scholarly journals Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 261
Author(s):  
Lorna J. Duncan ◽  
Kelly F.D. Cheng
Keyword(s):  
Public Health ◽  
General Practice ◽  
List Item ◽  
Home Visits ◽  
List Type ◽  
Face To Face ◽  
Delivery Models ◽  
Beneficial Elements

Background: To minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of English general practice consultations was modified in March 2020 to enable separation of diagnosed or suspected COVID-19 patients from others. Remote triage and consultations became the default, with adapted face-to-face contact used only when clinically necessary. This study aimed to identify the modified face-to-face delivery models used nationwide in spring/summer 2020. Information was also sought concerning COVID-19 outbreaks linked to English general practice. Methods: In June 2020, a survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) in England to identify local organisation of face-to-face general practice consultations since March 2020. An email was  sent to Public Health England (PHE) requesting data on COVID-19 outbreaks linked to general practice. Results: All CCGs responded. Between March and July 2020, separation of COVID-19 patients from others was achieved using combinations of the following models: zoned surgeries (reported by 47% of CCGs), where COVID-19 and other patients were separated within their own practice;‘hot’ or ‘cold’ hubs (reported by 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices were seen;‘hot’ and ‘cold’ home visits (reported by 70% of CCGs). One of seven combinations of these models was used across each CCG, with some flexibility shown according to changing demand through hub availability. PHE data indicated 25 possible or confirmed COVID-19 outbreaks or clusters in English general practice to July 31st 2020. Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified.  Analysis of the modified delivery in terms of management of COVID-19 and other conditions, and impacts on staff and patients, together with learning from investigations into confirmed COVID-19 outbreaks, may both aid future pandemic management and identify beneficial elements for practice beyond this.

scholarly journals Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 261
Author(s):  
Lorna J. Duncan ◽  
Kelly F.D. Cheng
Keyword(s):  
Public Health ◽  
General Practice ◽  
National Survey ◽  
Small Proportion ◽  
List Item ◽  
Home Visits ◽  
List Type ◽  
Face To Face ◽  
Delivery Models ◽  
Future Management

Background: To minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of general practice consultations has been modified to enable the separation of diagnosed or suspected COVID-19 patients from others. Remote triage and consultations are currently the default model, with adapted face-to-face contact used when clinically necessary. This study aimed to identify the modified face-to-face delivery models used across England, and evidence for their effectiveness. Methods: In June 2020, a national survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) in England to identify local organisation of face-to-face general practice consultations since March 2020. An email was sent to Public Health England (PHE) requesting information about COVID-19 outbreaks or clusters linked to general practice. Results: All CCGs responded. Separation of COVID-19 patients from others was achieved using combinations of the following models: zoned surgeries (used in 47% of CCGs), where COVID-19 and other patients are separated within their own practice;‘hot’ or ‘cold’ hubs (used in 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices are seen;‘hot’ and ‘cold’ home visits (used in 70% of CCGs). One of seven model combinations was used across each CCG, with some flexibility according to changing need shown through hub availability. Concomitant PHE data showed less than 2% of COVID-19 outbreaks or clusters in England were linked to general practice. Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified. While COVID-19 outbreaks or clusters linked to general practice constituted a small proportion of totals, their investigation, together with evaluations of the modified delivery models in terms of management of COVID-19 and other conditions and impacts on staff and patients, may aid future management of the pandemic and identify aspects of adapted practice of benefit beyond this.

scholarly journals Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 261 ◽  
Author(s):  
Lorna J. Duncan ◽  
Kelly F.D. Cheng
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Services ◽  
List Item ◽  
Home Visits ◽  
List Type ◽  
Face To Face ◽  
Care Services ◽  
Beneficial Elements

