James Malcom seen on the zoom meeting

A Shropshire GP has admitted to ‘being scared’ at the start of the Covid pandemic in March last year. Dr Jamie Malcolm, 51, a partner at Market Drayton GP Practice, told members of Shrewsbury Severn Rotary Club in a Zoom call how worried he was at the start of the pandemic about catching Coronavirus.

In particular, as primary care PPE is not as stringent as many hospital clinicians’ equivalent. He wears a thin plastic apron, rather than a gown, with gloves, standard mask and visor. He told Rotarians he developed a persistent fever early last year, but no cough. He recalled measuring his oxygen levels with a pulse oximeter whilst testing his breathing by repeatedly climbing stairs at work. Later, a blood test confirmed Covid antibodies.

He described how NHS England had, on 19th March 2020, instructed GP practices to implement a Total Triage System that would allow clinical staff to work remotely to protect patients and staff from risk of infection. Such was a dramatic and sudden change from traditional, predominantly face-to-face consulting. “We all had to learn very quickly how to consult remotely,” he told Rotarians.

Before the March 20 lockdown, about 70-80% of GP appointments were face-to-face. During the first lockdown, about 65% of GP appointments were by telephone or video. However, by mid March 2021 the proportion had adjusted to 54% telephone/video and 46% face-to-face. Dr Malcolm described that in March and April of 2020 there was a reduction in the number of patient consultations. But his surgery is now busier than ever. “In April 2021 we had 2,000 incoming calls per day to our surgery with a list size of about 18,000 patients. Access to appointments is compounded by our doctors and nurses being deployed to deliver covid vaccinations,” he told Shrewsbury Severn Rotary Club.

He told Rotarians of the pressures of being given a week’s notice to complete second Covid vaccinations for cohorts 1-9 by 24th May. “We reorganised physical space for patients to be seen in person – our building was never closed – and stagger appointment times to minimise patient interaction/contact. We ask patients to wait in their cars until we phone them to enter for a blood test.”  Dr Malcolm closed his talk with some thoughts on the future of General Practice including the development of Integrated Care Systems, and the role of Allied Health Professionals being attached to GP surgeries – believing them to be a welcome addition to the community workforce, rather than a substitute for GPs.

Julian Wells

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