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Independents' Day

How fake news caused this whole NHS mess

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In this brave new world of fake news, it’s hard to know who to believe. This week, the British Red Cross labelled the situation in our A&Es a humanitarian crisis. Personally I think people who immediately resort to hyperbole are worse than Hitler, so when Jeremy Hunt pooh-poohed the claim, stating that there are only issues in 'one or two' hospitals, I for one was reassured; after all, who would know more about accessing emergency care than a man who spends so much of his time with his pants on fire?

However, NHS middle management has more leaks than a night in with Donald Trump, and we quickly learnt that not only were the problems far more widespread than Mr Hunt had pretended, but that pressure to downplay the situation was coming right from the very top. Apparently trusts have been banned from using the phrase 'black alert', as if everything will be OK so long as we use a less threatening colour scheme: 'Earlier today the hospital was on magnolia alert, but then a couple of patients died on ward seven so we’ve been downgraded to taupe'.

A few smithereens of truth have floated in on the tsunami of spin emanating from the Department of Health, most notably the suggestion from Mr Hunt that many patients who present to A&E shouldn’t have gone there in the first place. Some secondary care colleagues were aghast at this, worried perhaps about sending home the odd aneurysmal zebra within the endless herd of lumbaginous horses. But those of us whose stock-in-trade is sifting through the trivial in search of the serious know he is right. We’ve read the discharge summaries. The question is not whether people attend A&E inappropriately, but why?

Having worked the last few weekends as a GP in my local emergency department, I’ve made it my business to find out, and the same answer keeps coming up: 'I thought this was the only place that was open. Well, that’s what you read, isn’t it?' It’s the fake news story that launched a thousand Mail headlines: 'your GP doesn’t work at the weekend so now you have to go to A&E', and it’s been repeated so often – again on Newsnight this Wednesday – that it’s become self-fulfilling, as the entire nation seems to have collectively forgotten the existence of the GP out-of-hours service. Well, now that Mr Hunt is on message, perhaps we’ll see an end to ignorant people schlepping their kids over to casualty when they should have seen a GP instead. But I won’t hold my breath. 

Dr Pete Deveson is a GP in Surrey. You can follow him on Twitter @PeteDeveson

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Readers' comments (10)

  • More fake news!
    On This Week last night Michael Portillo again stated that GP surgeries are shutting at 3 pm which exacerbated the A&E problem. Isn't there suppose to be evidence before statements are made or does it not matter as he isn't a journalist

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  • Fake news=daily heil

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  • Opel is the new Black.....

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  • NHS 111 must take some of the blame.
    Their systems make it devilish hard to get a timely response from an Out of Hours GP.Punters have learnt this and often no longer even bother to ring 111, heading instead directly to ED.

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  • Thank you so much for speaking out and certainly some of the principles of the issue you are trying to highlight have some merit but there are two points that somewhat cloud your argument

    Firstly you have only reached a certain level of observation when you say that people go to AandE because their GP is not open or they know AandE is always open. People go to AandE because they are scared, worried, lack confidence, need to solve a problem they do not understand and they are in distress and pain. The health literacy of our population, which involves both the understanding of one's own health and utilisation of health services, is poor at times. One needs to look much more into the psychology of fear and survival to get nearer to the answer and the solutions. Furthermore in our wonderful multi faith and cultural society the range of health and service utilisation beliefs are many and varied... that is not their fault !

    Secondly, and this I take slight offense at as a citizen and human being, you use the phrase "ignorant people". I am ignorant to about things I do not fully understand.. This is somewhat insulting, and I am sure you did not mean it in that way but hear lies the solution.

    We spend so much time throwing money, resource and pain into the flood defences that we never look out to sea to prevent the rising tide. The solution lies in a profound and widespread national conversation and education starting in schools and threaded throughout our society. A new message where the solution is lead by a health (NHS) literate, educated and responsible and empowered population. If we tap into the huge resource and voice of community leaders, charities, voluntary sector and of course the health service itself we can shift the tide.....

    It is time to stop saying what the NHS can't do but shifting the paradigm to helping our citizens to realise what they are capable of when it comes to their own health and wellbeing and maintaining whilst using services commensurate with every situation.

    Some of the clues are in Obama's closing speech.... worth listening.

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  • Dear happyJulien,

    It will take half a century to achieve your suggestions and ideas. We are in a culture of "see the doctor".

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  • I have a problem with this 'inappropriate use of A&E' thing. When in the role of PBP (poor b patient), rather than hospital doctor, I have experienced the OOH service at first hand on more than one occasion. I will never, ever use this again and instead will always go straight to A&E if I can't self manage. And every one I know who has had the same experience (and there are several) have said the same thing.

    The problem is not with general practice per se. The problem is that alternatives to the old practice-organised 24 hour care model were not properly thought through, and people go where they go not so much because of fake headlines but on the basis of their or others' experience.

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  • Thanks so much Esmat you are of course correct to some degree - to reach the ultimate goal would take decades
    However we must start now
    There is a short, medium and long game
    The short is to start the conversation immediately at multiple level using every media and connection we have at our disposal
    The medium is to establish formalised training and education throughout the system, appropriate to each demographic. This should be delivered with programmes that are designed with a clear end point of shifting the culture, the message and the approach associated with utilisation of the NHS but more generally with managing your life as a whole more effectively.
    The long game is to bed down the shift of culture such that citizens of the UK now know what it is take responsibility and embrace it...

    There are so many programmes out there such as the Expert patient programme and some others that are ready to fly if delivered at scale - this is only one of the elements needed. Some of John Oldhams work around long term conditions is worth a read or dip into the Health Foundation website to discover the possible.

    Global warming... something needs to be done now... If we shy away from it... the future is uncertain.

    Don't we want to take control and create a more certain future; give the NHS a better chance over the next 5 - 50 years?

    This culture would also be "see the doctor" but the selectiveness of patients will have shifted and many will be doing much more for themselves and using a host of the other resources and assets that are out there - these exist now... We have not come close to realising this fully yet. (look also to the Wandsworth Community Empowerment Network - interesting paradigm shifts there)

    Good luck out there...

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  • Bertie

    My suggestion is a fully nationalised NHS with salaried GP's giving all contracted time to the employer. A contract should specify time spent on management,surgery consultation and home visits depending on local need and individual interests. Primary care centres would need to be community and a and e based.

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  • Seriously, Dr Conrad? More control of your working life to NHS management? Another contract that can unilaterally be rewritten - just not by you!

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