A pathway for general practice involvement in caring for COVID-19 positive patients (children and adults) in the community is being collaboratively developed by the Northern Sydney Local Health District (NSLHD) Virtual Hospital team, local GPs, and Sydney North Health Network (SNHN). To inform the next steps, we are now calling for expressions of interest from general practices who would consider opting in to trial the model.
As we transition to living with COVID as an endemic, we are proposing a phased approach to involving general practice in ongoing care of COVID positive cases in the community:
Phase 1 – Selected general practices to trial the model and relieve pressure on the current virtual hospital (VH) demand. At its peak, the VH was caring for 570 patients and receiving 50-60 new patients per day. Currently, most patients are younger and state that they do not have a regular GP.
Phase 2 – Low risk COVID positive patients being transferred to the care of their nominated GP.
Phase 3 – Shared care of moderate to high-risk COVID positive patients in collaboration with their regular GP.
Overview of the Proposed Pathway
The model is based on the ACI guidelines “Caring for adults with COVID-19 in the community” and “Caring for children with COVID-19 in the community”.
The NSLHD Virtual Hospital will complete an initial assessment and triage all COVID-19 positive patients in Northern Sydney. Clinical Handover and Transfer of Care will be undertaken for those patients identified as low risk (green), to a participating GP practice who has opted in to deliver this model. Acceptance of care will need to be confirmed by the GP practice within a specified timeframe (to be determined). NSLHD will aim to transfer care as early as possible after notification of a patient with a positive COVID-19 result. The practice will need to have the ability to provide care 7 days per week between the hours of 8am to 8pm. (Flexibility with these hours can be discussed, depending on your practice’s usual after-hours arrangements.)
These practices will remotely care for patients via telehealth, providing health and welfare checks as per the protocol including:
- Assessment of COVID-19 symptoms to detect deterioration
- Provide reassurance, education, and advice
- Ensure isolation guidelines are adhered to
- Ensure social and welfare circumstances are stable
- Recommend release of isolation
To complement the role of the GP in the model, practices may wish to consider involvement of other multidisciplinary staff. Each general practice can set up a system and team that works for their practice. Administrative support is recommended.
GPs will be able to bill Medicare telehealth item numbers as part of this home surveillance program. This is possible as patients admitted to the virtual hospital are not classified as an inpatient by NSLHD. The “established relationship” requirement does not apply to people who are in a COVID-19 Commonwealth declared hotspot, in COVID-19 isolation because of a State or Territory public health order, or in COVID-19 quarantine because of a State or Territory public health order. Current list of declared hotspots is available here.
If you would like to participate in the phase 1 trial, please complete the survey and EOI below.
Enquiries
If you have any questions, please email dpallavicini@snhn.org.au.