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Farewell remote monitoring DES

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Directed enhanced services? Ditched enhanced services, more like. Because the new contract shake-up sees three of the new versions already consigned to the DES dustbin. Specifically, Risk Profiling will be swallowed up by the new Unplanned Admissions DES, Online Services will become a contractual requirement (see what they did there?) and Remote Monitoring has bitten the dust completely because no one gives a monkeys.

Except, that is, me. If it’s possible to mourn for a DES, then it’s Remote Monitoring that I shall shed a tear over. Not for the Tomorrow’s-Worldy ‘smart-toilet which each day performs a urinalysis on your morning micturition and electronically communicates it to your GP as a pee-mail’ sort of remote monitoring, because we all know that doesn’t work (and I don’t mean the technology, I mean the entire concept). I’m referring to the decidedly lower-tech versions - such as remote blood pressure monitoring.

Consider, for a moment, what remote BP monitoring would achieve: a dramatic reduction in patients attending for routine BP checks. And, therefore, a corresponding reduction in ‘while I’m here’ complaints raised by punters fully aware that attending something as tedious as a BP check is only worthwhile if it provides a forum for symptoms too trivial to be brought to a ‘normal’ appointment.

Imagine that. Then imagine the same applying to asthma, COPD, CHD, hypothyroidism et al. Suddenly, GP life seems almost worth living.

True, the payment for the original DES was only something like a groat per patient. But it was a PREPARATORY DES, remember? It offered more to come. It offered us untold riches if we managed to keep the patients away. See what we’ve lost? See why we should weep?

I can’t help wondering if we’ll ever see an opportunity like that again. The odds seem, well, remote. 

Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.

Readers' comments (4)

  • Perhaps the next contract will offer online consultation as a DES. I won't ever have to see any patient again! I'll be the first to sign up to it!!

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  • Goodness me that sounds to good to be true. 'While I'm here doc' via email isn't possible and could result in. Simple predefined response...'please self care and read this patient.co.uk leaflet and come and see us if not settling "

    Love it

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  • I try not to speak during consultations anyway. If you do, patients misinterpret what you say and then you get a complaint about the doctors "attitude".
    I listen to their narrative, uninterrupted, print off the patient leaflet, show the instructions in self-care section, point to the door and wave them good-bye. Job done.

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  • From my position as a locum pharmacist I see enhanced services being de-commisioned or slowly falling apart as the re-accreditation training is no longer available. This means for example that the EHC PGD requires me to offer chlamydia screening but that was decommisioned from local pharmacies last April so I have to refer patients back to you.
    On the plus side re BP checks I often do these in pharmacy, infact one local surgery requests us to do daily checks for a week and then send the details to them. Pharmacies could be used for more of these checks and typically fall over each other in their eagerness to provide additional services for free.

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder