A patient-safety expert and senior Obama-era US public health official has said the UK missed “a jewel” by ignoring GP practices when developing Covid-19 track and trace strategies.
Professor Don Berwick, who is now president emeritus of US-based non-profit organisation the Institute for Healthcare Improvement, described our system of GP registration as a “tremendous resource”.
Speaking at the Royal Society of Medicine’s weekly Covid-19 webinar, Prof Berwick said: “You don’t realise how special empanelment is.
“The idea that you can, at least in principle, tie every single person in your population to a general practice.”
He continued: “That is a tremendous resource – one of the whole problems in the case of tracking is that you don’t know where the people are.
“Empanelment is a jewel of a lever for proper public health.”
Prof Berwick said GP practices could have been used as a starting point for track and trace systems based on their patient data, and could be used this way in any second wave.
“You could have, if you had chosen, set up a GP system in the country which could be called into play for the preservation and improvement of public health – including even surveillance and contact tracing or at least exchanging data,” he said.
“The general practices in your country are a public health tool, they are apublic health resource – but only if they are trained to do that and only if they are resourced to do that.”
One of the whole problems in the case of tracking is that you don’t know where the people are. Empanelment is a jewel of a lever for proper public healthProf Don Berwick
He said as resources had become more squeezed over the pandemic, the ability of GP practices to carry out secondary, social functions had been significantly reduced.
“You can correct that, you can correct that any time you choose and get ready for the next pandemic much better, with indeed one of the strongest primary care systems in the world,” he said.
Prof Berwick compared the Government’s approach of trying to dictate a country-wide public health policy from Whitehall to “trying to help the (health) service with three layers of mittens on”.
“You can’t manage from one to 50 million in one step, it just doesn’t work,” he added.
Prof Berwick, who acts as an adviser to UK healthcare think-tank The King’s Fund, was also scathing of the US President’s attacks on science during the pandemic.
In response to a question from Sir Simon Stevens, chief executive of the NHS, about the danger of misinformation campaigns, he described Donald Trump’s handling of the pandemic as “murderous”.
“We have, for complex reasons, a president in place who let alone doesn’t honour science, he doesn’t seem understand science,” Prof Berwick said.
“He is all too ready to throw away the benefits of science and the scientific method – that’s a murderous mistake and for us it’s a political problem.”
He added: “The public wants answers, it wants to feel secure, and when someone offers a cheap answer it is all too easy to sell it in the short run.
“I do think we will get back to rationality, I do think science will return but we have a serious problem.”