1. Send out a memo to local GPs telling them that because of Covid etc etc, the system for requesting X-rays is different ie GPs should not send up patients with X-ray forms as per usual; instead, they should send requests electronically, with contact numbers, and the X-ray department will contact the patient with an appointment time.
2. Get the X-ray department to revert back to the original system a few weeks later without telling anyone.
3. At the same time develop a new default cut-off for non attendance for X-ray of six weeks.
4. Alert GPs to this by sending an X-ray report stating that because the patient has not attended for X-ray within six weeks, the request is now invalid and so the patient will need clinical reassessment and resubmission of X-ray form if it is still required.
5. At same time collude with rest of hospital to ensure that any follow up X-ray requirements post A&E attendance, inpatient discharge etc are delegated to GP.
6. Thereby achieve overall effect of giving GPs more work to do, which is then not done because the X-ray department the GP refers to is not sending out appointments, enabling that same department to claim that the patient has defaulted, and that the only way to rectify this is for the GP to re-enter this cycle of futility.
Ensure that any follow up X-ray requirements post A&E attendance are delegated to GP
7. Ensure that when this situation becomes clear and GPs are about to lose it, all three available telephone lines to the X-ray department are rendered useless by line 1 ringing endlessly with no reply, line 2 cutting caller off after three rings and line 3 inviting a message to a voicemail that is full.
8. Sit back and bask in the knowledge that, while GPs would currently be expecting an acute-on-chronic workload dump involving referrals not being seen, sick notes not being written, blood tests not being done, etc, they would not be anticipating anything quite as Geneva convention-busting as this.
9. Consider contacting colleagues in microbiology about a similar idea involving stool specimens.
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield
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