Background: In order to minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of English general practice consultations was modified in March 2020 to enable the separation of patients with diagnosed or suspected COVID-19 from others. Remote triage and consultations became the default, with adapted face-to-face contact used only when clinically necessary. Face-to-face delivery modifications were decided locally and this study aimed to identify the different models used nationwide in spring/summer 2020. Methods: In June 2020, a survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) responsible for planning and commissioning NHS health care services in England to identify the local organisation of face-to-face general practice consultations since March 2020. Results: All CCGs responded. Between March and July 2020, separation of patients with diagnosed or suspected COVID-19 (‘COVID-19 patients’) from others was achieved using the following models: zoned practices (used within 47% of CCGs), where COVID-19 and other patients were separated within their own practice;‘hot’ or ‘cold’ hubs (used within 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices were seen;‘hot’ and ‘cold’ home visits (used within 70% of CCGs). For around half of CCGs, either all their GP practices used zoning, or all used hubs; in other CCGs, both models were used. Demand-led hub availability offered flexibility in some areas. Home visits were mainly used supplementally for patients unable to access other services, but in two CCGs, they were the main/only form of COVID-19 provision.  Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified.  Analysis of the modified delivery in terms of management of COVID-19 and other conditions, and other impacts on staff and patients, may both aid future pandemic management and identify beneficial elements for practice beyond this.

scholarly journals Study protocol for the COvid-19 Toolbox for All IslaNd (CONTAIN) project: A cross-border analysis in Ireland to disentangle psychological, behavioural, media and governmental responses to COVID-19

2021 ◽  
Vol 3 ◽  
pp. 48
Author(s):  
Catherine D. Darker ◽  
Nicola O'Connell ◽  
Martin Dempster ◽  
Christopher D. Graham ◽  
Cliodhna O'Connor ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Risk Perceptions ◽  
List Item ◽  
Policy Transfer ◽  
Mortality Data ◽  
List Type ◽  
Incidence And Mortality ◽  
Media Messaging ◽  
Health Messaging

COVID-19 represents a serious challenge to governments and healthcare systems. In addition to testing/contact tracing, behavioural and social responses such as handwashing and social distancing or cocooning are effective tools for mitigating the spread of the disease. Psychological (e.g., risk perceptions, self-efficacy) and contextual factors (government, public health messaging, etc.) are likely to drive these behaviours. Collated real-time information of these indicators strengthens local, national and international public health advice and messaging. Further, understanding how well public health and government messages and measures are understood, communicated via (social) media and adhered to is vital. There are two governments and public health jurisdictions on the island of Ireland, the Republic of Ireland (ROI) and Northern Ireland (NI). This represents an opportunity to explore implications of differing measures and messaging across these two jurisdictions as they relate to COVID-19 on two similar populations. The expert research team are drawn from a range of disciplines in the two countries. This project has four nested studies: Assessment of key behavioural, social and psychological factors through a large, prospective representative telephone survey of individuals aged over-18 on a weekly basis over eight weeks (n=3072); and conduct qualitative focus groups over the same period.Interrogation of social media messaging and formal media responses in both jurisdictions to investigate the spread of (mis)information.Modelling data from Studies 1 and 2, plotting the psychosocial/behavioural and media messaging information with international, ROI and NI incidence and mortality data. Conducting an assessment of health policy transfer in an attempt to incorporate the most significant public health and political insights from each jurisdiction. The CONTAIN project will develop an evidence-based toolbox for targeting public health messaging and political leadership and will be created for use for the anticipated second wave of COVID-19, and subsequently for future epidemics/pandemics.

scholarly journals Study protocol for the COvid-19 Toolbox for All IslaNd (CONTAIN) project: A cross-border analysis in Ireland to disentangle psychological, behavioural, media and governmental responses to COVID-19

2020 ◽  
Vol 3 ◽  
pp. 48
Author(s):  
Catherine D. Darker ◽  
Nicola O'Connell ◽  
Martin Dempster ◽  
Christopher D. Graham ◽  
Cliodhna O'Connor ◽  
...  
Keyword(s):  
Public Health ◽  
Social Media ◽  
Risk Perceptions ◽  
List Item ◽  
Policy Transfer ◽  
Mortality Data ◽  
List Type ◽  
Incidence And Mortality ◽  
Media Messaging ◽  
Health Messaging

