Message from Clinical Lead Improving Access Services

IMPORTANT UPDATE – PLEASE READ – You may have received previous versions of the linked documents – we have updated these to include the latest guidance.Covid 19 guidance summary updated

Primary Care has now been advised to move to Total Triage.

This means that only essential activity will be seen face to face:

  • Face to Face examination only to exclude life-threatening of life-shortening illness where this cannot be done over telephone or video link
  • 2 week wait referrals – mostly can be done over telephone or video link – please see example scenarios
  • Long-term condition monitoring for unstable at risk patients – consider doing by telephone or video link
  • All above based on case by case individual clinical decision and risk assessment


As with other patients all contacts to go through clinical triage.

Consider managing by telephone or video where possible. Use decision aid tools, such FeverPain, Centor when appropriate.

It is recognised that most clinicians will have lower threshold  for face to face review of younger children, but this is a matter for individual clinical judgement

If require face to face and have been triaged to be low risk of Covid 19, consider a separate children only environment that can easily cleaned or dedicated time slot for paediatric reviews.

Please see attached COVID-19 Guidance Summary and BMJ Visual Guide

Implications for EHS

Within EHS this means that we will be reducing face to face capacity and the only patients booked for Face to Face must have had a triage from a GP or ANP prior to being booked based on the total triage criteria.

We will also have some telephone capacity from host sites for now for practices to book into.

Currently we are seeking assurance from host site practice managers that they are fulfilling the criteria laid out in the attached Practice COVID-19 Plan.

Please do take the time to look at the section on Protect Staff I have included here the information for us as individual clinicians.

  • Jewellery and watches removed – bare below elbow policy.
  • Avoid looking at phone as much as possible, use computer of clock to check time.
  • Mobile phone usage kept to absolute minimum (emergencies only).
  • No handshakes.
  • No lanyards or neck ties.

Moving forwards we are endeavouring to identify other ways that we can support the local healthcare system possibly to support 111 in order to keep you working.  Please be aware however we may need to cancel shifts.

Work at the BSUH UTC continues as normal for the time being and there are shifts available if you do have shifts cancelled.  Please let us know if you haven’t worked there before and we can arrange an induction.

Thank you for bearing with us, obviously things are changing by the hour but we are doing all we can to ensure that you are safe and can continue working.

Keep well


Dr Simon Hincks

Clinical Lead Improving Access  to General Practice Services

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