Last updated 18 February 2021

You can read the Government's Alert Level descriptions here, but the following principles relate specifically to general practice. 

The principles of Level 1

  • General practice is open for business, and full acute and chronic services should be offered.
  • The first service to contact for community medical care is your general practice.
  • Equity is central to care with a focus on Māori, Pasifika and vulnerable populations.
  • In-person visits should be preceded by assessment at reception for any symptoms of respiratory illness, and risks according to Ministry of Health guidance. 
  • Maintain physical distancing procedures within the surgery. In particular, patients with respiratory symptoms need to be separated from other patients within the practice, provided with a surgical mask and must maintain a two metre distance from others in waiting rooms.
  • Scrupulous hand hygiene before and after each patient examination is essential.
  • PPE should be used according to Ministry of Health  guidance for patients with respiratory illness. 
  • Proactive care and long-term management is key for patients with chronic disease.
  • Full preventative services should be offered including screening, immunisations and contraception services.
  • Continue to manage deferred care from the lockdown period. 
  • Medicolegally, any deviation from your standard practice as a result of COVID should be documented in the patient’s notes.
In Level 1, we anticipate that practices will continue to offer telephone, video or other virtual consultations as required. We anticipate 80 percent of consultations will be in-person, while 20 percent will be virtual. It is important we give patients flexibility in how they interact with their GP, and to maintain our ability to move back up a level if required as a result of a breach in boarder control. 

General practice needs to lead the ongoing fight against COVID-19 and demonstrate that general practice clinics are  a safe environment for patients and staff.

The principles of Level 2

In moving to Level 2 there will be a further loosening of the restrictions that have been in place up until this point. What does that mean for general practice? COVID-19 will remain a possibility in the community until a vaccine is available and physical distancing is still the mainstay of controlling COVID. We have a duty of care to our communities, in particular the most vulnerable people like the elderly and those living with co-morbidity and in deprivation.

  • We need to continue to reassure patients general practice is open for business.
  • The first service to contact for community medical care is your general practice.
  • Continue to offer virtual consultations to patients: telephone, video and in-person consultations as required.
  • Ask yourself whether you will add significant value to the patient by an in-person consultation compared to a virtual consultation. 
  • In-person visits should be preceded by virtual triage or assessment.
  • Maintain physical distancing procedures within the surgery. In particular, patients with respiratory symptoms need to be separated from non-respiratory within the practice, maintain one metre separation in waiting rooms.
  • Scrupulous hand hygiene required.
  • Maintain the use of PPE as appropriate.
  • Investigations should be provided for acute and chronic medical care. 
  • Proactive care is important for patients with chronic disease.
  • Equity is central to care with a focus on Maori, Pacific and vulnerable populations.
  • Continue to increase the focus on long term management for those patients with chronic conditions.
  • Continue to increase focus on elderly, children, and mental health.
  • Core services should be established including preventive screening, immunisations, contraception services and acute care.
  • Planning should be underway to undertake any deferred care that has occurred during lock-down.
  • Medicolegally any deviation from your standard practice as a result of COVID-19 should be documented in the patient’s notes

In level 2 we anticipate that 50 percent of consultations will be “in-person”, and the other 50 percent will be through telephone, video or other virtual means. 

The principles of Level 3

  • We need to continue to reassure patients that general practice is open for business.
  • The first service to contact for community medical care is your general practice.  
  • Offer virtual consultations to patients as first choice: telephone, video and patient portal.
  • In-person consultations should be available as required.
  • In-person visits should be preceded by virtual triage or assessment. 
  • Maintain physical distancing procedures within the surgery. 
  • Scrupulous hand hygiene. 
  • Maintain the use of PPE as appropriate. 
  • Investigations should be provided if there is a strong suspicion of pathology.
  • Proactive care is important for patients with chronic disease. 
  • Equity is central to care with a focus on Maori, Pasifika and vulnerable populations.
  • Long term management is important for our patients. 
  • Increase focus on elderly, children, chronic conditions and mental health. 
  • Business as usual services need to continue including preventive services, immunisations, contraception services and acute care.  
  • Medicolegally any deviation from your standard practice as a result of COVID-19 should be documented in the patient’s notes.

Maintaining Green and Red Streams in general practice  

As the frontline of health in New Zealand we can all take comfort from the early successes of the fight against COVID-19, and the critical role that we in general practice have played in this outcome. It is contingent on us to continue to demonstrate leadership regarding the health of our patients, and ourselves. As such, we need to maintain physical distancing procedures within our surgeries.  

In particular, patients with symptoms suggestive of respiratory infection must continue to be separated from non-respiratory patients within the practice. 

Signage for patients is essential, and some practices will find it necessary to have their doors locked - allowing only restricted access for the safety of patients and staff. It is essential that we continue to provide the environment and the assurance to patients and our staff that our practices are safe for them and their families.