Managing COVID-19: Advice for GPs with patients living in aged care facilities

GP attending to a COVID positive patient living in a residential aged care facility.South Western Sydney based GPs working in residential aged care facilities (RACFs) can use the tips on this page to support their involvement in RACF COVID-19 outbreak preparedness activities.

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Check all contact details are up to date

Review your patient's records

Manage your RACF patients

Plan for surge capacity

Be prepared for RACF outbreaks

Check all contact details and communicate intention to continue on-site visitation in the event of a COVID-19 outbreak

CHECK the RACF has your details

Make sure the RACF:

  • has accurate contact numbers and details for you, your practice and after-hours contacts.
  • they are stored with the RACF’s COVID-19 Outbreak Management plan.

CHECK the RACF has a list of your patients

Keep an up-to-date list of the residents you care for at each site and make sure the site also has a list of the residents you care for.

CHECK the contacts you have for the RACF

  • Refer to the RACF’s governance chart.
  • Ensure you know who is in charge and how to contact them. This may be a facility manager or nurse manager.
  • Check you have contact information for the local Aged Care Rapid Response Teams (BRACE, GRACE & ARRT) and understand the likely escalation points.
  • Ensure you can contact the pharmacy that supplies your residents, including after-hours, in case of urgent medication needs.

ADVISE RACF if you will visit during COVID-19

Advise the RACF whether you are willing to continue to physically visit the site in appropriate PPE in the event of a COVID-19 outbreak, for either COVID positive or non-COVID residents.

If you are visiting multiple RACFs, check you will be able to continue to visit unaffected sites concurrently. Potential solutions to this could be the use of telehealth or liaising with a “lead”, onsite GP linked to your other RACFs. SWSPHN can assist with coordination of GP workforce in these situations.

Review your patient's records

REVIEW the patient’s clinical details

Ensure patients clinical summary and details, including next of kin, are up-to-date and can be effectively used as a handover summary.

REVIEW goals of care and care escalation

Review goals of care and care escalation for each of your patients in the RACF.

REVIEW the patient’s ACP

Review of Advance Care Plans for all patients. Discuss plans for what would happen to a resident if they were to contract COVID-19.

REVIEW the patient’s medication charts and prescriptions

Review medication charts: make sure prescriptions are up to date. Consider:

  • ensuring all prescriptions have at least a seven-day supply remaining.
  • AVOID ALL NEBULISERS due to the increased risk of transmission of COVID-19 through droplet spread. Instead, consider prescribing a spacer.
  • anticipatory medications for palliative care needs (morphine and midazolam subcutaneously in appropriate dosage).
  • Check HealthPathways for latest recommendations.

Transitions of care are high risk for medication errors. Use of MyHealthRecord and the Pharmacy Shared Medicine List is recommended to ensure information can be accessed quickly and effectively.

Immunisation record

Ensure flu vaccinations are up-to-date.

Manage your RACF patients

PROVIDE continuity of care

Maintain continuity of care through face-to-face care or by telehealth. COVID-19 MBS telehealth items can be claimed, see for news and COVID -19 telehealth MBS items.

Provide ongoing care for residents who choose to go home with family.

CHECK infection and PPE Plan for visiting the facility

If you will be attending a RACF, always undertake best practice infection control and PPE requirements.

ACCESS to clinical advice and COVID-19 information

If you are managing patients with COVID-19 and have any COVID-19 specific questions you may: 

CONNECT and communicate with families

Contact families and be a conduit for information for them. Consider having a video conference for several families or all the families of your patients from the one facility at the same time for rapid sharing of information and to allay anxiety.

Plan for COVID-19 surge capacity

PLAN for surge capacity

Plan for surge capacity amongst your colleagues, if possible, in discussion with the nursing staff.

Consider forming a group where one (or more) “lead” GPs continue to visit the site if others need to self-isolate. The visiting GPs can perform any tasks that can’t be undertaken via telehealth. The RACF may be able to advise who the attending GPs are for the facility.

SWSPHN works closely with the Local Health District, Commonwealth Department of Health and the Aged Care Commission by attending outbreak management huddles with RACFs and local hospital in-reach teams to agree how best to manage COVID positive patients.  Email the SWSPHN COVID Response Team for details.

SEEK ADVICE for concerns about an RACF

If you have concerns about a RACF’s ability to prepare adequately or to cope with escalating issues, email SWSPHN COVID response.

When an RACF is affected by an outbreak: GPs need to BE PREPARED for:

New staff and management

  • Usual RACF staff may be furloughed/quarantined, and replacement staff put in place who do not know the residents, their medical care needs or care wishes. In some instances, this can include surge GP workforce to provide on-site care. However, SWSPHN is encouraging continuity of care with a patient’s regular GP wherever possible.
  • RACF management may also have been quarantined/replaced.
  • Breakdown in usual procedures when regular staff are replaced.

GPs impacted by COVID

Some visiting GPs may be in isolation or unable to attend facilities on site. Plan amongst GPs and facility staff. SWSPHN can assist with sourcing GPs from other general practices.

Communication difficulties

  • Difficulty contacting nursing staff within the RACF (e.g. phone calls unanswered or very limited information provided in response to GPs’ calls).
  • Difficulties with communication lines within the facility (e.g. messages not being transferred between wings or floors of the facility).
  • Frequent contact from residents’ family members seeking information about their family member.

Before you go, please consider checking the COVID-19 for health professionals in South Western Sydney section of this website.

This will help keep you on top of the rapidly changing situation. If you need further help, please email SWSPHN COVID response.

This article is also available in PDF to download [PDF | 5 pages | 200kb]

Acknowledgment - Adapted from Northern Western Melbourne PHN: Advice for GPs with patients in aged care.