This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

The waiting game

GP into A&E doesn't go

Copperfield 

GPs in A&E? Is that still a thing? Yes, I know, it was a promise, back in 2018, to have a divert and treat GP in every acute trust.

But I’ve heard about 6,000 promises which have come to less than nothing, so I assumed it never happened.

Apparently, though, not only is it still a thing, it’s even more of a thing than it was before.

Because, after vague and unsubstantiated claims of ‘success’, the Government is planning to expand the service.

Let’s run though it one more time, shall we? Whichever way you dice and slice this, it can’t work. If the triaging GP treats the patient, then all patients learn is that they can access quasi primary care on a walk-in basis by attending A&E: the very opposite of what is intended.

Oscillating between the services in triage limbo, until the inevitable happens

And if the triaging GP bounces patients back to their usual GP, then patients will point out that they have attended A&E because they can’t get an appointment with their GP, on account of a workflow crisis exacerbated by frontline GPs being directed to A&E which, on many levels, is the very definition of irony.

And if you want some more of that, let me tell you that my day duty GP triage (this is getting confusing: what I mean is the GP day job triage that I’m supposed to do as a GP, in my own GP practice where I work as a GP) is increasingly troubled by patients with A&E problems such as trauma or chest pain who are reluctant to go to A&E because of the long wait.

So how about we have a reciprocal arrangement whereby some spare casualty officers are seconded to general practice to triage out the real casualties and redirect them to A&E?

This is a logical, sensible and pragmatic solution which could (I’m guessing) reduce our workload by about 10%, the only flaw being the unfortunate cohort of patients who on being directed from general practice to A&E by the general practice based triage casualty doctor get directed back to general practice by the casualty based triage GP, and continue in this manner, oscillating between the services in some kind of triage limbo, until the inevitable happens. Or maybe it’s not a flaw.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

Rate this article  (4.87 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (10)

  • yep

    Unsuitable or offensive? Report this comment

  • So how about we have a reciprocal arrangement whereby some spare casualty officers are seconded to general practice to triage out the real casualties and redirect them to A&E?

    In the current A&E situation I'm sure that offer is up for grabs. Would give them the much needed breating space.

    Unsuitable or offensive? Report this comment

  • Hilarious. Only in Britain. The freebie service and benefit system generates certain situations and "diseases" that no pill or doctor can cure. eg. Fibromyalgia, personality disorders, ME etc.

    Unsuitable or offensive? Report this comment

  • Casualty doctor. Not heard it called that for years. Hope it was meant with irony otherwise it's a very good way of losing any credibility with a group of physicians who have a better understanding of primary care strains than any other secondary care docs

    Unsuitable or offensive? Report this comment

  • The merry-go-round of socialised medicine. They keep telling us it’s the “best system in the world” LOL Don’t you just love it!

    Unsuitable or offensive? Report this comment

  • Having emergency Drs in Primary care makes no sense at all. A&E Can deal with almost all true GP cases, Primary care can not deal with true A&E cases.
    A GP in A&E is NOT to replace a GP in primary care, the GP is there to take those inappropriate attendances who can't wait for a GP appointment. Everything else that CAN wait should wait for their GP.
    It's a spectrum, Primary care for things that can wait and A&E for things that are emergencies and a GP in A&E for GP stuff that can't wait or could become an A&E job if not dealt with.

    Unsuitable or offensive? Report this comment

  • GPSTWO - i think he is employing a technique known as irony. ‘We haven’t got enough GPs. Send them into hospital. Oh! We have even fewer GPs...‘ If we managed (miraculously) to properly staff primary care/ minor injuries, so that any time someone had a UTI or minor ailment the easiest and best route was for them to attend their GP, they would do so. Many people are now faced with a three or four week wait to see their GP. So off to A&E they trot...

    Unsuitable or offensive? Report this comment

  • @ GPSTWO - really? A and E can deal with primary care? Arrogance or ignorance. And the idea of emergency doctors to staff GP is a deliberate joke highlighting how it is assumed GPs should be mopping up hospitals inadequacies but not the other way round.....

    Unsuitable or offensive? Report this comment

  • Copperfield you are wasted. Start writing scripts for the BBC.

    Unsuitable or offensive? Report this comment

  • Wo, wo, wo, guys! Or maybe woe, woe, woe..
    Back in the day, of sense and sensibility, we had enough GPs to deal with coughs, colds and scabby ar*eholes and enough doctors in A&E (the clue is in the name) to deal with accidents and emergencies.
    But then we also had sisters on the ward who ran the ward, administrators who administrated and doctors who doctored.
    Much too sensible.

    Unsuitable or offensive? Report this comment

Have your say