Medicine alumnus and Sessional GP Dr Ridwan Ahmed has been working as the Clinical Lead for the Covid-19 Primary Care Assessment Service at Aston Pride Community Health Centre (APCHC) in Birmingham since March this year.
As part of the Covid-19 primary care response, NHS England provided funding for Clinical Commissioning Groups (CCGs) to establish sites across the country to help manage patients with suspected or confirmed coronavirus. APCHC was one of around 80 “Covid-19 Red Sites” across the UK to be set up as a Primary Care Assessment service, where patients experiencing symptoms of Covid-19 are referred to by their own GP for further assessment and subsequent management.
Dr Ahmed put himself forward to help configure the service in Birmingham and explains, “I saw this as a once-in-a-generation opportunity to perform my role in this historic global event. We were one of the first CCGs in the country to set up a Covid-19 Red Site primary care service well ahead of the peak of the pandemic in April.
“Many surgeries had legitimate concerns about setting up the service due to the significant risk of infection transmission. Logistically, it was very challenging as we needed to collaborate our IT systems with over 40 GP practices, serving around 250,000 patients in the West Birmingham area. Furthermore, we were devising an innovative system that needed to adhere to appropriate infection control measures, whilst responding competently to the plethora of delicate clinical cases we were receiving.”
“Nobody really knew what to expect as we were dealing with a novel virus. We had to reconcile patients’ anxieties in relation to the pandemic, as well as our own. Having a young family, I had to contend with personal concerns of potentially falling prey to the disease, since I was working on the front line”.
“Despite these challenges, we worked well together as a close-knit team, allowing the service to run smoothly. The service was live within just three days, with the capacity to manage up to 41 patients a day.”
The service has been a considerable success and has been greatly appreciated by the local GPs across the CCG, demonstrating a wide-reaching impact to primary care provision in the area. Dr Ahmed explains, “We are able to offer a holistic package rather than a limited ‘walk in centre’-type arrangement, due to IT collaboration enabling direct access to patients’ records. This radical way of managing suspected and confirmed Covid-19 patients allowed for effective integration with GP surgeries. Having reduced the burden of the ‘Red’ (Covid-19) related workload, we essentially increased local General Practice resilience, enabling our local GP colleagues to deal with the remaining ‘Amber’ (non-Covid-19) caseload in a safe and streamlined manner.”
The APCHC was originally funded from April-July, catering for the West Birmingham half of the CCG catchment area. After the Sandwell site was decommissioned in August, the Aston site expanded to take on the additional capacity from Sandwell, thus covering the entire CCG. The service now caters for 84 GP surgeries, serving around 575,700 patients across the Sandwell and West Birmingham area.
Dr Ahmed adds, "This arrangement will remain in operation for the foreseeable future as we proceed through the crisis. Having recently received recognition from the neighbouring Birmingham and Solihull (BSol) CCG, our service provision has now extended to accomodate some of the PCNs (Primary Care Networks) within in this CCG, hence increasing our catchment capacity by an extra 150,000 patients."
To date, over 1200 patients have been managed by the service and none of the staff have tested positive for Covid-19. Dr Ahmed says, “The system has been a remarkable achievement and has allowed us to develop a unique clinical skillset. Each referral is remotely triaged using telephone and video technology, minimising face-to-face contact with patients, which vitally reduces viral load.”
In reference to the wider impact of his work, Dr Ahmed further elaborated “We have analysed the dataset from the first 4 weeks of operation, which covered the peak of the coronavirus pandemic and have submitted a system review paper to the British Journal of Family Medicine for publication, sharing valuable lessons learnt. We have also been nominated for the HSJ Partnerships Awards 2021, in an attempt to share our achievements in improving patient outcomes as well as showcasing strategic partnerships.”
Reflecting on his time at St George’s, Dr Ahmed says, “My clinical placements as a student at St George’s have had an impact on the way I perceive Medicine. There is a profound clinical feel from the very beginning when studying at St George’s and the training strongly encourages seeing Medicine as a vocation, rather than merely focussing on academic study.”
“My GP placements as a student at St George’s helped to consolidate my ambition in becoming a GP. I thoroughly enjoy the flexibility of working as a sessional GP. This recent venture of setting up the CCG’s Covid-19 Red Site has been a challenging yet refreshingly rewarding opportunity. It is a deeply satisfying sentiment to be able to put myself forward, offering my support at a time of great need.”