Guidance

[Withdrawn] Recommendation 4: a more flexible approach to patient consultations in primary care and general practice

Updated 19 October 2021

This guidance was withdrawn on 22 April 2022

The information in this document has been superseded by Infection prevention and control for seasonal respiratory infections in health and care settings (including SARS-CoV-2) for winter 2021 to 2022.

Where changes are made locally to COVID-19 control measures, organisations are responsible for undertaking appropriate risk assessments, approved through local governance processes, to ensure that patient and staff safety is not compromised. For example, consideration of local factors, such as infection prevalence, patient mix and bed availability, need to be considered for the management of contacts of confirmed cases of SARS-CoV-2.

The UK Health Security Agency (UKHSA) is recommending a more flexible approach to patient consultations in primary care and general practice after reviewing the current infection prevention and control guidance on patient consultations in primary care.

Face-to-face consultations can now go ahead where this is safe for patients and staff, whilst recognising that telephone and video consultations continue to have an important role. The decision about when to see patients face to face or through video consultation is for local clinical leaders based on a number of factors, including patient needs and preferences, configuration of premises, local capacity and the ability to ventilate spaces.

Patients will continue to be required to wear a face covering if attending a face-to-face consultation unless exempt. The importance of hand and respiratory hygiene should be emphasised, along with other control measures to minimise the risk of transmission of infection. Patients with symptoms of coronavirus (COVID-19) or influenza should telephone their GP or primary care provider before attending an appointment.

Physical distancing can be reduced from 2 metres to 1 metre in primary care and general practice with appropriate mitigations, such as the continued use of face coverings or masks. This builds on the recommendation from UKHSA to align physical distancing guidance in acute care settings that was published in September 2021 with updated World Health Organization (WHO) advice.

Primary care providers and general practitioners will need to undertake local risk assessments, including the hierarchy of controls, to identify where physical distancing can safely be reduced. This decision will need to be based upon factors such as the configuration of premises, access, ventilation and so on. Health Building Note 11-01: Facilities for primary and community care services provides best practice guidance for these settings.

Clear information will need to be provided to patients and visitors on the changes to physical distancing and what this means to them, in order to comply with the duty of candour.

WHO states that physical distancing of at least one metre remains a key infection prevention and control intervention and public health and social measure to reduce the transmission of SARS-CoV-2.