Level 1: What does it mean for general practice?

4 June 2020

In moving to Alert Level 1, there is a further loosening of the restrictions that have been in place up until this point. What does this mean for general practice? Although community spread seems to have been eliminated at this point, COVID will remain a possibility in the community until a vaccine is developed. Strict border controls will need to remain in place to keep COVID out.

There needs to be a shift in emphasis to the principles of infection control. Hand washing, surgery hygiene, use of personal protective equipment (PPE) when appropriate, and physical distancing are still the mainstay of controlling infectious spread. We have a duty of care to our communities, and to our most vulnerable patients particularly the elderly, those with co-morbidities, and those living in deprivation.

We need to be seen as the leaders in mitigating the spread of infection. A few key points for Alert 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.