GP Communique – September 2020

Updates from Dr Roger Halliwell (Chair of GCPHN) and Dr Kat Mclean (Acting Chair of GPGC Board).

Dr Roger Halliwell Gold Coast Primary Health Network (GCPHN) Board Chair Spring has arrived! This is a great time of year with warmer temperatures and mainly low humidity, ideal to enjoy the outdoors. It is an opportunity to explore our region – the national parks, the broadwater, the surf, and of course, those sporting destinations many enjoy. It is a wonderful contrast to the challenging times we find ourselves in.

The team at GCPHN are returning to the office, and while it is slightly different than before with the physical distancing, it is a delight to see the energy being applied to the many activities we have responsibility for. Most of the commissioned services have continued through the last six months with most of our service delivery partners pivoting to telehealth. The direct support of the primary care sector has been ramped up and we would encourage any with challenges to reach out – if we do not have a solution, we can help brain storm ideas.

With the end of the financial year a couple of months ago, we have run through the annual external audit process. It is pleasing to see an unqualified sign off given the turmoil of the last six months – well done to Matt Carrodus and his team.

Part of the enhanced engagement is a direct link to Queensland Health (separate to the Gold Coast Health operational arm). Dr Carl De Wet has been instrumental in a number of initiatives to improve the public system for patients and continues his leadership across the whole health care system in Queensland.

Our work with Gold Coast Health also continues, we meet with the executive team fortnightly to share ideas, and there is regular contact between the managers for mutual benefit. The work behind the scenes regarding Cat 3 Out Patients has finally seen a return to normal activity levels across all specialties. We also have enhanced primary care access to patient specific advice with a phone call, it certainly feels that we are walking in sync with them.

We continue to have a good relationship with the media and you will likely have seen TV, radio and Print media activities every week. Aside from the strong messaging around COVID-19, we continue to promote “business as usual” for all other health conditions.

With mild weather ahead, and a sense that we are all finally settling into different work systems, I look forward to a less stressful time into the future. And if challenges ramp up I believe we are fairly well placed to respond logically and positively as required.

Kind regards,
Dr Roger Halliwell

Dr Kat Mclean General Practice Gold Coast (GPGC) Acting Board Chair As we continue to live with the uncertainty with COVID-19, I reached out to colleagues in Victoria and asked the question: “knowing what you do now, what would you have done differently?” With the Gold Coast moving to ‘moderate risk’ and the recommendation now for patients and practice teams in general practice to wear masks, I’d like to share some of their responses with you.

• Try to work from home for a day before you need to – iron out the crinkles and make sure your set up works.
• Discuss how your practice can care for a COVID-19 positive patient. We found as cases escalated, we were managing our patients with mild symptoms. Work out how you would assess and monitor them.
• Lots of patients were still presenting with ‘hay fever’ or ‘asthma’ symptoms. Use your website/Facebook group to communicate to patients that these may be COVID-19 symptoms.
• Wear eye protection and surgical masks!
• Be careful in the tearoom – if you can, eat outside. Stagger breaks. Avoid sharing any food.
• Factor in 1/3 of your team being away – what would you do if no admin came in? No nurse? Have a contingency plan. Upskill GPs to be able to take on these roles if needed.
• Trust your instincts – follow a precautionary approach. Don’t let others talk you ‘down’ from enhanced safety measures. You are not being paranoid!
• Staff meetings via zoom – check in regularly.
• Guidelines lag behind, don’t wait for your team to become unwell or quarantined. Our approach was to go one level up on all official recommendations. P2 masks for all patient contact when transmission is high.
• Scrubs are great, I change before I leave work. I was the first in my practice to wear scrubs, some of my colleagues accused me of being an ‘anxious Nelly’. Now they all wear them.
• Co-design the PPE and orange and red zone processes with the GP team – input optimised processes and engaged our team.
• Implement protective changes really early, spend time putting new procedures and protocols in place. I doubted myself, thinking we were ‘overdoing it’, other practices were taking a more relaxed approach – Looking back I could have felt far more confident and more like a trendsetter. If you have COVID-19 in your area “go hard and go early”.
• Don’t rely on PPE being supplied to you. If you get some great, don’t assume you will though. Protect yourselves.
• Screening questions at reception are a token and do not actually help. Either you practice paranoid (everyone is potentially infectious) and act accordingly. Or you practice with optimism and naivety (hoping you are lucky). I prefer to plan for the worst and hope I’m wrong.

On the Gold Coast we currently have low levels of community transmission. This is the time though that I feel we risk being exposed. We have two positive cases who have presented with atypical symptoms (one to ED chest pain and an infected healthcare worker who had abdominal pain), on at least one of these occasions it has resulted in healthcare workers being classified as close contacts and having to quarantine. With the vast majority of GPs having no sick leave or access to WorkCover the financial risks alone are significantly higher than our hospital colleagues. We need to factor this into our ‘risk matrix’.

Pause, check in with your teams, review your approach, and perhaps take on board some of the advice from our Victorian colleagues. Stay safe. And finally, a reminder that GPGC is here to help support you all. Please reach out, join the discussions on our Facebook group.

Collectively we all need each other to navigate whatever lies ahead.

Kind regards,
Dr Kat Mclean

For more information on COVID-19 and your nearest testing clinics, click here. The COVID-19 health pathways can be found here.