc in the prevention of the spread of coronavirus.’