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GPs asked to spare time to join ward rounds at ‘challenged’ hospitals


hospital ward rounds


GPs in one area have been asked to free up time to join hospital doctors on ward rounds and help identify patients who could be discharged.

An email sent to Nottinghamshire GPs, seen by Pulse, said the two local hospital trusts, and the East Midlands ambulance service, find themselves in ‘extremely taxing positions’.

Current pressures on health services in Nottingham are ‘extremely challenging’ and the system has been in OPEL 4, the highest alert level, for weeks, according to the email which was sent last week (13 April).

The message, from NHS Nottingham and Nottinghamshire CCG, recognised that local GPs have ‘once again come forward’ and offered help in the form of additional extended access hours, urgent GP appointments and acute home visiting.

But it added: ‘A further proposal is being explored. This is that GP colleagues could, with their community service colleagues, support secondary care and the system through this difficult time by joining secondary care colleagues on their ward rounds to support the safe, early discharge of those patients who could go home.’

GPs supporting secondary care colleagues on hospital ward rounds has happened before, and both parties found it ‘very helpful to combine their thinking’, the email said.

However, many GPs need ‘rest from their existing responsibilities’ and ward rounds are not ‘work that would suit everyone’, the email acknowledged.

The CCG reassured GPs that contracts to indemnify them can be drawn up, and they would only play an ‘advisory’ role.

‘Terms/payment will be in line with those currently paid for similar shifts in the out of hours/primary care 24 services’, the letter added.

However a local GP told Pulse: ‘There is a huge crisis in general practice with overwhelming workload and a shortage of doctors. On top of that there are massive outpatient waits, delayed treatments and increasing rejection of GP referrals.’

The GP, who wished to be anonymous, said they understand hospitals are under pressure with ‘reduced inpatient beds and delayed discharges, mainly due to the collapse of the social care system’, but said ‘these issues pre-date the pandemic’. 

They added: ‘So when a request comes in to support our hospital colleagues with discharges, you can imagine the negative reaction from grassroot GPs.’

Nottinghamshire LMC chief executive Michael Wright told Pulse: ‘We have a collective responsibility to care for our population, but GPs as a profession are very stretched as it is and patients are wondering why they can’t get the access they want. This may look like GPs have a lot of spare time if not understood.’

Speaking to Nottinhamshire Live, which first uncovered the story, associate director of primary care commissioning in Nottinghamshire Joe Lunn said the CCG was ‘doing all we can to help ease the pressures on NHS services’, especially over the Easter weekend.

Covid pressure, including staff sickness, already forced a number of hospitals to divert patients across England earlier this month.

In February, GPs stationed at the front door of a London A&E redirected patients to help relieve pressures on hospital departments as part of a new pilot scheme.

Letter in full

Good Evening GP Colleagues

As you will be aware, the current service pressures being experienced across the Nottingham and Nottinghamshire system are extremely challenging. The system has been on OPEL 4 for the last few weeks with Secondary Care and EMAS being in extremely taxing positions.

GP colleagues over the last week have, once again, come forward to help provide extra support the system in a number of ways. Examples of this additional offer over the next few weeks are shown below:

  • Additional Extended Access
  • Additional WAF/Practice level urgent
    appointments
  • Additional Acute Home Visiting in Mid Notts

A further proposal is being explored. This is that GP colleagues could, with their community service colleagues, support Secondary Care and the system through this difficult time by joining Secondary Care colleagues on their ward rounds to support the safe, early discharge of those patients who could go home. This service has operated before when both GP and Secondary Colleagues found it very helpful to combine their thinking.

It is not work that would suit everyone. Moreover, many GP colleagues need some rest from their existing responsibilities. However, there may be colleagues with the time, interest and disposition to help with this. We are not looking for colleagues with ‘specialist’ medical knowledge but generalists with knowledge of the culture and capabilities of general practice and primary care.

Contracts can be drawn up which will also indemnify those involved, who in any case would be advisory. Terms/payment will be in line with those currently paid for similar shifts in the Out of Hours/Primary Care 24 services.

Contracts can be drawn up which will also indemnify those involved, who in any case would be advisory. Terms/payment will be in line with those currently paid for similar shifts in the Out of Hours/Primary Care 24 services.

