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Blog – Professor Mike Holmes

The development of a complex test and trace system has been the focus of much scrutiny. There are many aspects of the service but the testing capacity that it is on offer to the public has risen steadily to a point now where capacity is exceeding demand. General Practice has now stepped into this domain too to offer an important contribution, not as the main route for testing patients, but to support the already existing networks.

We piloted a new service in June which began with 18 general practices trialling PCR testing with their patients. The objectives were to streamline patient care and increase access to testing for patients who would otherwise be unlikely to get a test via the primary testing routes. For example, due to barriers around language, disability or digital inclusion. Practices were able to use their discretion to offer the swabs where they deemed it to be clinically appropriate.

The pilot was a success - having access to the service enabled GPs to support patients and help practices improve the service they offer to patients. The key benefits included providing a joined-up service for patients and improving access to testing for those patients that are most vulnerable. Participant sites also described how they viewed the service as a helpful addition to the wider testing capability, the testing process was straightforward and quick to administer and patient feedback was positive.

Through continuous discussion, involvement and engagement with NHS England and NHS Improvement, and really constructive dialogue with both the RCGP and the BMA, we explored how the service would look if was offered more widely.

We reached a point where we were able to launch the service on 4 November to all Practices in England with an opportunity for them to opt in and order swab test kits.

Through feedback and requests from GPs themselves, we were also able to extend the service to include the testing of GPs, practice staff and their household members if they developed symptoms. The aim being to ensure sustainability in supporting practices to remain viable in the long term.

One month on from the service launch, the response has been really encouraging with over 3,100 practices having signed up and with over 157,000 tests being ordered across England. We continue to monitor progress as the numbers continue to rise and have sent out a short survey to opted-in practices where we can look to improve and scope opportunities to further develop the service. You can find the survey here

I want to take the opportunity to raise awareness of the service and to encourage any practice that feels their population would benefit to opt in to the service. Information can be found at https://www.gov.uk/government/publications/covid-19-testing-in-general-practice   

It has been a real privilege to see how critical General Practice has been in supporting and caring for patients during the pandemic.

We’re also talking to Devolved Administrations now to discuss how the service could be of value right across the UK.

At a time when General Practice is under significant pressure to see a response like this to a service aimed at tackling health inequalities is truly phenomenal and I would like to thank the profession for that. Having a Test and Trace service that is available to all, in a swift and convenient way, is critical if we are to get through the Pandemic.

Seeing multiple stakeholders collaborating to find solutions has been one of the really positive aspects of the pandemic for me, I am seeing it with increasing frequency and I am hopeful it will be one of the lasting positive legacies of this really difficult time.

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Professor Mike Holmes

Mike Holmes is a General Practitioner at Haxby Group in Yorkshire and the Vice Chair (Membership) at the Royal College of General Practitioners. He writes here in his capacity as Clinical Advisor for GP testing in NHS Test and Trace.

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