Jo Scott-Jones addresses questions about streaming respiratory patients, and the supply of PPE.
Question 1: Just wondering where we are officially with streaming? We are still streaming our respiratory patients and seeing them in the car etc. We have had a number of comments from patients that other practices have stopped doing this.
Response: I get asked this question by different practices once every 2-3 weeks and have asked both the College and Te Whatu Ora when guidance is going to change. Currently there are no plans to change the guidance, which in a nutshell is; to keep separating people with respiratory symptoms from those without respiratory symptoms, for patients and staff to be encouraged to wear masks when in a health service, unless working in the admin area, and for providers to wear N95 masks if they have a patient with a high suspicion of COVID-19.
The current rise in 'flu cases and ongoing approximately 1,500 Covid cases a week, along with the ever present threat of a measles outbreak whilst we have such low levels of immunisation, suggests to me that we should continue pre-consult triage for these conditions and streaming. As a patient I would be really angry if I picked up 'flu or Covid from a patient I was exposed to in a waiting room, especially if I was particularly vulnerable either myself or living with someone who was vulnerable.
As the clinical director for the PHO I don't have any power to ensure practices are following the guidance, which is just guidance - practices are at liberty to make a risk assessment and set up their own health and safety processes. PHCL practices continue to stream and use masks. Practices that are not encouraging mask use, and not separating people with respiratory symptoms from others are taking a risk as this is neither common practice nor in line with the guidance, and if a patient complaint arises, they will find it hard to justify, although I am sure MPS will do their best (if your practice has subscribed to their "practice liability" insurance.)
Question 2: With the note regarding the DHB stopping providing PPE – what are the current recommendations about this? To be honest I don’t even know where to look for updates anymore!
Response: On a positive note, talking to practices who have kept streaming and masking they find that there is reduced staff illness and positive feedback from patients who feel safer. There is discussion currently ongoing about the provision of PPE - national stocks that were built up over the pandemic are not being replenished to the same levels, and over the next year stocks are going to gradually diminish.
There has been a lot of discussion about access to free stock from the national supply, and what has now been proposed is that primary care loses access to the free stock from October 2023, in a phased approach. The scenario appears to be that, like the hospital system, we lose access to the various stocks as the national stock is depleted. Updates are available on the Te Whatu Ora website and I will let you know if there are any significant changes via the newsletter and Facebook page.
Ngā mihi nui, Dr Jo Scott-Jones.
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