‘New ways of working’ is a phrase that has been bandied about in General Practice for a few years. We felt the need to do things differently because we have been stretched, at times to breaking point. Then the tragedy of Covid19 and lockdown came along. Suddenly we had to find these new ways of working, and we had to find them in a matter of days.
So much has changed over such a short period. Most GPs have never seen anything like it in their careers. We now do the majority of appointments on the phone or by video link. We encourage patients to request appointments through an online system. The patients we see in the practice are vetted for symptoms of Covid before they are allowed in. Those with Covid symptoms are assessed in a car park outside the surgery before they are seen in a separate Red Zone, and when we do see patients face-to-face it is from behind a mask and PPE.
All these new ways of working come with new challenges. As GPs we like to connect with people and help solve problems. At the height of the pandemic we were faced with some searching questions. How do we help people look after their mental wellbeing during Covid and lockdown? How do we help those really sick patients, even those in the last days of their lives, from a distance? How do we help those unwell with Covid but too scared to go into hospital? How do we safely visit frail patients at home, or look after our patients in Care Homes, without putting them or their families at risk?
We worried we were missing other illnesses, as the world focused entirely on Covid. We worried about all the routine checks that people were missing, checks which are vital to prevent illness in the future (including Annual Health Checks for our patients with learning disabilities). I particularly worry that for my patients with learning disabilities, some of whom live in Care Homes, and whom I have spent years establishing a trusted relationship with, I have become a distant figure on a video screen.
As in any time of emergency and challenge we see heartbreak, sadness and confusion, but we also see so many heartening acts of kindness. Community volunteers delivering medications, patients making scrubs and face masks for us, the thank yous and the ‘claps’ which have meant so much. Within our practice we have seen our team pull together, working from home when they are shielding or isolating, supporting each other, reaching out to patients who were struggling. As we begin our mission to overcome some of the ongoing problems, and restart our routine work, my biggest question is not how we manage all these new ways of working (as I’m sure we will get there with a little understanding from our patients!), but, does the patient still see the GP behind the mask? I do hope so. We are still here…