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"We'll keep refining the model and find a new balance as we go through, because it's not going to disappear overnight."

These were the words of one rural GP, as doctors face a cold and flu season like no other.

Covid-19 has changed how the health service works. For most of us, the face of that health service is usually our GP.

Like the rest of the health service, doctors in general practice have had to change how they work.

"As GPs, we miss seeing patients, we like seeing patients," said Dr Rachael Wright, a GP in Lisnaskea, County Fermanagh.

"We still are seeing patients that need seen."

Reduced risk

Like most practices throughout the UK, Dr Wright's surgery has largely moved to a "telephone first" system.

"Patients phone in and they're given a telephone appointment," she said.

"Then the doctor, or nurse, or person on the multi-disciplinary team - physio, mental health practitioner - will phone the patient back.

"That is an appointment. Things can often be dealt with well over the phone and it also reduces the risk for the patient having to come over to the health centre."

Dr Rachael Wright said some changes may remain post-Covid

The aim is to prevent people having to gather in a waiting room, especially as the cold and flu season begins. The symptoms of these illnesses are similar to those of Covid-19.

"But there are patients who need seen," Dr Wright said.

"There are things that can't be dealt with on the phone - tummy pain, examining a breast lump - and those patients are still being seen in practice."

But on the streets of east Belfast, some reported a mixed experience.

One older couple said: "It's very good. When we phone the health centre the doctor phones back the same morning and he'll usually say, 'come down' or he'll say, 'I'll leave a prescription for you', so really the contact with the doctor's brilliant."

One woman was persevering with the problem she'd spoken to the doctor about, but would rather see her GP.

She said: "You're only telling him what you think's wrong with you and, you know, they're just giving you something over the phone.

"I've had a pain from the beginning of lockdown in my leg and I think it's just sciatica so they prescribed me with tablets, it has eased it a bit but it's definitely not away.

"I mean you prefer to get in and see the doctor, so you'd know exactly what's wrong with you."

A younger man said he'd had no problem and welcomed the changes.

He said: "I did it over the phone, I had a consultation with my doctor as well, and I've been in and collected prescriptions. It's been pretty efficient to be honest."

One woman on a mobility scooter had just been to have her blood pressure taken by a nurse, but hadn't been able to see a doctor.

She said: "I have been in contact with the doctor. You can phone him and tell him your symptoms and he'll see if he can help you.

"I think some doctors are different because you can get in to see some of them, but I can't get in to see mine, no."

Positive changes

The question for everyone is when will things return to the normal we used to know? That, Dr Wright said, may never happen.

She said: "If Covid vanished tomorrow, by a vaccine, yes, things will revert, but will they revert 100% or will we use some of these things as a positive?

"Phone calls don't work all the time, but they do work.

"Things like video consultations, sending in photos, better networks with secondary care - there have been positives and I don't think we'll throw all that out."