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The waiting game

Better self-care could beat the cold weather crisis

Dr Zahid Chauhan laments the lack of a self-care public awareness campaign around colds and flu, which he believes could ease pressure on GP surgeries at this time of year

Dr Zahid Chauhan

Typically the furore around this year’s winter pressures has been focused on A&E units and the cancelling of operations.

In the midst of this perfect storm, little thought has been given to the impact of increased demand at practice level. Our waiting rooms are rammed and we are burning the midnight oil with home visits.

This is no surprise, as GPs have borne the brunt of health and social care cuts, becoming everything from triage door manager at A&E departments, to bureaucrats assessing whiplash disputes and the writers of sick notes for children so that school attendance records are attained.

But austerity and buck-passing to practices aren’t the only factors to blame for our annual cold weather meltdown. It is also – elephant in the room time – the lack of patient education and personal responsibility that has helped create a demand on primary healthcare that has us creaking to the point of breaking.

The huge number of patients coming in and expecting an examination and a pill to cure conditions such as colds has helped create this crisis

Perhaps we as doctors are victims of our own success. Put simply, the public expects the GP to fix them when they are broken. Every time. And immediately.

My surgeries have been packed with patients with such expectations since temperatures dipped during December. Sure, unscrupulous bosses put pressure on people to get well quick, but the huge number of patients coming in and expecting an examination and a pill to cure conditions such as colds has helped create this crisis. Ironically enough it has also led them to complain about the lack of appointments.

Certainly we need more resources devoted to NHS services, but we also require campaigns to instruct the public to choose well and manage their own health.

This can have a dynamic impact. This year for example, we have seen a change in attitudes towards antibiotics. Thanks to the Public Health England campaign and the work of charities such as Antibiotic Research UK, patients are finally getting the message that drugs such as penicillin are not the answer to everything. Could not the same type of message be promoted around colds and flu? And instead of headlines advertising NHS Armageddon, couldn’t the mainstream media encourage patients to rest, take fluids and stop rocking up at surgery, spreading germs and wasting their family doctor’s time?

I welcome the call outlined in the General Practice Forward View to manage demand more effectively, by supporting people to look after their own health. I have seen for myself the creation of minor ailment schemes, closer working with pharmacies, even events held by practices to encourage healthy eating and improved fitness.

But putting the burden on practices simply scratches at the surface. The recent outcry following Tameside Hospital’s decision to ban sugar in their restaurants, reveals just how much work we have to do to persuade the public of the need for personal responsibility around their own health. 

I am a fervent believer that the NHS should be free at the point of contact and be for all of the people. But the public must do their bit too and realise their part of the contract – namely, that the NHS is by the people too and that they need to protect it and assist it, particularly at difficult times.

Otherwise, they are going to be faced with the prospect of a packed waiting room, no hospital beds and cancelled operations every winter. And everyone is sick of that situation.

Dr Zahid Chauhan is a GP in Openshaw, Manchester


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Readers' comments (5)

  • David Banner

    When the NHS inevitably mutated from privilege to right, it sealed its own doom. We’ve had decades of information bombardment pleading with patients to take more responsibility for their own health, and they have failed, but this is hardly surprising. If you offer an all-you-can -eat buffet for free, don’t be alarmed if nobody is prepared to fill up before they leave the house.

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  • what a common sence article. Sadly such outdated thinking has been overtaken by no win no fee Lawers and the upsurge in low risk ' cover your own bottom' practice; the worst case scenario health messages put out by main stream media creating a " better to check dr" neurotic society and the obsessional, glamorisation of being a patient in the endless TV soaps and fly on the wall documentaries.
    We knew a flu epidemic was imminent but I have yet to see one public health message on peak time TV telling people en mass how to care for themselves rather than getting worn out gps to do it on an individual basis .
    As the NHS sinks we need more collective, mass messaging not less ie a cohesive public health approach. cutting the public health budget just shows how little our overlords understand or highlight the fact they are sailing a completely different course.

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  • To be contrary no amount of improved self care is going to resolve the crashed Social Care causing impaired hospital functioning
    Self care & increase sensible use of pharmacies will help but the big problem is lack of resources

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  • The idea of a self-limiting illness that has a natural history that gets better over a period of time is an alien concept to many patients. Education in schools surely must be key, but this is a generational problem with learned illness behaviour and consumer culture values wanting quick fixes where they don't exist. Major public health campaigns promoting safe and effective self- care must happen but will be interepreted as rationing, and all it takes for it to go wrong is for one adverse incident to happen where someone has not sought medical advice who needed to. Self -care still must be promoted but the world wants to be deceived..

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  • Is it patients demanding a quick fix or Doctors ingrained in the Medical Model of consulting, expecting to fix everyone?

    You get the patients you deserve....

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