GPs in New South Wales have been left scrambling less than a week before Christmas after the state health department told them they will now be responsible for the management of Covid patients in the community.
On Friday NSW Health informed GPs through the state's 10 primary health networks that there is a new state-wide approach for the management of low-risk Covid-positive patients, effective immediately. It came as NSW hit another Covid record on Wednesday, reporting 3,763 new cases.
Each region of NSW is managed by a different primary health network, which collaborate with general practitioners and other health professionals to support and manage the health workforce, and to provide care to patients in that region.
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A directive sent to health workers from the Nepean Blue Mountains primary health network said low-risk Covid-19 patients "will be 'self-managed' and will receive information via SMS from NSW Health about managing any mild symptoms".
"NSW Health has announced that from today there will be a new state-wide approach for the management of low-risk Covid-19 positive patients," the statement said. "Patients who have been identified to self-manage at home will be advised to contact their GP or a dedicated Covid-19 service for an initial assessment and continued care."
"Patients who are self-managed will require a GP to complete their de-isolation."
De-isolation means permission to leave isolation, which requires medical clearance for people with confirmed Covid-19, including those who are fully vaccinated.
An urgent meeting was held on Tuesday night by the health network with GPs who are distressed about how to manage Covid patients at such short notice. One Sydney clinician told Guardian Australia that while GPs knew such a move was on the cards, they assumed the government would give them more notice before implementing it, along with additional support and resources.
"We were told the week before Christmas, when already many staff are already on leave, with no planning and no protocols in place," she said. "An urgent meeting is being held so we can be informed how the hell we are supposed to manage this."
Low-risk patients in NSW are considered to be those aged three months to 50 years old, those who have received two or more doses of an approved Covid-19 vaccine, those who are not identified as Aboriginal or Torres Strait Islanders, who are not pregnant, and do not have any specified chronic conditions are deemed at low risk of hospitalisation.
The president of the NSW branch of the Australian Medical Association, Dr Danielle McMullen, who is a GP, said most of the low-risk patients would have minimal symptoms.
"But many will have questions and symptoms, and will want support from their GP and there is just not enough flexible funding, support or notice to recognise the pressure and impact this announcement has on general practice," she said.
"It is the GP who talks to these patients and assesses symptoms, and who talks through their worries about getting medicines delivered."
McMullen said she was shocked there was no additional funding offered to GP practices. "We need more flexible funding offered to general practices so they can field the calls that will come and have them handled by the most appropriate staff member," she said.
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"So that might be funding for more reception staff or clinic nurses. But those staff, and GPs, are exhausted, broken and were looking forward to trying to get a bit of a break. This additional work has come on top of ramping up boosters and managing vaccinations including for children.
"We are all feeling the pinch of these increased Covid numbers and it's not easy for anyone in health. But general practice has been thrown this at the last minute and we were not expecting it to come the week before Christmas.
"Next year is also going to be a challenge with high Covid numbers, boosters and kids aged 5 to 11 eligible for vaccines, and general practice just need more support and recognition."