The SA Private Practitioners Forum (SAPPF) has reiterated its support for healthcare practitioners during the COVID-19 crisis and has taken the following measures to support their financial well-being and to offer a safe and efficient service.

Concessions

1) A letter went to all banks highlighting the financial hardship we will be facing, and we have had a very positive response from all the major banks. Now that the banks have been sensitised to the situation, we recommend that we individually contact our own financial institution and arrange the assistance we need. Each institution has its own plans and policies, so we are not able to broker a “one-size-fits-all arrangement.”

2) Medical Malpractice Insurers

a. PPS Medical Malpractice Insurers sent a communication to its members. The letter contains clear instructions about a 50% reduction in premiums over three months, working outside one’s scope of practice and Telemedicine.

b. MPS sent a communication offering advice about telemedicine and working outside your scope of practice and have announced a two-month premium holiday.

c. Hollard and EthiQal will be contacted and asked to provide a statement about their stance on these issues.

3) Hospital groups have offered rental relief.

4) HPCSA and PCNS fees. These fees are due now and payment can be delayed without penalty. They are unlikely to consider any concession so the SAPPF will not approach them.

Income supplementation and payment for services

1) We have written to the Council for Medical Schemes and approached all fund administrators to work with us to develop a plan where we can be compensated from the Medical Aid Reserves. If the release of this money is allowed, we can then propose our plan.

2) COIDA – we will ask the Compensation Commissioner to make payment to groups that claim from COIDA. No payments have been made since September 2019. Even a nominal payment now, while we sort out the issues with the system, will go a long way to alleviating the pressure temporarily.

3) Public patients in private – We have a plan that would allow compensation of doctors in the private sector based on the salary earned by a principal specialist in state. The details are being developed and will be presented once completed.

4) A system that uses the current fee for service model and procedure/consultation codes is being explored. 

General 

In letters sent to the Minister of Health and the Minister of Justice, SAPPF has asked for comment on working outside the scope of practice and has requested a consideration on suspending patients’ rights to litigate as a result of incidences that have occurred during this crisis. The HPCSA has been asked for a ruling on work done outside our scope of practice. 

SAPPF has set up an information portal that contains relevant information and communications about the COVID-19 crisis.Send an email to COVID@healthman.co.za and you will receive an email with the information.

Efforts to Support Members to Offer Safe and Efficient Service

1) We are participating in discussions with all hospital groups to ensure that the voice of the doctor on the ground is heard loud and clear.

2) We are ensuring that protection of the HCP, by supplying adequate and appropriate PPE that is a critical point of discussion in every forum. A central PPE receiving and distribution hub, which can be contacted by individual hospitals, is almost ready to go live. We encourage you to ensure that your hospital manager assesses and responds to your needs for PPE.

3) We have asked HASA to perform an audit on the HCP and PPE needs of each hospital in the private sector and to let us have that data. We will then be able to assist hospitals that feel they are understaffed or are not adequately stocked with PPEs.

4) Arrange multi-disciplinary clinical teams to cover the ICU and wards in shifts. Each team should be headed by an intensivist/ physician or anaesthetist with intensive care experience. We have started looking at a guideline of how to set up and organise multidisciplinary teams. This will provide guidance on the size of teams and how patient numbers and patient acuity potentially influence team size and composition.

5) We encourage every hospital to appoint dedicated intubation teams and for these teams to strictly adhere to the guidelines on intubating COVID patients.

6) Please be sure to practice donning and doffing PPE. Do this with a colleague an ask them to assess your performance.

7) Appoint a champion or lead at your hospital who will interact with hospital management and drive the process to ensure you are prepared and protected and working efficiently.

8) Ensure your hospital has a standard operating procedure for wearing of masks by all hospital staff and patients, triage, storing and access to PPEs and handling communication to families of admitted patients to name a few.

Casper Venter from HealthMan has also put
together a document that summarises all the opportunities and concessions that
are available for financial compensation for private practices that are struggling
deuring the COVID-19 crisis. The document is available on:
https://docs.mymembership.co.za/docmanager/419ae5a4-f8c7-11d4-9fb7-0090279a6a88/00149482.pdf