Narrative accounts of primary care practitioners in a time of Covid-19

In response to the Covid-19 crisis, rapid and wide-ranging changes have been made to general practice and primary care teams, and their ways of working.  GPs, nurses, pharmacists and others have had to quickly implement on-line, phone and video consultations and primary care practitioners are frequently working as part of larger teams in ‘hot hubs’ across cities or districts for patients with suspected Covid-19 symptoms.  There is also a major challenge in ensuring that patients with non-Covid-19 symptoms and conditions can access primary care, and as necessary be referred for specialist secondary care services, and for this to happen in a way that is (and feels) safe for patients and their families.

While there has been a lot of policy and media focus on the experiences of delivering secondary care in hospitals in a time of pandemic, in general there has been less of an emphasis on the changes made to primary care and the related experiences of primary care practitioners and their patients.

Research being undertaken by the University of Birmingham and the University of Aberdeen seeks to collect and draw attention to the experiences of primary care professionals at this time of Covid-19. Professor Judith Smith is leading a project in conjunction with Professor Louise Locock at the University of Aberdeen, and Emily Burn at HSMC, with support from the Health Foundation, to capture the real-time stories of GPs, practice nurses and managers. Participants are recording and sharing their reflections on a regular basis about how it is for primary care practitioners to work during the Covid-19 crisis, the changes they are observing in their professional practice, and the impact on their working and home lives.

Reforms to primary care delivery – such as using phone triage, and video, email or phone consultations - have previously been debated at length, with apparent reluctance on the part of some professionals to implement such changes. In the context of Covid-19, these developments have been introduced almost universally with great speed, as practices closed to most face-to-face visits, and consultations moved online or via telephone. There is concern about an increasing backlog of demand for health services as people may be avoiding accessing primary care services, through concern about safety, or not wanting to bother what they perceive to be very pressurised NHS practices. This means that Covid-19 is likely to not only have a significant effect on the current delivery of primary care, but is also very likely to have long-term ramifications.

This research project is not only considering changes to service provision and the development of primary care professionals’ roles, but is also capturing professionals’ experiences of and reactions to these changes. Data are currently being collected with GPs, practice managers and practice nurses providing audio recordings and written accounts of their experiences to date. Once the main active phase of the pandemic is over, in-depth interviews will be conducted with our respondents to capture their overall reflections on the experiences of being a primary care practitioner during the Covid-19 crisis. The Health Foundation will host workshops where respondents will come together to share and reflect jointly on what they have experienced, learned, and wish to take forward in their future practice.

 The overall aim of the research is to explore how it is for these primary care professionals to be at work during a pandemic, what is satisfying about the job and also the challenges and frustrations that face this workforce. The exploration of professionals’ narratives will examine the wider effects of changes within primary care teams. From this, the sustainability of the shifts made to primary care delivery will be considered, as well as the implications for primary care staff recovery and support. Please contact Emily Burn e.burn@bham.ac.uk for further information.