This toolkit provides a step-by-step guide for managing coronavirus (Covid-19) in a primary care service such as general practice. It provides links to key information and template policies on Croner-i. The information is being continually reviewed and updated.


The World Health Organization (WHO) describes coronaviruses (CoV) as a large family of viruses that cause illness ranging from the common cold to more severe diseases such as SARS (Severe Acute Respiratory Syndrome). This particular episode, which first appeared in December 2019 in Wuhan, China, has been named “Covid-19”.

Symptoms include a high fever, a new, continuous cough, and loss of, or change to, sense of smell or taste. Some may suffer from a mild illness and recover easily. However, in other cases people can become seriously ill and suffer a range of complications. Reports suggest that the elderly, those with weakened immune systems, and those with underlying health conditions such as diabetes and chronic lung disease are the most susceptible to serious illness and death. Symptoms can appear in as few as two days after infection or as long as 14 days.

A national “lockdown” was needed to suppress transmission of the virus and reduce pressure on hard pressed health and social care systems. Despite the lockdown being eased, local areas may be subject to further restrictions if transmission rates increase again.

Employer duties

Primary care service employers should remember that they have a duty of care towards their staff, patients and visitors, and should take reasonable steps to protect their health and safety, preventing them from exposure to unnecessary risk.

What should you do as a primary care service employer?

  1. Make sure that at least one person is responsible for keeping abreast of developments from the World Health Organization, the UK Government and official NHS public health coronavirus guidance for primary care services. Ensure that the practice complies with the guidance, including standard operating procedures.

  2. Review risk assessments and assess the risks of exposure to coronavirus in your practice’s operations. Draw up a policy on how your practice is taking steps to address risks identified. See a template policy for general practice.

  3. Communicate plans to staff. Keep patients informed about the outbreak and any changes to services as appropriate, including changes to the way they access practice services and arrange consultations.

  4. Keep infection prevention risk assessments and procedures under review and ensure they are informed by current guidance and best practice. Covid-19: Guidance for the Remobilisation of Services Within Health and Care Settings Infection Prevention and Control Recommendations describes the recommended standard infection prevention control precautions (SICPs) and transmission-based precautions (TBPs).

  5. Obtain expert infection prevention advice and support as needed. Liaise closely with local planning teams and public health directors, and their teams.

  6. Increase levels of environmental cleaning in primary care premises in order to prevent the potential transmission of the virus by touching contaminated surfaces. Frequently touched objects and surfaces should be cleaned more often than usual. Cleaning in General Practice

  7. Ensure your practice has robust hand hygiene policies and procedures in place. Staff should use sanitisers or wash their hands frequently. Hand sanitisers should be distributed around the practice, including for patients use. Effective Hand Hygiene

  8. Ensure your staff follow the latest guidance on using personal protective equipment (PPE) and are competent at putting it on and removing it. Maintain a stock of appropriate items. The proper use of PPE is a vital element in ensuring the safety of staff and patients from Covid-19 infection. Coronavirus (Covid-19) PPE Guidance

  9. Any member of staff who develops symptoms of Covid-19 infection, tests positive for it, or is told to isolate by NHS Test and Trace, should follow public health guidance and self-isolate themselves for the required period. Under no circumstances should they attend for work. Self-Isolation

  10. Communicate the practice policy on the use of masks. The use of face masks (for staff) or face coverings is recommended in addition to social distancing and hand hygiene for staff, patients and visitors in both clinical and non-clinical areas. Infection Control Management

  11. Physically arrange general practice premises to enable people to keep a distance of two metres from each other wherever possible (social distancing). If it's not possible to stay two metres apart, they should stay at least one metre apart but with extra precautions in place (such as face coverings). Assign maximum room occupancy levels and install precautions such as Perspex screens where needed. Display appropriate safety signage, eg hand hygiene and face mask posters, floor markings to ensure social distancing, etc. Infection Prevention and Control Procedures

  12. Revise working procedures to minimise risk of virus transmission. For example, avoiding face-to-face working where possible, cancelling non-essential face-to-face training and meetings, increasing use of online digital working methods, etc.

  13. Provide a range of patient consultation methods. Increase the use of remote consultations, such as email and phone, but still provide face-to-face access for those patients that need it. Appointments

  14. Identify members of staff who may be at increased risk from the virus, such as those with underlying health conditions. Consult with them and make reasonable adjustments to their working arrangements as necessary.

  15. Follow all appropriate NHS workforce, employment and human resources initiatives. Covid-19: HR Policy and Practice in the NHS

  16. Review your emergency planning and business contingency procedures. Ensure they are up to date and cover disruption caused by the Covid-19 pandemic, particularly in the case of staff emergencies and the delivery of services such as flu immunisation. Emergency Planning topic.

Useful Q&As

Q: Please can you confirm that it is acceptable to dispose of Covid lateral flow tests in the general waste, if they are used as part of a large-scale workplace testing programme?

Q: What should Advance Care Planning look like during a pandemic?

Q: What emergency medicines should be available in the GP’s home visit bag and how should Covid-19 vaccines be transported?

Q: Is extended GP access going to be supported in 2021/22, during Covid-19 pandemic pressures?

Q: How can practices balance delivering the Covid vaccination programme against other practice priorities?

Q: How should I approach the treatment of patients if I think PPE in our practice is inadequate during the Covid-19 pandemic?

Last reviewed 26 April 2021