This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

Home truths from Chesterfield

Copperfield

There will be a new and unlikely name to add to Pulse’s annual Villains of the Year list. Among the Johnsons, the Hancocks and the coronaviral pangolins, there will be the Suzannes from Chesterfields. Because, the other day, during a Government briefing, Suzanne from Chesterfield appeared to shaft we GPs. Specifically, she stated: ‘We are seeing large numbers of patients referred to the emergency department because their GP or dentist are refusing face to face consultations.’

Subsequently, Suzanne from Chesterfield was apparently unmasked as a Professor of emergency medicine at the University of Sheffield, or at least she would have been if she actually had any PPE. Cue reflex GP uproar and equally predictable ‘GPs are doing an absolutely fantastic job’ from that lovely Chris Whitty, showing that Profs can be nice, too.

And yes, Suzanne of Chesterfield, on the face of it this does appear anecdotal, lopsided and underhand, with perhaps a naive acceptance that patients might twist a lack of F2F into a surfeit of TTFO. But, like most things that induce apoplectic GP splutterings, it also contains a germ of truth.

The truth hurts, though not so much that we’d take it to A&E

Consider this. We GPs work along a spectrum. For all I know, some have coped with the Covid crisis by erecting ‘business as usual’ signs. Whereas, at the other extreme, yes, I have heard of some who really are refusing F2F – either because of ‘no PPE/no see’ or simply because that’s the way they have decided to cope.

Most of us sit somewhere between these polarities and that’s where I reckon you’d locate me. But even as a ‘moderate’, I’m aware that my opening remote consultation line is: ‘Sorry we’re having to do this by remote, but I’m sure you understand the situation.’

In other words, while I do occasionally see punters F2F, that may not be the impression I give them. And that’s the problem. Their perception is that we’re closed, or more specifically, virtually closed. Those who do ‘consult’ may not be happy with the remote outcome, and you can guess where they might end up. And if we’re honest, we’d probably admit that our new way of working will inevitably lower our threshold for bouncing people in the direction of A&E.

So the Prof has a point. A tiny part of the problem is that the remote consulting pendulum may have swung too far. And a huge part of is the public’s confusion about the current status of general practice and some dissatisfaction with its new modus operandi.

Time and tweaks will fix those – plus we have a duty to let the public know that we’re dealing with everything, as per usual, but we’re dealing with it in a different way, so make sure your phone’s charged and don’t go to the loo when I’m trying to call.

In the meantime, let’s go easy on a doubtless knackered and stressed emergency medicine prof. And admit that, hey, the truth hurts, though not so much that we’d take it to A&E.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

Rate this article  (3.06 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 (20)

  • As a GPWSI in head,neck & facial pain I would point out that all my hospital F2F clinics are cancelled, as are all the other regional pain intervention (injection) sessions in the Pain Clinic & Rheumatology.
    A significant number of these 'high end of need' pain patients must certainly also add to the A&E figures.

    Unsuitable or offensive? Report this comment

  • Having volunteered to spend a day a week that I’m not working in GP land to provide senior cover in the hospital for Covid / medical inpatients, I spoke with lots of docs of various grades including SHOs who’d stopped doing A&E Locum shifts as they were too dull with no patients to see! I’ve seen patients F2F in GP land throughout this for anyone who phone /video was suboptimal and referred as needed. Paeds consultant friend told me most of the patients weren’t examined by them - they put them in a aside room given fluid challenges and observation only and went by the GPs examination findings rather than “risk another exam”.... A&E are far from full through this pandemic and if GPs are advising people to go, it’s probably appropriate and still less than normal. Very sad that some hospital colleagues still stick a wedge in our working relationship.

    Unsuitable or offensive? Report this comment

  • There are without doubt some bad apples - I’ve seen a few cases in out of hours who clearly needed an examination which their own GP declined. However the majority are doing a good job.

    There are more appropriate ways the professor could have shared her concerns - eg a phone call to the practice or discussing with the local ccg, lmc, federation etc to have a professional dialogue rather than a rant on national TV. Plenty of GPs have been working in 111 which unlike a&e has at times been busier than ever whilst dispatching fewer ambulances - the stats are clear

    Unsuitable or offensive? Report this comment

  • Suzanne might have been attempting to shaft US GPs. That’s the sort of grammar that sends I mad.

    Unsuitable or offensive? Report this comment

  • A&E cost top nhs per visit £200
    GP cost £25
    AED had received huge amounts of funding and has been relatively quiet. They are tooled up to deal with COVID we aren't.

    Unsuitable or offensive? Report this comment

  • Dear All,
    The evidence is against her, as is the behaviour, she should apologise or resign.
    If she does not do this in equal measure to her indiscretion, i.e. on national radio, then she should be reported to the GMC and her employers.

    Regards
    Dr Paul Cundy
    GMC 2582641

    Unsuitable or offensive? Report this comment

  • I wonder how many sessions in A+E the Professor does? A+E footfall has dropped by more than half. Only fools generalize. I have not sent anyone I would not usually send and has seen people F2F if needed. Most of my colleagues are the same. The telephones actually takes longer.

    Unsuitable or offensive? Report this comment

  • Contacts have gone up. Telephone appts take longer than f2f in many instances. The initial "not wanting to bother us" is well and truly over. Trivia up, actual pathology up (and often worse as some patients have held on). Secondary care dumping worse. More patients needing to be seen f2f. It's a worsening nightmare, so I'd suggest the esteemed Professor sticks to doing (presumably) very few shifts in A&E and keeps her ill-informed opinions to herself.

    Unsuitable or offensive? Report this comment

  • I for one will not be paying much attention to the ill informed “Suzanne from Chesterfield”. Imagine my surprise to learn on social media that Suzanne regards the Prime Minister as a “hero” and has described criticism against him as “vitriol”. How could such a champion of the Prime Minister be so lucky to be randomly selected to pose an independent question/statement to the Prime Minster on a Downing Street coronavirus briefing? I wonder?

    Unsuitable or offensive? Report this comment

  • A stage managed career builder, standing on the shoulders of her colleagues and scampering up the media ladder. Tony unfortunately has given her a helping hand by offering his sympathy - are you OK tony?

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page

Have your say