COVID-19 represents a serious challenge to governments and healthcare systems. In addition to testing/contact tracing, behavioural and social responses such as handwashing and social distancing or cocooning are effective tools for mitigating the spread of the disease. Psychological (e.g., risk perceptions, self-efficacy) and contextual factors (government, public health messaging, etc.) are likely to drive these behaviours. Collated real-time information of these indicators strengthens local, national and international public health advice and messaging. Further, understanding how well public health and government messages and measures are understood, communicated via (social) media and adhered to is vital. There are two governments and public health jurisdictions on the island of Ireland, the Republic of Ireland (ROI) and Northern Ireland (NI). This represents an opportunity to explore implications of differing measures and messaging across these two jurisdictions as they relate to COVID-19 on two similar populations. The expert research team are drawn from a range of disciplines in the two countries. This project has four nested studies: Assessment of key behavioural, social and psychological factors through a large, prospective representative telephone survey of individuals aged over-18 on a weekly basis over eight weeks (n=3072); and conduct qualitative focus groups over the same period.Interrogation of social media messaging and formal media responses in both jurisdictions to investigate the spread of (mis)information.Modelling data from Studies 1 and 2, plotting the psychosocial/behavioural and media messaging information with international, ROI and NI incidence and mortality data. Conducting an assessment of health policy transfer in an attempt to incorporate the most significant public health and political insights from each jurisdiction. The CONTAIN project will develop an evidence-based toolbox for targeting public health messaging and political leadership and will be created for use for the anticipated second wave of COVID-19, and subsequently for future epidemics/pandemics.

scholarly journals Standing order use in general practice: the views of medicine, nursing and pharmacy stakeholder organisations

2017 ◽  
Vol 9 (1) ◽  
pp. 47 ◽  
Author(s):  
Robyn Taylor ◽  
Eileen McKinlay ◽  
Caroline Morris
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Access To Health Care ◽  
Timely Manner ◽  
Face To Face ◽  
Standing Order ◽  
Access To Health ◽  
General Practices ◽  
Pharmacy Data ◽  
The Impact

ABSTRACT INTRODUCTION Standing orders are used by many general practices in New Zealand. They allow a practice nurse to assess patients and administer and/or supply medicines without needing intervention from a general practitioner. AIM To explore organisational strategic stakeholders’ views of standing order use in general practice nationally. METHODS Eight semi-structured, qualitative, face-to-face interviews were conducted with participants representing key primary care stakeholder organisations from nursing, medicine and pharmacy. Data were analysed using a qualitative inductive thematic approach. RESULTS Three key themes emerged: a lack of understanding around standing order use in general practice, legal and professional concerns, and the impact on workforce and clinical practice. Standing orders were perceived to extend nursing practice and seen as a useful tool in enabling patients to access medicines in a safe and timely manner. DISCUSSION The variability in understanding of the definition and use of standing orders appears to relate to a lack of leadership in this area. Leadership should facilitate the required development of standardised resources and quality assurance measures to aid implementation. If these aspects are addressed, then standing orders will continue to be a useful tool in general practice and enable patients to have access to health care and, if necessary, to medicines without seeing a general practitioner.

PP159 Telemedicine In Paraguay: Contributions Of The Institute Of Health Sciences Research, National University Of Asunción

2020 ◽  
Vol 36 (S1) ◽  
pp. 18-18
Author(s):  
Ronald Rivas ◽  
Pedro Galván
Keyword(s):  
Public Health ◽  
Biomedical Engineering ◽  
List Type ◽  
Telemedicine System ◽  
Cellular Telephony ◽  
Imaging Department ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
National University ◽  
Development And Validation

