In-hours General Practice and existing OOH shall still be the primary port of call for patients who believe themselves to be ill. 

1. If suspected to be Covid related, in hours-GPs, and OOHs GPs will risk-assess these patients, and give advice that is specific to their needs.  If patients are coping well with the infection, GP Practices/OOHs will advise patients regarding self-care and give “safety netting” advice. These patients should not be referred to Covid-19 Centre.   
2. If patient needs to be assessed and treated urgently, a decision will be made to determine if this is suitable for Covid centre  by the triaging GP.
3. If patient is unwell with the infection, but not requiring emergency assessment, and clinician feels that they need clinical assessment and management, the in-hours GPs and OOH services will refer the patient to the nearest Covid-19 Centre via CCG 
4. The administrator in the Covid-19 Centre will take the patient’s details, and a staff member will contact the patient to arrange an appointment time for review.

Each Centre will provide induction, and supervised training in the use of PPE and has agreed rigorous processes for cleaning and infection control for the clinical and non-clinical areas. Standards for PPE within the Covid centres are based on current guidance from Public Health England and the WHO. Recommended PPE to be used by healthcare workers within one metre of a patient with possible or confirmed COVID-19 including staff working in hospitals, primary care, ambulance trust, community care settings, care homes and domiciliary care settings:  

•     Fluid repellent facemask
•     Apron  
•     Gloves  
•     Eye protection if there is a risk of splashing
•     Arms to be bare below the elbows and to scrub your hands, your wrists and your forearms. 

The guidance is under constant review, and practice, policies and provisions will be amended accordingly. The HSCB is working closely with the Department of Health and colleagues to ensure PPE is supplied in good time with adequate stock.

Existing GPs should contact their Medical Defence Organisation to check if their existing indemnity arrangement extends to their additional professional work undertaken in response to COVID-19. Where the MDO confirms that existing indemnity arrangements will cover the additional work, those arrangements will continue to apply. Where a GP is advised that their existing indemnity arrangement will not cover this work or where indemnity will only be available at an additional cost, the Department of Health will provide clinical indemnity to cover this additional work.  GPs should keep a record of where and when they performed any additional work that is not covered under their existing indemnity arrangements.The Department of Health will provide clinical negligence indemnity cover for retired GPs who return to provide support in response to the COVID-19 emergency.

There is a co-leadership model (per centre) with Trust Lead Clinicians and Covid-GP Leads.

All GPs will have an induction before their first shift in the centre.GPs working in the centre will follow the Clinical Protocols agreed by the Lead GPs and the Governance Leads. 

Alongside GPs, COVID Centres have input from secondary care clinicians and other members of the MDT (in primary and secondary care). Also admin support, infection control, porters, etc