Posted by: Lisa Harrod Rothwell12 November 2014
‘My little boy fell over. I washed his knee and put a plaster on it but his nursery told me that I needed to get a doctor to look at it.’
I peel back a well-applied 3cm plaster (credit where credit’s due) to reveal a trivial graze to a left knee.
I praise Jonny’s mother for her swift home management, try but fail to gain understanding regarding the nursery’s concerns, and re-apply the plaster. My medical training and experience having been put to cost-effective use: a relieved mother ushers out her son, plaster now dangling precariously from his knee.
As I return to the growing list of ‘urgent extras’, I devise a plan to help GPs withstand the tsunami of patient demand:
‘Required: Volunteer triager for GP surgery. No formal medical training required. Only very experienced (great) grandparents need apply. Willingness to working from home desirable.’
But there’s a flaw. I fear the required grandparent cohort is endangered, maybe even extinct. They used to be commonly seen talking over garden fences, waving at bus stops, walking our streets carrying shopping bags. They occupied a position of respect and authority.
Do you remember them? They were the first port of call to the worried and less experienced, always welcoming with a listening ear and a therapeutic cup of tea. They knew how to manage minor self-limiting illness and minor injury; they advised and educated their fledglings. They could be heard saying, ‘You mustn’t trouble the doctor unless there’s something wrong with you. You’ll be fine; you’re just feeling a little queer’. Yep, times have clearly moved on. I need a plan B.
‘Nurse practitioners’, I hear you cry. ‘They’re great at standing in front of GPs and protecting them from the ever increasing patient demand tsunami.’
Of course, how silly of me! Let’s take highly-skilled and experienced practice nurses and put them through intensive additional training to become formally qualified to manage minor illness and injury.
They can offer a listening ear, give advice and educate. We will use the term ‘nurse practitioners’ to demonstrate their position of authority and to command respect. And when they too are no longer able to cope with this tsunami of growing magnitude, we can shunt patients to our pharmacist colleagues. Sorted.
OK, so it doesn’t address the issues of increasing over-dependency on the NHS, nor actually manage the unsustainable demand on the NHS, but it does put a sticking plaster on the problem - although not very firmly.
Dr Lisa Harrod-Rothwell is a GP in Essex and former chair of a local CCG.