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The worst winter ever?

There’s no question that the last 17 months have been especially challenging for general practice. But could things be about to get worse?

COVID-19 is refusing to fade into the background, and the length of the pandemic is in itself creating issues; there’s a huge backlog of built-up demand that’s now flooding general practice. At the same time, the vaccination programme has been relentless throughout this year, not only taking many staff to the point of burn-out but also removing those staff from core general practice where they’re urgently needed.

Most practice staff need a break, not having had one for over a year in many cases. But as the virus fights back, following the relaxation of lockdown rules, the number of staff having to isolate is rising rapidly. Now, as practices start to think about an expanded flu vaccination programme, on top of a COVID booster programme, practice managers are wondering where the staff for this additional work are going to come from.

Planning for all of this might have been made easier if there’d been some clarity. We need to know, for example, is the 15-minute observation period going to be needed; is it acceptable to deliver the booster jabs at practice level; and can the COVID and flu vaccines be given together? But with the answer to these questions being “the information is on its way”, or “we’ll let you know once the results of the study have been published”, or “guidance will follow by the end of the summer”, then there’s no certainty, and the practice manager role is made even more challenging.

Where does the delivery of core general practice stand in all of this? Is it really possible to undertake flu vaccinations, the COVID booster programme, and meet all the requirements of the core contract? What about QOF? There doesn’t appear to be any sign of the previous QOF protection payment being reintroduced. Will practices end up in a situation at the end of the year where they’re simply having to let big swathes of potential QOF funding go?

Maybe PCNs could help. However, the guidance on extended access is also imminent, the new DES specifications could still be introduced in October, and the expectations of PCNs are likely to rise significantly with the introduction and development of Integrated Care Systems. The likelihood is that the demands on practices will increase because of PCNs, rather than the other way round.

Even CCGs, whose teams in many places have been really helpful in supporting practices with their COVID response and vaccination programmes, aren’t going to be able to provide much support this winter, as they themselves are being reorganised out of existence by the end of March.

All in all, it’s shaping up to be an extremely challenging winter for general practice, maybe the most challenging ever.

In this month’s podcast, our Practice Index Practice Manager Panel share their thoughts on the challenges that lie ahead, give their take on just how well the demands on core general practice are understood by those above, and outline what they think needs to be done.

Rating

Ben Gowland

Director and founder Ockham Healthcare, presenter of The General Practice Podcast, supporting innovation in General Practice

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