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GPs should look after elderly patients so well, that they stop attending surgery

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I keep going over a quote from that nice Jeremy Hunt in this story, and the more I read it, the more it doesn’t make any sense.

He says: ‘We need to free up GP time to play more of a role in looking after the frail elderly before they end up walking through the surgery door.’

Let’s break that down. ‘We need to free up GP time’. That’s a tricksy start, something I can’t put my finger on there doesn’t ring true. ‘To play more of a role in looking after the frail elderly’. That, I’m guessing, would be the frail elderly I already spend 99% of my working day looking after and who are already a key QOF, DES and commissioning target . ‘Before they end up walking through the surgery door’.  Before they walk through the surgery door? So on the one hand I’m supposed to increase my input and on the other he wants to reduce their attendance?

I don’t know what madcap thinking is behind this latest pronouncement - probably something to do with telehealth, admissions avoidance schemes or whatever today’s policy-based, evidence-free plate of cack-shaped whimsy happens to be. But I think a further clue is that Mr Hunt is also quoted as saying that, as well as looking after the frail elderly so well that they never have to see us, we should also prevent people with long-term conditions reaching the ‘tipping point’ of needing A&E.

All of which surely indicates that the reason we need to have our time freed up is to hone our carpentry skills: because we’ll only be able to achieve this Nirvana of non-attendance and non-admission by going round to patients’ houses with nails and planks of wood, and boarding up their doors while they’re still inside. And if that doesn’t work, we can use it to crucify ourselves.

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

  

Readers' comments (10)

  • What GPs need is a time machine so that when someone turns up requiring any medical care they can go back to the time when they started; smoking; or drinking; or medication; or got injured; or started becoming frail, and put everything right.
    You know spinning round the world like superman in that old film!
    It's a pity the government can't put together any sensible policies because they are too busy listening to the 'evidence' of companies that make money out of these things - rather than 'listening' to health professionals. Although they are very good at handing responsibility for this to health professionals in order to make sure these companies can have tax breaks?
    I supsect to know the real message we should stop listening to Mr Hunts words and find out who his SpAd is texting with the opportunity of lucrative contracts to take elederly care out into the community if (when) GPs fail! - former Southern Cross executives or their ilk perhaps?

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  • I must say I do think it makes very good sense to schedule elderly persons, and in fact everyone for that matter, for a regular health maintenance visit, with increasing frequency as they get older, as envisaged by Breslow and Somers in the 1970s (N Engl J Med. 1977 Mar 17;296(11):601-8). These visits are not really time-consuming and can be largely managed by support staff.

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  • Do let us know what drugs you're taking, and the location of your planet so we mere humans can visit and wonder.

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  • About time something was done to stop crackpot ideas from wasting NHS money.

    No interventions into NHS policy unless there is clear EVIDENCE of benefits to patients.

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  • NHS Free at the point of need
    ??? but we'd rather you didn't need it
    ?? or didn't use it
    Sad times Sad Times

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  • I loved the one from the Secretary of State about how we should "look after patients" rather than "reaching targets". I am one of many thousands of GP's who have been saying that regularly for around 15 years. he was trying to make out it was the fault of health service staff, not of the people who set the targets

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  • It's an extension of the idea that whenever patients are diagnosed with anything, it's because "the GP missed it". Now we've "missed it" if anyone ever becomes ill enough to seek medical attention.

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  • Mark Struthers

    This youtube video is absolutely essential viewing for all GPs ...

    http://youtu.be/OkTnCtg_Omk

    ... who have any interest in the future of the NHS.

    As 'amjed munir' so rightly said, "Sad times Sad Times".

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  • Reducing surgery attendance as an independant measure of care is a novel idea. Where is the evidence? Even the highest earning, lavishly funded and fatly staffed practices in my area of SE London have not managed to justify lower consultation rate on the basis of presumed "superior" care. In reality their claimed morbidly data are no better than average, to put it mildly. So where did this nebulous magic bullet dream get hatched? Answer: in the fantasy world of Jeremy Hunt.

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  • That's a new non-starter target - for the frail elderly to stop attending surgery! 1. The frail elderly always require a home visit (using non-free GP time). 2. It follows the frail elderly never walk through the surgery door. 3. A GP cannot play more of a role because a GP's time is already consumed by "frail elderly", non-frail elderly, chronically ill elderly and non-elderly, acutely ill elderly and non-elderly, meetings with elderly and non-elderly CCGs and PCTs, QOFs for elderly and non-elderly............

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From: Copperfield

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