To arrange a honorary contract NUH or SFH will need you to confirm the following details below — this should be readily available as have been part of the Performers List application process, the checks undertaken when you became a partner or a salaried GP at your practice, and some as part of the annual revalidation and appraisal process:-

Identity checks

  • Professional registration and qualifications
  • Employment history/reference checks
  • Work health assessments (self-declaration as part of the annual appraisal)
  • Criminal records checks
  • Right to work checks

For NUH there is a simple form attached to help collate this information, for SFH please include the information in the body of the email.

READERS' COMMENTS [17]

David Church 19 April, 2022 1:27 pm

Ha Ha Ha Ha Ha
but it’s 18 days late!?

Long Gone 19 April, 2022 1:36 pm

Have to give that 0/10 for perspicacity.
Let’s see how many they recruit.

Vinci Ho 19 April, 2022 1:49 pm

I can see that was from desperation from hospital(s) and CCGs
May be , some younger colleagues might step forward !!??🤨🤔
I would rather argue the whole system needs GPs more than the other way round.
But then you would ask the ones in charge why is that the case ?

Kevlar Cardie 19 April, 2022 2:07 pm

Sorry, I’d absolutely LOVE to help but there’s no point in me putting my name forward.

I’ll fail the paper sift as I’ve lost my De-radicalisation training certificate, my manual handling badge and my British kayaking association level 2 patch.

Have fun.

Patrufini Duffy 19 April, 2022 2:18 pm

They used to laugh at you when you said “I’m a GP trainee”. No time for lunch. No allowance for study leave. You find the cover for your holiday. No rest place on nights. And a guilt trip if off sick. And now you’re back. Like an abusive relationship. You want to always be the saviour. Which will ultimately destroy you.

Andrew Schapira 19 April, 2022 2:19 pm

Love standup

Bonglim Bong 19 April, 2022 2:26 pm

Can we look forward to a load of consultants helping out in the most challenged GP practices in Nottinghamshire next week?

John Clements 19 April, 2022 5:45 pm

To our GP colleagues who do decide to do this you should expec/demandt to be paid the same as a hospital consultant. Not a penny less. Dont sell yourself short. We are not SHOs! Its insulting if they pay you less.

Patrufini Duffy 19 April, 2022 6:39 pm

The GP recommends stopping a drug and sending them home. The Consultant wants to give some co-amoxiclav (just in case) because the CRP is 22, and wants a septic screen and keep in overnight.

paul cundy 19 April, 2022 7:02 pm

Dear All,
“Current pressures on health services in Nottingham are ‘extremely challenging’ and the system has been in OPEL 4, the highest alert level, for weeks, according to the email which was sent last week (13 April).”

Well GP Land has been at Strawberry Opal Fruit since the last review, when it was bananas. In view of the serial nature of this pressure we might need to upscale to full fruit loop status.
Regards
from a still sane but increasingly incredulous
Paul Cundy

Turn out The Lights 19 April, 2022 8:37 pm

Two fingers rampant from me.

Patrufini Duffy 20 April, 2022 3:14 pm

Dentists are 100% free. They’re actually at the golf course. And closed to ground level public interaction and oral health, just private iciing welcome. And they are Doctors which is a bonus. They’ve got better handwriting too, and mastery of bedside manner.

gregory rose 20 April, 2022 3:38 pm

Laughed my socks off at these comments. Thanks!

Malcolm Kendrick 21 April, 2022 9:44 am

This makes me think of a man, who cannot swim, diving into the sea to save his drowning dog.

Mark Essop 22 April, 2022 5:15 pm

I did a job just like this for about three years and sadly, it was a waste of time. Firstly, hospital doctors simply refused to abandon the culture of keeping patients in for trivial matters that could be dealt with in the community. Secondly, even if I spent hours organising follow up etc with the GP or myself so that a patient could be discharged, I would return two days later to find the patient still in hospital for some ridiculous reason such as patient transport not turning up. Most of the hospital staff didn’t share the vision and really couldn’t care less. In fact, I had the impression that they preferred patients to stay because towards the end of their admission they were fairly low maintenance compared to newly admitted patients. I gave it all up in the end as the job satisfaction was zero.

David jenkins 23 April, 2022 9:39 am

very sorry.

when they’re in your hospital, they’re your problem.

when they’re on my patch, they’re my problem !

always has been, always will be !

end of…………

Kevlar Cardie 25 April, 2022 1:14 pm

Doubleplusgood : the thoughtpolice took my last comments down.

2+2 = 5.

Long live Airstrip One !!!!