A group of consulting actuaries working in the UK life insurance sector have helped a network of GP surgeries to remain open during the Covid-19 pandemic, by modelling the risk of staff contracting the virus.
Last month, soaring Covid-19 infection rates and protective equipment shortages led to concerns among GPs about the risks of surgeries having to close and insufficient clinical staff being available if they contracted the virus simultaneously.
One GP network in north-west England approached actuary Jon Halstead to support the decisions they were making around resource allocation.
Over the course of two days, Halstead worked with six other consulting actuaries – Ankit Agarwal, Gary Hibbett, Nikos Katrakis, Paul McHugh, James Sharpe and Phil Taylor – to develop models for the options available to them.
“We received the request on a Friday via our WhatsApp group and delivered the modelling results on the following Monday,” Sharpe told InsuranceERM. “The models helped convince the GPs of the best course of action.”
GPs knew carrying out patient-contact (“front-line”) activities carried a much higher risk of contracting Covid-19 compared to “back-office” roles such as telephone consultations, prescriptions, etc.
In many GP practices, the same individuals carry out both front-line and back-office roles, and it was unclear what front-line services might be reliably maintained and whether greater coordination across a network of GP surgeries could improve outcomes.
The actuaries developed their models to investigate the effect of various approaches to resource allocation, including:
- Operating as normal
- Protecting a proportion of GPs by keeping them in back-office roles. This pool of protected GPs could then be used to substitute their front-line colleagues should they fall ill
- Taking turns in the front line
Each member of the actuarial team produced prototype models, which were compared against each other. Two models, one deterministic and one stochastic, were selected to take forward.
The deterministic model allowed quick and easy what-if analysis and validation of the more complex stochastic model, which was slower to run but had greater functionality. The stochastic model produced a distribution of outcomes and results for individual GP practices.
The model considered an illustrative network of seven GP practices with six GPs in each practice. A public health statistician provided the assumptions around rates of infection, time working while infected and time off work.
In approach 1, GP absence was seen to spike sharply within two weeks, well above the level required to ensure normal service could continue.
Modelling of approach 2 showed the peak could be flattened to more manageable levels of absence.
Using the information provided by the models, the network of GPs created a “hot site” to carry out face-to-face consultations with high-risk patients. Clinical staff at the hot site had no contact with those in the back-office or other hot site clinicians, and were provided with the best available protective equipment. If they fell ill or had to self-isolate, they were replaced by others from the back-office.
The seven consulting actuaries are now working with the C19 Actuaries Response Group and are available to help with similar modelling challenges. Email: [email protected]