News | Published April 15 2020

Partner at Pickering Medical Practice: “The pace of change in primary care is unlike anything I’ve seen in my two decades in the NHS”

The work of the NHS has been fundamental to the coronavirus effort in the UK. The sacrifice of our doctors and nurses cannot be understated, with half a million frontline medical workers in England alone. The Parliamentary Review spoke with Dr Helena Ebbs, partner at, Pickering Medical Practice on the impact of Covid-19 upon her practice.

Reflecting on the last two months in general practice, two themes emerge. Rapid process re-engineering and mitigation.

The pace of change in primary care is unlike anything I’ve seen in my two decades in the NHS. Whole scale transformation of appointment systems has taken place. The switch to telephone triage for all practice activity was achieved in a seven-day period. Video consultation technology went from a hypothesis for most, to widespread release and implementation in less than a week. These changes usually take months if not longer.

Training and upskilling all staff on the use of personal protective equipment we’ve never needed or used before. There have been new protocols and processes to write for triage assessment, the safety of staff and patients, the division of practices into “hot” and “cold” sites to separate those with respiratory illness from others, the creation of new home visiting teams, new death certification management, new ways of recording information and research programmes. The list of changes feels endless now.

There has been a coming together of large-scale organisations, such as community nursing providers and adult social care, working with us in hubs centred around our populations and primary care directly. The barriers have shifted and evaporated in some instances. Progress has been rapid, energised and ambitious. The collective drive to make things happen is awesome in the truest sense of the word. The answers to problems have largely been local and not central. Our practice nurses, our local carers, our GPs in our communities show they know how to implement effective change and make things work. It feels like the system is listening, knowing that without this passion at the front door of this crisis, we won’t manage the work that comes our way.

With this pace of change in the way we organise ourselves to meet the new demand, the patients have not been forgotten. Those of us working in primary care know we have little control over the spread and impact of Covid-19. Public health guidance, government policy and human behaviour has far more influence than us. And so we have focussed our minds on mitigation. The ways in which we can soften the blow, prepare our community and support those who are most vulnerable. Working in a “divide and conquer” approach, in our Primary Care Network of seven practices we have identified all of our most vulnerable patients.

With our county council colleagues, the voluntary sector organisations such as Dementia Forward, our local mental health teams and more, we are reaching out to those who we know will suffer the consequences of the virus and this isolation period. We are telephoning, connecting people to the services they need, hearing their concerns and recording their preferences for care. We are helping to prepare our patients for difficult times ahead. Some of the best medicine we practice is simply allowing people to be heard. Promising to walk alongside our communities through whatever the future holds. They know we can’t stop the virus ourselves. But there is great strength in our staff and patients knowing they are not on their own.

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Authored by

Dr Helena Ebbs
Partner at Pickering Medical Practice
April 15 2020

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