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25 March 2020
Dear Colleague
Safety of clinicians to keep patients safe
We need to challenge our traditional thinking of how we best assess patients. We need to remember that 90% of the diagnosis comes from the history and be creative in the way that we use video consultations to maximise the examinations that we can perform remotely.
The BMJ has published a guide on assessment of suspected covid-19 cases to enable this to safely be done remotely. If setting up an examination site/room for non-covid related assessment, we would strongly advise that the decision to bring the patient in for assessment should require the agreement of at least two clinicians. This decision should be based on agreeing:
- what specific examination is needed,
- that this could not be performed by another method,
- that the examination findings alone could significantly affect the clinical management, and
- that the management of the patient being delivered in the primary care setting would have a significant impact on morbidity or mortality of the patient.
There are very few clinical scenarios that fulfil these criteria, we are working with other groups across London to try and more clearly define these situations. In any case, if a face-to-face consultation is required it should only be undertaken if PPE is available and the clinician uses it with the correct donning and doffing techniques, to reduce the risk of vector transmission.
Please keep a watch out for further bulletins and check in to our website daily for more covid-19 guidance: www.lmc.org.uk/coronavirus-covid-19.
As ever I welcome your feedback at mword@lmc.org.uk, and know that my team of experts and leaders here at Londonwide LMCs will always be by your side.
Keep well. Stay safe.
With best wishes
Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs
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