Phil is standing up for local knowledge in the face of another hare-brained NHS scheme.
Haven’t we been here before? I’m sure we have. I’m almost certain that a few months ago some Government arse dipped his hand into the hat marked ‘Goddamn Stupid Ideas Designed To Irritate GPs’ and pulled out the card that says: ‘Let’s scrap receptionists and get everyone to call NHS Direct to make an appointment with their doctor.’
Maybe I dreamt it, but I’m fairly sure that there was a brief chorus of ‘Piss off, morons’ and then it all went quiet again. But it seems that instead of throwing the card away, someone dropped it back into the hat, and here it is again, in all its foolishness.
A report in Pulse earlier this month detailed a pilot scheme in Surrey where 20 practices, for some insane reason, are going to hand the management of their practice appointments over to that Keystone Cops operation NHS Direct, via their 111 number.
How is it that, however ludicrously hare-brained a scheme is, there are always a few bone-headed practices prepared to play along with the farce? Is there some sort of locally distributed nerve gas involved?
Dr Brian Gaffney, a GP in Northern Ireland – and therefore, I note, not personally involved – told Pulse: ‘We know as GPs we can’t cope with demand for our practice appointments.’
Well stop right there, Dr Gaffney. Don’t presume to speak for all of us. We can cope just fine, thank you, so don’t foist this crap onto those of us who have taken the trouble to employ enough people to deal with the demand.
Dr Joe McGilligan, speaking from his island no doubt, says: ‘If it was up to me I’d launch this tomorrow… it’s time we stopped being so negative towards NHS Direct and worked with the service.’
Why? What has NHS Direct ever done for general practice, other than lazily punt unnecessary work in our direction?
Dr McGilligan, have you ever taken the trouble to walk into your reception area and listen to what your receptionists are doing? It would be five minutes well spent.
‘Mr Johnson! Mr Johnson! You’re holding the phone upside down again! Turn it the other way round!’ might be a sample.
Our receptionists are an incredible resource; dedicated people who know our practice population inside out, who know the patients and their foibles, who can intuitively detect cant or serious illness by the tone of a voice, and 99 times out of 100 give it the priority it deserves.
What if someone dials up and bellows: ‘It’s me legs!’, as sometimes happens at our place? The patient is too deaf to respond, but my receptionists know it’s Geoff from the sheltered housing and he just wants some more cream. If he’d dialled 111, they wouldn’t have a clue, and he’d be down for an urgent home visit to be on the safe side.
And what happens when ‘Keith’ (or rather, Ganesh in Mumbai) is answering the phone? How much does he understand local conditions in Roker? Will he be able to tell Elsie that she doesn’t need to phone the doctor every time her tablets from the chemist are a day late? How will he know which chemist?
Local know-how is irreplaceable. Dedicated local reception staff with intimate, long-term knowledge of the infinite intricacies of our three-ring circus of a practice population are the absolute backbone of our operation.
How insane would we have to be to involve a bloody call centre? Do we need ‘Greensleeves’ played on a xylophone, and an electronic voice telling you that your call is important, but we can’t take it right now?
Some things cannot be centralised. This is one of them. Punt this one into the long grass. Do it now.
Dr Phil Peverley is a GP in Sunderland.