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GPs buried under trusts' workload dump

The need for speed

Dr Kate Harding

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Now and again, as must happen to us all, I find myself cast back into the role of patient – always an educational experience (amongst other possible phrases). On this occasion, I decided that I probably had bowel cancer, and was likely going to die. I really felt cross about this prospect, having no time or energy for the necessary associated business of Going Downhill.

I knew that I needed some (more objective) medical input, and phoned my GP surgery, as usual forgetting that I am no longer in New Zealand, and that the next-day appointment with their very own cradle-to-grave GP that Kiwis consider their birth right is a fantasy that I need to let go of. Sure enough, the dreaded phrase ‘that will be a three-week wait’ was trotted out, and I abandoned that avenue forthwith; instead, I made an appointment at my own place of work, the local extended hours surgery.

What a revelation! I was seen within two days (a much more acceptable delay, to my hypochondriacal mind) by, yes, a GP I had never met before; so what? She did the necessary, referred me to hospital, I was seen there two weeks later, I don’t (yet) have bowel cancer, I am happy and (given the generous hourly rate of pay), presumably so is she.

I will always value speed and efficiency over a cosy doctor-patient relationship

Yes, I know. It would have been lovely if she and I had met many times over the years; if she had delivered my children; visited me at 3am in my fever-bound bed; sectioned me during that difficult period back in ’05 (I made that up! Honest!) and so on. But, hey, it’s 2019. I was fine with her being a complete stranger, because she did the job that I had asked her to – helped me to exclude The Worst – and she did it FAST.

As for the hospital-based part of my experience – to my surprise, I almost enjoyed it. I was seen in a crowded outpatient clinic, this time by someone I DID know (Hereford is a small place); given the somewhat intimate nature of my complaint, was that worse or better than being seen by a stranger? Once again, I say – so what? I was so impressed by the speed and efficiency of the process that I was just delighted to be getting help so soon.

The final stage in my journey of personal lower GI discovery was a sigmoidoscopy – my first encounter with bodily cameras in any shape or form. I must admit to a certain modest pride in the pristine pink landscapes revealed within, as a nurse held my hand and we all admired the pretty pictures on the screen together. Frankly, it was the first time I had had time to lie down all week, and to have my hand held and soothing words murmured to me at intervals enhanced the experience all the more. Maybe this is what a spa break feels like. Minus the phosphate enema.

All in all, I had a positive experience of the NHS, and I would use the extended hours surgery again in a heartbeat. My personality is such that I will always value speed and efficiency over a cosy doctor-patient relationship that has spanned several decades. Of course, when you are terminally ill, or your wife has left you, or your son has discovered heroin, it is a huge comfort to be able to confide in a doctor who is familiar, whom you know and trust. But for many other complaints, the services that are springing up to mop up demand are doing a valuable job, and – in the modern way – I will be ‘feeding back’ accordingly.

Dr Kate Harding is a locum GP and hospice doctor in Herefordshire

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Readers' comments (4)

  • Surely if you presented as a 2ww concern you would have been offered triage on the day by the on call GP or an emergency slot. A 3 week routine appointment would have been offered based on what you told the telephonist. Sorry love your articles but cheap shots at your practice access is beneath you. Leave that to the Daily Mail.

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  • Kate Harding

    You’re probably right. I still don’t seem to be using the right words or phrases when I contact my surgery despite my supposed inside knowledge! I think the truth here is that, deep down, I knew that I wasn’t likely to have a true emergency on my hands, so felt remorse at making a fuss and asking to be seen ‘urgently’. I know that the doctors at my own surgery are *great* when I do see them and this is in no way a slur on them.

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  • I'm glad you got the all clear promptly- waiting is very soul destroying. In my own case my neck gland in feb was squamous cell cancer and I am now in the final third of very heavy radio chemotherapy with a chance of cure. i'm well looked after by gps and hospital staff.
    however as a traditional GP my recurring worry is that young GPs are too protocol driven and slow as a result. the public bring us any amount of trivia and to cope we need to be confident enough to zip through this work. 10 mins is an eternity for a sore throat or simple viral illness. if we hive this stuff off to nocters we end up with surgeries full of demanding neurotics that exhaust us. that is the route to perdition. the family doctor if practicing in the traditional surgery should be able to provide continuity plus ready access. this is timeless general practice which for me has been by far the best job EVER and i have thoroughly enjoyed 35 years so far and hopefully more to go.

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  • Kate Harding

    Jonathan - I am so sorry to hear of your health issues and wish you well, so good to hear you are being well looked after. I totally agree with the points you make. And how wonderfully positive you sound about general practice - so lovely to hear.

    I think I have trouble declaring myself a 'same day emergency' yet also feel too vulnerable and anxious to wait 3-4 weeks for attention for my (very occasional! I promise!) health concerns! I think there is room for both systems - I am so grateful to my GP surgery whenever I do take one of my kids or (rarely) need to go myself and manage to tolerate the wait to be seen. But for me, the extended hours service is a great middle ground option for the things that aren't 'same day' urgent, but would weigh on me for weeks on end if I were to wait.

    The last thing I want to do is criticise my unbelievably heroic in-hours GP colleagues. I know how hard they work, I used to be one of them until I bailed out! I couldn't do your/their job. It is heartening to hear how much you have loved your job over such a long time, and hope to continue loving it for a long time to come. Thanks for your comment:-)

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