I remember that moment. I was outside an elderly patient’s door, peeping through the letterbox shouting out to see if she would respond.
A few minutes passed before two feet in red socks wriggled forward on the floor. The elderly patient discharged early from hospital the previous evening had fallen overnight. She was responding to voice commands. I called the family, asking them to give me access. Someone did arrive.
We helped her off the floor. I did a quick assessment to see if she had come to any harm, then arranged a quick assessment by the admission avoidance team. In two hours, we had a district nurse, physiotherapist, occupational therapist and social worker setting up a support package for her.
I’d sent her in two days prior, after she sounded confused to her nieces. An initial assessment confirmed possible sepsis, but her bloods revealed hyponatremia and she needed to go in. Two days later, she was discharged after having her sodium level corrected and oral antibiotics. I called to check if she was managing at home, and when she didn’t respond, my heart sank.
Covid has highlighted that general practice is the backbone of the healthcare system
This prompted me to rush out and see her. Hearing her respond to voice commands was a big relief. Anyone who saw me while I was leaning down peeping through the letterbox with the neighbour checking through her half-open door would wonder if I had completely lost it.
This is just one story. Day in, day out, most of we GPs step out of the so-called professional boundaries to do that little extra that makes a huge difference to our patients. During the months of April and May, hospital referrals were reduced to almost nothing.
With dental practices closed, GPs supported patients with dental concerns. With health visitors only doing telephone consultations, general practice stepped in to fill that void. The list is endless.
This entire experience of Covid has only highlighted that general practice is the backbone of the healthcare system. We gracefully plugged any gaps that were created in primary care; supported secondary care to only look after the most ill; and adapted quickly to remote working and technology.
I’m proud to be a GP, but there’s much more work to be done to overcome the differences when it comes to the inequalities relating to BAME people or women. But we GPs are a resilient bunch, determined to better the foundations. As Mahatma Gandhi says: ‘You must be the change you wish to see in the world’, and I think general practice is more than ready to reinvent the wheel.
Dr Rajivi Sanjeevi is a GP in Tower Hamlets, East London
