Returning to placements during Covid-19 pandemic – a “changed primary care”.

Written by Dr Sukhpal Gill

General practice is ever adapting to challenging times and none more so now than the Covid-19

pandemic. So what can medical students going back to their GP placements expect?

Safety / Protect yourself

Access to appropriate personal protective equipment (PPE) is extremely vital when coming in to

contact with patients. Whereas most patient contacts are now taking place via telephone or video consultations, face-to-face appointments are inevitable for some important tasks like vaccinations, baby checks and cervical screening. Students can really protect themselves and others by following the practice protocols for donning and doffing PPE and washing hands after each patient contact and keeping them well moisturised. Most pharmacies offer flu vaccinations and although there is a national shortage for flu vaccinations, opting in for one privately via a local pharmacy if the occupational health department hasn’t already made provision would be really worthwhile.

Remote consultations

Pre-Covid, around 90% of consultations were face-to-face and remaining via other methods like

telephone, video, email – however, now it has flipped totally the other way around. Previously, GPs could have been observed skilfully communicating and sharing their expertise about how to have an effective professional conversation with patients. However it may be difficult to comprehend some of the non-verbal communication skills, so be prepared to ask lots of questions about how clinical scenarios may have been handled differently if this was a patient-facing appointment, if at all!

Students may find an incredibly diverse team of people in the GP practice doing some of the work traditionally done by GPs. There is much learning to be gained from members of the primary care team other than medical doctors. For instance, Advanced Nurse Practitioners and Practice Pharmacists are highly skilled in triaging calls and dealing with many of the incoming patient queries and medication reviews. Other members of the team worth observing include, social prescribers, link workers, physiotherapists, mental health workers and associate physicians who have so much to offer in terms of learning opportunities. Some practices now also have input from Paramedics who are part of the team and may carry out many of the home visits traditionally done by GPs. If you are able to, observing the home visiting professional at work is a rich opportunity to experience patient care in their own home – why not reflect on pros and cons of providing medical care to housebound patients in the own home?

Red site or hot hub

Many practices will either cordon off areas within their building or refer

patients to another site called a hot hub in the local area for managing patients who are displaying signs of Covid-19 – not to be confused with hot tub as most of us may do sometimes nearing the end of a busy working day!

Chronic disease management is an extremely important area of general practice that you will

inevitably encounter during placement. However, ask the team member you’re observing how they go about looking after patients with long term illnesses. They may nicely talk you through electronic templates that help prompt our team to cover all the relevant areas.

In the practice, we all rely on each other to keep us all and patients safe by following the rules at all times. Look out for symptoms of Covid e.g. dry persistent cough, fever or loss of sense of taste or smell. If you develop any of these, keep a low threshold to stay at home, inform your supervisor and get yourself tested by either going online via NHS website of calling 119, and seeking appropriate medical advice from your own GP.

General practice is still a really fun place to see the best variety of clinical presentations anywhere.

Keep safe, and have a great time on placement!