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Independents' Day

Of course we should have the right to ring consultants

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So, the Cabinet Office has suggested that patients should be entitled to Skype their GP, that those who move away should be able to remain registered with their doc of choice even if outside the catchment area and that GPs should retain the right to freely communicate with consultants by telephone.

Hey, one out of three isn’t bad. Of course we should have the right to ring consultants. What sort of totalitarian state would we have to be working in to believe that we might not have the right to phone the local specialist on the rare occasion that the combined forces of our clinical acumen and Pulse Learning leave us clueless about what to do with a patient? 

Punter X has strange symptoms Y, unresolved by treatment Z. It probably doesn’t warrant an outpatient appointment and he’s certainly not ill enough to send up acutely and screw up my QP figures. So who am I gonna call? My friendly local consultant, who suggests diagnosis A, investigation B and treatment C, and suggests I try starting at the beginning of the alphabet next time. Ah, that’s why we have them.

Everyone’s a winner. The patient’s sorted, I’m relieved, an unnecessary appointment’s saved, and the consultant gets a warm intellectual glow. It’s a no-brainer – except for a hospital which has apparently banned the activity to ‘game’ an increase in outpatient activity. After all, what is for me a friendly, educational chat with a specialist is, for them, an undermined revenue opportunity.

I can believe it, too. And doubtless it’s the shape of things to come. Already, a quick chat with the haematology department has transmuted to a formal, funded, email care pathway, and on-tap advice from the biochemistry lab is under threat as the service is likely to be outsourced far enough away to render the phone-line dodgy.  

Ah, remember the days when we were self-employed, independent, unfettered professionals with easy, mature and mutually beneficial communications with our consultant colleagues? Nah, me neither.

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

Readers' comments (2)

  • when recently asking to speak to the consultant neurologist on -call I was advised by switchboard she could only page the SpR on-call. Pending on how expierenced the SpR is the level of expert advice could be very variable

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  • Tony ... How long to go?
    How have we fallen so low. A once proud profession is bossed around by a crazy system of adminstration that you couldnt invent.
    We nood to be mindful of waste, use referral and all our colleagues time in a way that is thoughtfuland mindful of the greater good. However the appropriate referral to the right person was what I was trained to do for thirty years.
    Every procedure that the mad administrators have thought up .. have just produced more and more middle men ... and it gets in total more expensive. YOU COULDN'T MAKE IT UP!!!
    May 1st may not be a day of revolutions, but for this once NHS supporter it can't come a day too soon. My old plans of retiring at 65 long gone. I look forward to retirement with gusto. If I was a 30 year old ... I would emigrate .... in the blink of an eye....half the money would do.

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From: Copperfield

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