A view from Dr Silvana McCaffrey, Kington Medical Practice and Clinical Director for the North and West PCN

When Coronavirus started making itself known, I was minding my own business working as a salaried GP in Kington. Then the virus began impacting Italy, my country of origin, where all my family live. I started reading, trying to understand what this meant for the UK.

From there, ‘Infection Control Dictator Silvana’ was born. This involved spending cash to get scrubs, writing protocols, looking at where Practice high risk contact points were and saying to ourselves this is day one.

We came in at the weekend and decluttered consultation rooms (a shocking experience), took down all the notices, removed the children’s toys, tidied and organised the cupboards and trolleys with infection control in mind. Then we created what became ‘Amber Hub’ where we would see any patients with COVID symptoms or who were at risk of COVID or for whom prolonged contact with a health professional was needed. The measures are even stricter here so that every person in the Hub, patients and staff, feels safe within its walls.

An unexpected phone call later I was now COVID Lead for the North and West Primary Care Network which covers 44,000 people (I suspect we are outnumbered by sheep and cows). It is fair to say I had no idea what this title meant but soon learned I could let my inner Bossy Beast out a little!

Three other hubs were created to cover all of Herefordshire and we have been working across Practice and Network boundaries to ensure that whatever occurs in the pandemic, we remain on our feet, caring for the population.

All the surgeries are assessing patients by video and telephone determining the next steps needed. We have not been able to provide a normal service but have been striving to do our best within the Level 4 Health Emergency. Clinical Directors and the Taurus Exec Team have video conferenced regularly (initially seven days per week) as have the networks. Information, ideas and inspiration have been shared (WhatsApp - a blessing and a curse) and methods of working updated. We have coordinated with hospital and community colleagues to return to thinking as one NHS.

Now we look forward. This means expanding what we have been able to offer, whilst not easing infection prevention and control measures and preparing for ‘flu joining us in the winter. Things will not be back to normal for some time and our hearts break for all who experienced severe ill health, loved ones of people who have died and those who suffer the impact of social isolation and financial hardship.

General Practice is here. We plan, prepare, adapt and we are open.