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Village life provides OOH lesson

I have recently returned from a three-month sabbatical working in a village health post in Gambia.

One of the things I learned there was the value of patient-held records – in many cases a couple of tatty bits of paper stapled together.

This hit home when I was doing an out-of-hours session for my local GP co-operative, and met a colleague who was dismayed by the lack of available information about a patient he had just visited, which he felt compromised his ability to provide a high standard of care.

Thinking about how this problem can be addressed, I am of course aware of the potential confidentiality and security issues surrounding the proposed NHS database of patient records.

I wonder, however, if anybody has seriously considered a far simpler compromise solution.

Would it not be possible to print off a patient summary record and ask the patient to keep it somewhere safe at home in case they need to call a doctor outside office hours?

This could be done after each consultation if one wished it to be completely up to date, or only after consultations where there were significant changes to diagnoses or medication, or perhaps simply annually.

Given that GP co-operatives are now contracted to look after patients for more of the time than their actual in-hours GP practice, is it not time to start finding ways to ensure this service is provided to the highest possible standard?

If this suggestion has been made before and there are numerous obvious reasons why it couldn't possibly work, I apologise for wasting everybody's time.

I look forward to being enlightened on this.

Dr Costi Stavrianakis, north London

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