The impact of Covid-19 on primary care practitioners: transformation, upheaval and uncertainty

The Covid-19 pandemic has had a great impact on almost all areas of life. Primary care is no different and the pandemic has disrupted the usual routines in general practices up and down the country. With very little warning, consultations had to shift to being conducted via telephone or online wherever possible and practices had to implement ways to provide care for people with COVID-19. The scale and pace of change would have been unimaginable prior to the pandemic but primary care practitioners had little choice other than to adapt quickly and continue to deliver care to their patients.

 Since April 2020, Judith Smith and Emily Burn at the University of Birmingham and Louise Locock from the University of Aberdeen, with support from the Health Foundation, have been undertaking a study which collects narratives from primary care practitioners to document their experiences during the pandemic. These narratives document the changes made to primary care as the pandemic evolves, as well as exploring what it is like to be a general practitioner, practice nurse, or practice manager in the midst of a pandemic.

 A recurrent theme from the narratives collected at the start of the pandemic was the sense of uncertainty within practices. Participants reflected that initial guidance and plans for practices frequently changed to respond to the evolving situation. Although there was an initial overload of information in some areas, there was silence in others. Whilst the pace of change did subsequently slow, practices still needed to plan continually for the future delivery of care.

Some of our primary care respondents framed this uncertainty in more positive ways – identifying a feeling of liberation to pursue innovation and an increased impetus behind the changes that had been creeping in to general practice pre-COVID (such as telephone triage and remote consultations). Narratives frequently highlighted an initial reduction in external monitoring and a greater freedom to ‘get on’ with testing out new ways of working to meet evolving guidance. However, this initial autonomy is unlikely to last as an emphasis on oversight and performance monitoring returns.

Participants reflected on the high levels of exhaustion they have experienced over the past six months and the challenges of keeping both their own and colleagues’ morale high. As we face the second wave of Covid-19 this winter and the increased clinical pressures that this will surface, primary care remains in a state of uncertainty and flux. Primary care practitioners are continually making sense of a changing work environment and it remains to be seen how these shifts will affect a long-term understanding of their profession.

Our study will continue to collect narratives during the winter and into the spring to capture primary care practitioners’ experiences of the evolving pandemic, along with their thoughts about their professional identity during a time of great uncertainty. These narratives will enable us to trace the cycles of the pandemic and the effects of this on the primary care profession.

For further information about this study, please contact Emily Burn e.burn@bham.ac.uk