As NHS returns to ‘new normal’, please be patient – Dr Andrew Buist

A visit to a GP’s surgery will not be the same as before, with strict infection-control measures and physical distancing, writes Dr Andrew Buist.

Medical staff wearing PPE safety equipment at Edinburgh Royal Infirmary. (Picture: Andy O'Brien)

In just a few short weeks, the NHS in Scotland transformed completely to fight Covid-19. Now we’re looking at an entirely different form of transformation: that of how we recover services that were stood down and get healthcare back to a “new normal”. GP surgeries have, in the vast majority of cases, remained open – although working very differently, with increased digital and remote consultations, and all the infection control measures we have needed to try to stem the rate of infection. It’s been a difficult time, but I think the profession has risen to the challenge.

Now, as lockdown cautiously eases, and all the indications are that the virus is – at least temporarily – on the retreat, primary care and GPs face a whole new set of challenges; something I think it is important for the public to be aware of. There are, of course, suggestions that the health service – and GPs – should get back to the old normal, and do so quickly.

That’s understandable: GPs play a pivotal role in communities, and we’re often your first point of contact for any health-related concerns. But it is important to be realistic right now that the old normal will, in many cases, have to change.

Covid-19 is still with us – it likely will be for some time to come. We can’t dismiss the possibility of a second wave. For primary care that will mean we need to consider carefully what level of capacity is retained to support the management of suspected Covid-19 – so in order to reduce the risk of cross infection, Covid hubs and Covid assessment centres will remain essential for some time.

We want to bring patients back into general practice settings, but we must be able to say that is it a relatively virus-safe environment – patient confidence, trust and safety is crucial. By doing this, GP surgeries can be designated as Covid-free, and can concentrate on health needs outside of the pandemic. But that’s not to say GP surgeries can, or should, return to operating as they did before Covid-19.

As a patient, what might you expect from a GP practice in the new normal? There will be stricter infection-control measures in place: the days of full waiting rooms, where appointments follow one after the other are simply not feasible while physical distancing continues to be necessary. More use will be made of the digital innovations that have supported remote consultations – these are necessary, and indeed useful, but in some cases the only effective way to assess a patient is face to face. In those circumstances you will see your GPs wearing PPE – masks, gloves, aprons – more than you would have done in the past.

It’s also important to remember that doctors are not superhuman – we often like to think we are but the truth is we’re not. This pandemic has been intense and everyone needs to be mindful of the impact of Covid-19 on the long-term well-being of NHS workers. That means factoring in the right and necessary time for recuperation and reflection in the long-term plans as they come together.

I also have no doubt there will be staff shortages impacted by the implications of test and protect – and on that basis it is clear that the old pre-Covid normal is not something we can expect to return to any time soon. So patience is key: your GP services are open, but when accessing them, how, when, and who you see may be different for some time to come. As doctors, our very reason for being is to care for people – but we must do it safely, both for ourselves and for our patients.

Andrew Buist is a GP in Blairgowrie and chair of the BMA’s Scottish GP committee

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