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NHS Highland response to coronavirus infections is 'very rapid', says Dingwall GP helping to man NHS24 helpline's Highland Hub

By Scott Maclennan

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Dr Miles Mack.
Dr Miles Mack.

A GP in the frontline of the fight against Covid-19 has assured those afraid they are infected that they will be seen “very rapidly” once they contact NHS24.

Dr Miles Mack, of the Dingwall Medical Group, is a volunteer at the Highland Hub which fields calls from NHS24 and determines whether someone needs to be given advice or sent to an assessment centre.

He said he experienced some apprehension at first but soon realised that GPs were ideal for diagnosing those with viral infections, saying that this was “using the skills that are very much my bread and butter in my workplace.”

Speaking after his first shift, he said one of his main concerns was understanding the new virus and ensuring that not only do people get prompt care but that it does not mask another serious condition such as viral pneumonia.

With that in mind he said that between a quarter or a fifth of all calls he took from all across the Highlands and Islands led to a referral at one of the assessment centres for Covid-19.

Dr Mack said: “It started off with a steady stream of calls coming in from right the way across the Highlands and Islands of Scotland. All of them having some form of fever and infective-type symptoms, some of them clearly sounding to be Covid-19, some appearing to be more routine infections and illnesses that we deal with as GPs.

“The majority of the calls were dealt with either through some general advice about staying at home and self-care or else organising a prescription for a few more and I organised for two or three patients to be assessed at the Covid-19 assessment centre that evening.

“Most of the time I was able to phone them back within about 30 minutes of their first call to NHS24. One of the criticisms or worries is that people will have to wait a long time to be consulted but that didn’t seem to be the case from my experience.

“As a GP there was a certain amount of anxiety about taking on these calls but actually when I arrived there you realise that you were using the skills that are very much my bread and butter in my workplace.

“One of the odd things is that at off times people degenerate general practice as just a place where people go with viral illnesses but of course now that is our key skill, actually to be able to make risk assessments and judgements about who has got a simple self-limiting illness and who has got something more serious.

“It is actually something that is of crucial importance on the frontline of our response to this disease. We are beginning to understand the natural history of this illness and it begins with some relatively mild symptoms and for some people that is as far as it goes but then it can progress to a moderate viral illness but it is really the second week that they really become unwell and it is at that stage that they require hospital admission.

“You phone the NHS 111 number and people need reassurance that they will be assessed very rapidly and if they do need to be seen face to face then they will go to the assessment centres.

“We are referring-on about one in four to one in five patients, some of those may not be that ill but what we are looking for is some objective measurements from these patients particularly how fast their breathing is and what their oxygen saturation is.

“We have a finger probe that we just put on their fingers which gives an idea of what percentage of what blood cells are carrying oxygen, which give us a pretty accurate measure of how ill they are.”

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