How CCFP has made changes to keep our community safer during Covid-19
We have made many changes to our operations at CCFP in response to Covid-19. Some of these changes are temporary and will be rolled back in accordance with appropriate State and Federal advice, some changes we will adopt as standard practice moving forwards. All changes have been made to help keep our patients, our staff and our community safer, and all changes are in keeping with current best practice in healthcare settings, clinical governance and in accordance with Qld Worksafe legislation. Please find a list of the most salient changes below. This list is not exhaustive but is provided to give you some guidance as to what you might expect at our practice.
Giving to the community
You will be bulk-billed for all Medicare eligible consults (excluding surgical procedures and iron infusions). We normally charge out of pocket fees for all patients who are over 16 years old without a Healthcare card for all consults, and for all consults on Saturdays, however our GPs have decided to support our community during this difficult time providing care with zero out of pocket cost for almost all consults until 30th September. You will also notice that we are providing influenza vaccinations at below cost price – this is because we believe in supporting our community in staying as safe and as well as possible.
Using telehealth consults
Face to face consults will be limited until at least 30th September. You will find this is now the new standard practice at local hospitals, specialist rooms, allied health providers and other GP clinics. At CCFP prior to Covid-19 we would see upwards of 150 patients plus family members per day. Having this number of people coming in and out of a relatively small space is a major contagion risk during a pandemic. For this reason, where it is safe, telehealth consults will be provided so that we can still provide appropriate medical care for our patients.
During a telehealth consult a GP can take a detailed history, can perform a limited examination (especially with video consults), and decide if a patient should be seen in the clinic, sent to another facility, or referred for further investigations. Only a GP can decide whether a patient is seen in clinic for the physical exam part of the consult, as only a GP has the necessary triage skills to safely determine this. For this reason, reception staff cannot safely book patients for face to face consults (unless it is for a baby check and immunisation) and will direct all patients to have a telehealth consult via phone or video. Most patients find this very convenient, as many consults do not require face to face contact – e.g. mental health consults, referrals for specialists and referrals for routine pathology testing.
There is good evidence that shows that telehealth is a safe method of medical care, and that patient satisfaction for these consults is very high as it is very convenient to access – recent academic studies have shown that more than 85% patients are very happy with telehealth consults, compared with over 75% very happy with in-clinic consults – so telehealth is often favoured by patients.
Even when you do need to attend for a physical exam a telehealth consult can be useful to reduce the amount of time spent in the clinic (and therefore reduce the amount of time potential exposed to infection risk). This is because the GP has already taken a detailed history prior to your physical appointment. Reducing the number and length of face to face consults is not only more convenient for many patients, it is much safer for a very vulnerable patients who require in clinic care – we are determined to make CCFP a safe place for those with severe chronic illness, infants, pregnant women, the elderly and those undergoing immune suppressing treatments including cancer treatments.
Methods of telehealth
Your mobile phone is what we use to get in contact with you. If you have a smart phone we can easily arrange for a video consult, you do not need to do anything other than be available at the appropriate time, and click the link sent via a text message. You will need to allow access to audio and video for this to work. The platform we use is called GPConsults, it is encrypted and no details are recorded.
Resuming more face to face consults
When face to face consults resume it will be in a gradual and controlled process – starting with preventative health care such as cervical screening, and moving on to ATSI health checks, diabetes checks, skin checks and so on. We will still be required to abide as best as possible to physical distancing rules, and Qld Worksafe regulations, so this will need to be very closely managed for some time.
Medical procedure that are high risk and will not be offered in any circumstance
There are a small number of medical procedures that will not be offered until at least 30th Sept, this includes lung function testing, nebulisers, ENT exams/procedures in symptomatic patients.
Outdoor vaccination clinics
For our large influenza vaccination clinics where we will see up to 50 patients in 3 hours the safest option is to hold these outdoors with physical distancing. This reduces infection risk to both staff and patients. We will hold these clinics from our ambulance bay, or if it is raining from under our front covered car park. It is also a great opportunity to use our bubble machine, which is a bit of fun!
Your scripts (except for S8 drugs of addiction), referrals and requests for pathology and imaging will all be sent directly to where they need to go. We will also email any medical certificates or other documents that you might require to you. You may also email us any information you think will help us to care for you best, we can incorporate this information into your patient file.
When you visit the practice
Please come alone to your consult as we trying to limit the number of people inside the clinic. For children please only attend with one care-giver and the one child. If you are entering the clinic you are required to don a surgical mask and to use the alcohol hand sanitiser. Kids under 5 do not need to wear a mask as they as considered very low risk for the transmission of Covid-19. We ask that everyone puts the mask on prior to entering, leaves the mask on unless asked to remove it by a GP, does not touch the mask while it is on, and discards it only after leaving the clinic. Masks are used as there is no practical way for a GP to examine a patient without close interaction and risk of infection. We are using surgical masks as they have been shown to reduce the transmission of respiratory viruses by 75%. If the GP is examining you they will also don a mask to protect you in case they are an asymptomatic carrier of any infection. As we all know by now, many patients infectious with Covid-19 have been completely free from symptoms, so this rule applies to everyone entering the clinic without exception.
Assigning Medicare benefits
On the completion of the consult you will not have to sign any paperwork. This is because the Federal government has overturned the rule that Medicare benefits paperwork needs to be physically signed. This allows us to reduce the risk of infection to our reception staff, reduce the amount of time you need to spend in the clinic, and to bulk-bill you for telehealth consults without any extra paperwork.
Inside the practice
Our clinic looks different. We have stripped all soft furnishings, toys, magazines, pamphlets, books and almost all the chairs from the waiting areas and consults rooms. All remaining items are regularly sanitised with hospital grade antiseptic including everything that has been touched or used following every consult. We have installed Perspex sheeting around our reception counter to help protect our staff from respiratory droplets and our chairs are placed 1.5m apart.
All staff and contractors at CCFP are using the COVIDSafe app, and we encourage everyone in the community to also use this app to help make any contact tracing of cases of Covid-19 much faster to trace and contain.
Thank you for helping us in our endeavours to provide excellent and safest medical care to the community. Please find a list of further articles and links that you might find interesting and informative.
https://www.sciencedirect.com/science/article/pii/S2590061720300272 (Governance, technology and citizen behavior in pandemic: Lessons from COVID-19 in East Asia)