There was once a casualty officer who was utterly incensed by a patient presenting with a non-emergency, non-accidental sore throat, supposedly because he was unable to get an appointment with his GP. So incensed, in fact, that he marched the pharyngitic person to a phone booth to test this claim, paid for the call himself, secured an appointment with the GP and sent the patient on his way.
Then again, I was a stroppy git in those days. But it does mean I have some sympathy with the current Bright Idea for potential A&E attenders to be filtered by 111 first .
The problem for us GPs, of course, is that this plan has horrendous workload implications. While the concept is being sold as a means of controlling A&E flow and overcrowding, the reality is likely to be the redirection of significant numbers of patients to us. And when we protest, it’ll simply be dismissed as work that we ‘should be doing anyway’. Which is, of course, correct, but also completely wrong.
After all, the delicate balance of GP work/staffing/income is predicated on the system as it currently runs (and has done for aeons). We know that patients attend A&E inappropriately – they always have, largely because of factors like geographical proximity and the tendency for cas officers to dish out the antibiotics that the GP refused a few hours previously. And we’re still left with more than enough work to do.
Besides, this isn’t a one-way street. We GPs spend inordinate amounts of our time on secondary care issues which aren’t our responsibility, increasingly so since the pandemic. So if there’s to be a work redistribution, it should flow both ways.
But if the simple assumption is made that the 111 gateway can slam A&E doors shut on what are perceived to be primary care problems, and dump them in our surgeries, someone needs to crunch some numbers, and fast. Because the workload reality of that policy – assuming the dump will be the one slot per 500 patients sneaked in under Covid-cover – is a requirement in my practice for just over one FTE GP per week. Unfunded.
It’s enough to make me want to make another stroppy phone-call. Anyone have Mr Hancock’s number?
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield