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Living Guide

The Living Guide and linked documents are archived and are no longer being updated (last updated April 2021). Our monthly newsletter and website continue to provide updates on Covid-19 and many other issues.


This living document is produced by the GP medical directors of Londonwide LMCs in collaboration with clinical colleagues within the NHS system in London to guide London’s GP practices to best help our patients. We have produced this guide in the early stages of an unprecedented coronavirus (Covid-19) pandemic during which the imperative is to flatten the curve to enable NHS services – emergency, hospital, community and primary care – to work together to beat the consequences of a novel infectious disease which has no vaccine, in the context of substantial risk that services might become overwhelmed. Such times demand rapid learning and change in practice.

The balance of power between our ability to prevent disease versus end of life care has, for now at least, shifted. Given time this will change. But during this period where drastic social distancing appears to be the main defence, we must park our accustomed practices and give permission to ourselves to concentrate on the task at hand. That task is defined by safely caring for our patients’ most pressing needs – be they Covid-19, or related to other key disease – maintaining immunity against diseases preventable by immunisation, preventing practice staff from being vectors of disease and caring for ourselves so that we remain fit to care for our patients.

We draw on available evidence and information from multiple sources, including real-time examples from China, Italy and elsewhere, and we recognise that, as in all times of trouble, there will be innovations and advances in both clinical practices and in the systems to support them. These may well challenge decades of traditional practice but our hope, as we work through this coming period, is for us all to get through and come out the other side safely, armed with those new solutions and ways of providing the care that will enable us to meet our patients’ whole person needs for the rest of the decade and beyond.

Finally, I wish to pay special tribute to Londonwide LMCs’ GPs Dr Lisa Harrod-Rothwell, Deputy CEO and Dr Elliott Singer, Medical Director for their unheralded insight and tireless work in creating this living guide.

Dr Michelle Drage MBBS FRCGP
CEO Londonwide LMCs