Online hospitals rubberstamp GPs’ role as community housedog

Copperfield laments the digital revolution of the NHS, arguing that GPs already know how best to deal with patients

Oddly, whenever I hear the words online, digital or virtual, my lunch wants to make a reappearance. Fortunately, ChatGPT has reassured me that this is completely normal. Because, while the Government believes that simply attaching those words to any NHS problem instantly solves it, those actually working within the NHS know that the opposite applies.

I have two examples, and neither even touch the current furore over online access.

First, the new ‘online hospital’ project trumpeted by the PM. Let’s just for a moment ignore the digital – as in two-fingered – exclusion of the very people who really need hospital services, and instead be a bit GP-centric.

You don’t have to imagineer these remote specialist consultations for long before you figure out what will happen. Hence the following clinic letter: ‘Dear Doctor C, I remotely consulted today with this patient who seems to have inflammatory arthritis. She requires ultrasound of her joints, a full blood screen, initiation of DMARD with full monitoring, physiotherapy and an OT assessment, all of which need to be organised locally and which I will therefore leave to you. Have a nice day, love nameless and faceless Rheumatologist. PS – Can you also clean her windows?’

Forget A&G, this is Referral and Guidance. And it finally rubberstamps our new role as community housedog, and our old role as crushed out of existence.

And second: a self-help app for musculoskeletal problems employed by various ICSs and being proactively promoted to the public via text, symptomatic or not. Hence this case: a lady with minor back pain who probably wouldn’t have bothered consulting at all but decided to give the app a click. Its screening function diverted her to 111 because she disclosed a rash on her leg. 111 directed her to the pharmacist. Her pharmacist sent her to us. And we reassured her about her varicose eczema. Always good to have four different opinions where none was required. It’s not all bad, though, because by then her back was better.

I’d laugh about it now, but that’s hard when you’re retching. But it made me realise that ‘remote’ really refers to the odds of the digital revolution not wrecking the NHS.

So maybe Wes, yes, we do want to turn the NHS into a museum, in the sense of preserving what is worthwhile. I’d rather that than turn it into a virtual vortex of despair.

Dr Tony Copperfield is a GP in Essex