Timing to implement hot and cold sites in primary care

An evidence review of the best timings to implement hot and cold sites in primary care.

This review aimed to answer the following research questions:

• What is the best timing to move to hot and cold sites in primary care?
• Should this be before the number of cases rise over the next week, or delay until a certain number of cases have been reached?

Population: patients who require an appointment in primary care
Intervention: hot and cold primary care sites
Comparison: usual primary care
Outcomes: primary care resilience, for example staff sickness

Three further questions were considered in parallel. For primary care hot (suspected COVID face-to-face) hubs and cold (non-COVID face-to-face primary care) sites to manage the COVID response, is there any evidence, in the UK and abroad, of:

1. models that have been used to achieve this
2. scale (in terms of population size)
3. effectiveness in treating people and in minimising spread of contagion

Overview of findings

Limited evidence is available on the timing of this intervention, or on this intervention in general.

One Canadian study suggests opening separate clinics when emergency department volume exceeds its six-month average by 10 per cent. This study covered the Kingston, Frontenac, Lennox and Addington (KFL&A) public health region of Ontario, Canada and was moderately successful in reducing emergency department volume. No published models were identified.

Citing this report

This report should be cited as:

Thom, H. and Watson, J. Timing to implement hot and cold sites in primary care BNSSG COV23. 7 April 2020. Available from: https://arc-w.nihr.ac.uk/research-and-implementation/covid-19-response/timings-to-implement-hot-and-cold-sites-in-primary-care/