Operation Moonshot: GP clinics could be used to improve access to covid-19 tests

General practices and pharmacies could be used to make covid-19 testing more available to the public, according to the government’s proposed Operation Moonshot mass testing programme revealed by The BMJ.

The documents, which outlined the £100bn plan to deliver 10 million tests a day by early 2021,1 said that a “huge new operational infrastructure” would be needed to process results across the country and “develop novel methods of allowing people to access testing.”

For this the government plans to use “familiar locations” where people access healthcare, such as GP surgeries and pharmacies, as well as accessible local venues. “A new workforce with the appropriate skills and expertise to deliver, administer and process our new testing technology in every corner of the UK” would also be needed, said the documents.

Several GPs The BMJ spoke to were keen to now be included in plans to try to help control the pandemic.

Jackie Applebee, a GP in London, said that local public health services, including general practices, were frustrated by being excluded from testing, tracing, and supporting patients affected by the pandemic.

“In general practice we don’t know which patients have had covid-19 because we are not aware of test results, and we see patients who find it hard to get a test because they don’t have a car,” she told The BMJ. “By centralising everything, local health bodies have felt excluded when in fact local systems are best placed to get on top of the pandemic. The money going to Serco, Deloitte, and others would be better spent on NHS public health and primary care services.”

However, Jane Wilcock, a GP in Salford, pointed out that not all GP premises could safely offer covid-19 testing. “We have been enormously successful at not passing on covid-19 onto patients in the community, and we don’t want this to change. But it is essential that there is local testing available where it is possible to have a separate pyrexia room,” she said. “Also when you’re not well, it is not always possible to travel a long way for a test, so having this available locally would be beneficial.”

Primary care networks, which Oxford GP Joe McManners admitted had fallen off the radar during the pandemic, have been set up partly to integrate health systems and should be well placed to enable GPs to work together to decide which practices could act as testing sites in a local area.

Basing testing on the networks would ensure that each locality in England had a testing site easily accessible to patients, assuming that staffing and funding issues could be resolved, said Azeem Majeed, a GP and head of primary care and public health at Imperial College London.

Improving access to tests will be especially important during the winter, when other viruses are circulating, said Majeed. “A saliva test would be a big step forward for patients,” he said.