IntroductionThe modalities of telemedicine that have been developed and applied so far by the Department of Biomedical Engineering and Imaging at the National University of Asunción (IICS-UNA) are as follows: (i) telediagnosis: the remote sending of data, signals, and images for diagnostic purposes; (ii) general telediagnostic imaging; (iii) telemonitoring (including telemetry): remote monitoring of vital parameters to provide automatic or semi-automatic surveillance or alarm services in emergencies, epidemiology, or tele-public health; and (iv) tele-education: the use of telematic networks to provide virtual platforms for educating and training health professionals.MethodsWe conducted a comprehensive review of the scientific works developed by the IICS-UNA in order to evaluate the systematic implementation of Telemedicine in Paraguay. Documents, pilot projects (satellite telegraphy), telediagnostic research, telematics, tele-education, published articles, and statistical data (number of patients attending or studies performed, etcetera) relating to the implementation of the National Telemedicine System by the Ministry of Public Health and Social Welfare since 1999 were reviewed.ResultsImplementation of the telemedicine system has meant that 472,038 patients have attended referral centers nationwide, with 297,999 electrocardiographs, 165,323 computed tomography scans, and 8,697 electroencephalograms being conducted. Projects developed within the framework of the Telemedicine Research Line have included the following: (i)Development and validation of a clinical telemicroscopy system based on cellular telephony;(ii)Implementation of a telemetry system for temperature monitoring of the collection of biological samples from a biomedical research center; and(iii)Production and development of a virtual campus at the National University of Asunción.ConclusionsGiven the current healthcare environment, developing a line of research based on telemedicine is a proactive step, since telemedicine provides an alternative solution to the problem of access to the health system. That is why the IICS-UNA Biomedical Engineering and Imaging Department has developed telemedicine as one of its main lines of research.

scholarly journals Utilizing asynchronous email interviews for health research: overview of benefits and drawbacks

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Michelle Amri ◽  
Christina Angelakis ◽  
Dilani Logan
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Data Quality ◽  
Health Research ◽  
Geographic Location ◽  
Public Health Research ◽  
Data Accuracy ◽  
Global Public Health ◽  
Snowball Sampling ◽  
Face To Face

Abstract Objective Through collating observations from various studies and complementing these findings with one author’s study, a detailed overview of the benefits and drawbacks of asynchronous email interviewing is provided. Through this overview, it is evident there is great potential for asynchronous email interviews in the broad field of health, particularly for studies drawing on expertise from participants in academia or professional settings, those across varied geographical settings (i.e. potential for global public health research), and/or in circumstances when face-to-face interactions are not possible (e.g. COVID-19). Results Benefits of asynchronous email interviewing and additional considerations for researchers are discussed around: (i) access transcending geographic location and during restricted face-to-face communications; (ii) feasibility and cost; (iii) sampling and inclusion of diverse participants; (iv) facilitating snowball sampling and increased transparency; (v) data collection with working professionals; (vi) anonymity; (vii) verification of participants; (viii) data quality and enhanced data accuracy; and (ix) overcoming language barriers. Similarly, potential drawbacks of asynchronous email interviews are also discussed with suggested remedies, which centre around: (i) time; (ii) participant verification and confidentiality; (iii) technology and sampling concerns; (iv) data quality and availability; and (v) need for enhanced clarity and precision.

Public Health Control Measures in Response to Global Pandemics and Drug Resistance

2015 ◽  
Vol 43 (S2) ◽  
pp. 49-56
Author(s):  
Polly J. Price
Keyword(s):  
Public Health ◽  
Communicable Disease ◽  
International Health ◽  
Control Measures ◽  
World Health ◽  
Legal Authority ◽  
List Type ◽  
Resistant Disease ◽  
Global Pandemic ◽  
Health Organization

These teaching materials explore the specific powers of governments to implement control measures in response to communicable disease, in two different contexts:The first context concerns global pandemic diseases. Relevant legal authority includes international law, World Health Organization governance and the International Health Regulations, and regulatory authority of nations.The second context is centered on U.S. law and concerns control measures for drug-resistant disease, using tuberculosis as an example. In both contexts, international and domestic, the point is to understand legal authority to address public health emergencies.

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