Healthcare Leader is speaking with decision makers and those on the ground dealing with the coronavirus pandemic, to find out what’s happening nationally and how best to solve problems. Today, we speak with clinical director of Central Liverpool Primary Care Network and GP partner, Dr Ian Pawson.
Primary care has had to go through massive organisational changes in a matter of weeks in response to the Covid-19 pandemic, but being part of a PCN has ‘added an additional layer of resilience’ in dealing with the challenge, Dr Pawson suggests.
He and his Central Liverpool PCN colleagues worked together to set up a central hot hub to deal with Covid-19 patients, which opened two weeks ago.
‘We’re a fairly large network, with around 100,000 patients across nine practices. We were only seeing a handful of possible Covid patients each week, so we thought pooling those would be more efficient. It also centralises that risk.’
The process of setting up a hub rapidly was ‘intensive’, he says, as it required so much coordinated planning and structural changes across the PCN. This included introducing a new patient triage system and setting up another digital system alongside EMIS to share patient records.
‘Not all practices, particularly smaller ones, have the estate that would allow safe separation of patients. This is not true of our practice or network, but we’ve been able to share resources across the network for the benefit of all.
The network has also been holding regular meetings with practices to discuss plans, progress and to make decisions collectively. There is now a ‘network operating procedure’ which all practices are following together, Dr Pawson says.
An alliance of PCNs
As well as being clinical director for the PCN, Dr Pawson is also medical director for Liverpool Networks Alliance, a body set up last September to represent the collective voices of primary care networks across Liverpool.
During the Covid-19 crisis, the alliance has been ‘acting as a liaison point between networks and the CCG to agree a response at the general practice level,’ he explains.
The alliance has been working to ‘share the burden’ between the individual PCNs. It has also helped manage the response efforts.
‘We decided the leads will come up with plans and put those protocols and processes in place locally and then, learning from that, we’d build on it and work those up.’
‘Grouping together with other networks and working collaboratively really helps. If you’re isolated in one practice or even a smaller network, it could be much more challenging.’
‘It’s an argument in favour of scale. I’m absolutely for having the smaller units within that, but being able to scale up and having that peer support in a situation like this is important. You can also share ideas and tasks, so you don’t have to write up practice protocols 10 times for every individual practice. You can do it once and make those local modifications.’
This has been especially important, as health professionals are being ‘overwhelmed by the mass volume of information being churned out by lots of different bodies,’ he adds.
Dr Pawson concludes: ‘Having a team approach to do that across the network has been really helpful. It means that every individual practice doesn’t have to keep apprised of every daily update. It would be a massive workload to do as a practice on your own at the moment.’