Abstract
ObjectivesThe study aims to investigate GPs’ experiences of how UK COVID-19 policies have affected the management and safety of complex elderly patients, who suffer from multimorbidity, at the primary care level in North West London (NWL).DesignThis is a service evaluation adopting a qualitative approach.SettingIndividual semi-structured interviews were conducted between 6 and 22 May 2020, 2 months after the introduction of the UK COVID-19 Action Plan, allowing GPs to adapt to the new changes and reflect on their impact.ParticipantsFourteen GPs working in NWL were interviewed, until data saturation was reached.Outcome measuresThe impact of COVID-19 policies on the management and safety of complex elderly patients in primary care from the GPs’ perspective.ResultsParticipants’ average experience was fourteen years working in primary care for the NHS. They stated that COVID-19 policies have affected primary care at three levels, patients’ behaviour, work conditions, and clinical practice. GPs reflected on the impact through five major themes; four of which have been adapted from the Safety Attitudes Questionnaire (SAQ) framework, changes in primary care (at the three levels mentioned above), involvement of GPs in policy making, communication and coordination (with patients and in between medical teams), stressors and worries; in addition to a fifth theme to conclude the GPs’ suggestions for improvement (either proposed mitigation strategies, or existing actions that showed relative success). A participant used an expression of “infodemic” to describe the GPs’ everyday pressure of receiving new policy updates with their subsequent changes in practice.ConclusionThe COVID-19 pandemic has affected all levels of the health system in the UK, particularly primary care. Based on the GPs’ perspective in NWL, changes to practice have offered opportunities to maintain safe healthcare as well as possible drawbacks that should be of concern.
Highlights
Primary care is fundamental to a resilient healthcare system, providing safe and timely services in all settings, including outbreaks and emergencies [1]
Participants’ average experience was fourteen years working in primary care for the National Health Service (NHS)
They stated that COVID-19 policies have affected primary care at three levels, patients’ behaviour, work conditions, and clinical practice
Summary
Primary care is fundamental to a resilient healthcare system, providing safe and timely services in all settings, including outbreaks and emergencies [1]. Even though multimorbidity is not exclusive to a specific age group, evidence shows that it is higher amongst elderly people aged 65 years and above, who represent nearly 20% of the overall UK population [3,4,5,6]. Healthcare management for those patients requires a collaborative approach to provide closer monitoring and constitutes the majority of GPs’ workload in the UK [2, 7]. To combat the pandemic and protect people, many countries have introduced strict public health measures, such as shielding of complex elderly patients [10, 11]
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