Primary care services are a local link into the wider health and care system - the first port of call when we have a problem. Local GP practices, pharmacies, dental practices, and opticians are deeply rooted in the communities they serve, so primary care services have been critical to our response to the Covid-19 pandemic.

The Greater Manchester primary care cell was set up early in the outbreak as part of a wider incident management structure. It strives to provide a coordinated, single voice for primary care and to make sure that voice is heard. The cell links into a range of different boards, bodies and groups so can draw on views, ideas and feedback from practitioners across the whole sector. We help to create links, to fast track decision making and make things happen.

The nature of primary care encourages innovative working. Primary care teams are brilliant at collaborating, finding creative ways to do things, solving tricky problems, and coming up with new initiatives. Their strong community connections mean they know what will work well in their patch and we’ve seen how invaluable this local insight is over the past year. We’ve seen primary care at its very best. Everyone has gone above and beyond to deliver for the communities they serve whilst continuing to provide core services to those who need them.

For example, when dental practices ‘closed their doors’ colleagues adapted quickly to provide telephone triage to patients, ensuring access to expert advice and prescriptions for pain relief and antibiotics where required. Practices could also refer patients to one of Greater Manchester’s 92 urgent dental centres if they needed to be seen face to face. The centres continue to operate, supporting practices and offering urgent dental care to those who do not have a regular dentist. Practices are now once again offering face to face routine dental care with changes to how they operate to reduce the risk of Covid-19 infection.

Early in the outbreak there were concerns that serious eye conditions could be missed as fewer people were coming forward with eye health problems. With high street opticians’ premises closed, Covid Urgent Eyecare Services (CUES) were set up and delivered by local opticians in partnership with hospital ophthalmology services. CUES provided remote consultation, with face to face assessments arranged where necessary. So, more patients were able to access eye care services, at home or close to home. This minimised travel and hospital visits, which reduced the risk of infection.

Whilst some pharmacies may have had to alter opening hours and reduce the number of people allowed in their premises, they have remained open throughout each and every lockdown – on the frontline in our communities. They have continued to provide an essential community resource, providing expert advice and over the counter medicines – with no appointment. For those who have been shielding, regular doorstep deliveries of prescription medicines have been vital. Pharmacy teams are truly unsung heroes, quietly continuing to deliver a vital service in difficult circumstances.

Our GP practices have dramatically changed the way they work by shifting to remote consultations practically overnight. Not all patients could be assessed remotely, necessitating the creation of ‘hot clinics’ with robust infection prevention measures for patients with Covid-19 who needed to be seen by a clinician. More recently, we have seen the roll out of pulse oximeters to support patients with Covid-19 who are most at risk of becoming very unwell. These devices monitor oxygen levels, linking in with practices and community teams. This has all been undertaken whilst ensuring ‘business as usual’ continues.

Both GP practices and pharmacies have played a key part in delivering the Covid-19 vaccination programme. The whole system has worked together and mobilised to make this happen so quickly.  It’s incredible. In just 13 weeks, we reached the one million vaccines milestone in Greater Manchester. The involvement of general practice and pharmacies has helped to provide vaccine centres within communities, often in familiar locations closer to where people live. The existing relationships and links into local networks have helped to provide reassurance and tackle vaccine hesitancy.

The hard work across primary care has been underpinned by the strong partnership approach we’ve taken in our response to Covid-19 in Greater Manchester. Relationships between organisations and individuals were already well-developed, based on our long history of working together. This has made a big difference, allowing us to respond quickly to a rapidly changing situation.

Of course, none of this takes away from the loss of life we have seen over the past year. Our thoughts are with all those who have lost loved ones.

We are currently working on the next steps for our health and care partnership, including our response to the changes set out in the government’s latest health white paper. Our Covid-19 response has highlighted that our approach is the right one, focusing on people and places rather than organisations, pulling services together and integrating them around communities or neighbourhoods. With primary care providers – across the whole sector – already embedded in communities, they will be vital to making this happen.

We must do all we can to focus on prevention and continue to deliver on our vision of improving population health. Covid-19 brought health inequalities into still sharper focus in Greater Manchester as we saw the impact of the virus on different groups. This is why we must place inequalities at the heart of what we do next and ‘build back fairer.’

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