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.
Highlights
Introduction iationsSevere acute respiratory syndrome coronavirus 2 has led general practice in the UnitedKingdom to change more rapidly in the last six months than in the last decade [1]
We report the gap findings of a service evaluation of abase primary care development service forofpatients in the literature, both adding an evidence for the future similar services within primary care and indicating where further research is needed with suspected COVID-19 in Islington, London
There is some evidence from Australia and Canada suggesting that Influenza Assessment Clinics (IAC) during the 2009 H1N1 outbreak reduced the burden on Emergency
Summary
Res. Primary Care and Population Health Department University College, London NW3 2QG, UK. James Hibberd and Jessica Carter are joint first authors and contributed to this paper
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