What does Level 2 mean for general practice?

1 May 2020

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.

The principles of Level 2 remain the same as Level 3:

  1. We need to continue to reassure patients general practice is open for business.
  2. The first service to contact for community medical care is your general practice.
  3. Continue to offer virtual consultations to patients: telephone, video and in-person consultations as required.
  4. Ask yourself whether you will add significant value to the patient by an in-person consultation compared to a virtual consultation. 
  5. In-person visits should be preceded by virtual triage or assessment.
  6. 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.
  7. Scrupulous hand hygiene required.
  8. Maintain the use of PPE as appropriate.
  9. Investigations should be provided for acute and chronic medical care. 
  10. Proactive care is important for patients with chronic disease.
  11. Equity is central to care with a focus on Maori, Pacific and vulnerable populations.
  12. Continue to increase the focus on long term management for those patients with chronic conditions.
  13. Continue to increase focus on elderly, children, and mental health.
  14. Core services should be established including preventive screening, immunisations, contraception services and acute care.
  15. Planning should be underway to undertake any deferred care that has occurred during lock-down.
  16. 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.