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GPs go forth

Mr Hunt meets his named GP

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Westminster Nursing Home for the retired and demented. Matron’s updates to shared clinical records:

1 Nov 

We have a new resident today, a Mr Hunt. I believe you, Dr Copperfield, are his named GP. He had a lovely lunch and has opened his bowels.

2 Nov

Opened his bowels

3 Nov

Opened his bowels. 

4 Nov

Opened his bowels.

5 Nov

According to the handover book, he has opened someone else’s bowels. I will look into this.

6 Nov

The above was a handover error. It was his bowels he opened. He has done so again today. Opened his, I mean. And he very much enjoyed his dinner.

7 Nov

Opened his bowels.

8 Nov

Opened his bowels.

9 Nov

I am giving you these regular updates because Mr Hunt is most insistent that, and I quote, ‘Care homes updating records daily help with named GP responsibility’ . Opened his bowels.

10 Nov

I have looked back through his notes and see that Mr Hunt stated something very similar on 13th December last year about nursing homes updating GP records daily. At the time, you diagnosed a TIA. Do you think this is a recurrence?

11 Nov

Forgot to mention in yesterday’s update - opened his bowels. Apologies.

Also opened his bowels today. Have not heard from you regarding ?TIA.

12 Nov

I’m concerned that Mr Hunt is becoming increasingly agitated about the need for us to give you daily bulletins on his condition.

For example, today, he has repeatedly said, ‘Under the named-GP policy that we have announced, there is a big opportunity for care homes to access GP records and keep them updated daily, so that GPs are kept in daily contact with how some of the most vulnerable people are doing.’

He is becoming increasingly difficult to reassure that we are doing this for him. Perhaps we should start updating you twice a day, maybe that will placate him. Are these still TIAs? Or could it be a urinary infection? Or is he dementing? Do you think you could pop in when you’re passing to assess him? He has opened his bowels today.

13 Nov

I’m confused as to why you sent round a community nurse to give Mr Hunt an enema. I have no reason to suspect that he was constipated. He has had his bowels open every day, including today, a fact you would have been aware of had you read my daily updates. Could you please respond ASAP?

14 Nov

I find your response to the above question – I quote, ‘I arranged for the enema because it’s my belief that Mr Hunt is full of sh**’ – completely unprofessional. Mr Hunt is becoming increasingly agitated and I don’t think that having a large length of rubber tubing inserted into his lubricated anus was helpful.

On the plus side, he has had his bowels open. And, yes, there did seem rather a lot.

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

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Readers' comments (32)

  • Can we do this now as we seem to be getting to regular updates form Mr Hunt.I can think of many people who will want to shove i the rubber tube personally! Excellent blog

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  • I hope you have sent a copy to the honourable Jeremy Hunt, so that he can see what we think of him and his ideas.

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  • Brilliant!

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  • Only serious omission was number of times he pu'd. Worried re fluid balance. Oh and would help to know he's not in AF on a daily basis. Cracking

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  • Peter Swinyard

    I am concerned that the record does not state whether he slept on his left or his right. If the former, can a political adviser please be sent by the GP to correct a lamentable slip to the left? This is clearly the GP's fault also. CQC should be involved and inspect the records of bowel function and sleeping side and discuss the findings with Monitor, LAT, the CCG and the GMC before finding the GP guilty in absentio of failing to diagnose a leftward bias.

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  • Fantastic !

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  • Absolutely brilliant !!!

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  • This is absurd !! the records are incomplete. We as GPs demand to know the exact amount ,colour and odour of every bowel motion !! how on earth can we look after him if we don't have the full picture !!! .. how about NHSE devise a DES for a template to record detailed bowel habits?

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  • when the enema finished were any m'urdoch or d'acre lesions flushed out?

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  • Siraj Shah

    Tony It seems you got the diagnosis wrong Mr Hunt is suffering from faecal impaction leading to “overflow incontinence” secondary to some neuro-degenerative disorder; you need to hold an urgent MDT meeting otherwise he will end up in A & E as an unplanned admission for a colonic washout.

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From: Copperfield

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