It’s long been a contention of mine that the inability of people to distinguish ‘life was better in the past’ from ‘life was better in the past because I was young’ has been the source of so many political problems in recent years.
But the health secretary seems to have taken this concept to the nth degree when he speaks about wanting general practice to return to the way it was pre-pandemic. Because if I remember rightly, there were masses of complaints about waiting times and even GPs’ refusal to embrace digital technology in those heady days.
And GPs – the people who do know the situation best – agree with this. Our survey of 1,000 GPs found that eight in ten feel a return to pre pandemic levels of face-to-face appointments was unnecessary. Strikingly, only 9% said it was desirable.
There are a few reasons for this. Principally, the genie is already out of the bottle. Despite the prevailing media coverage, a sizeable percentage of patients embraced the easy access provided by digital consultations and they will not let that go.
But also, a greater number of remote consultations does help with infection control (and not just Covid). And there have already been benefits to care – according to our surveys, waiting times for face-to-face appointments have halved.
Of course, GPs will rightly be pointing out that things are not good now. Their workload is still unsustainable and, on top of that, they are dealing with a hostile media, which is being echoed by patients.
Unfortunately, the fact is that with current levels of demand and shortage of GPs, there is no system that will satisfy either doctors or patients. And this is a failing not only of Mr Javid’s but successive governments, which have encouraged patient demand without providing resources.
I, for one, look back longingly to the days of Frank Dobson as health secretary. In those days, public health was so good that I didn’t get hangovers after drinking and I didn’t spend the whole day limping after doing sport.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk.
READERS' COMMENTS [5]
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One’s referral rate is increasing exponentially. It is quite liberating and allows the comment “talk with the Consultant’s secretary, it’s what you wanted isn’t it – your care is transferred now”. As I said, NHSE has destroyed the definition of Primary Care, it’s a shameful inside job, but it is what it is…and the universe is doing it’s rounds
Different rules for different people and it sadly missed the elephant. Low morale is — directly proportional to waste, error, lack of purpose and retirement. Chaos ensues. I hope those within NHSE are proud of their medals, blue suits and selfies with CV trophies and future profits from
“innovation” and backhanded procurement contracts. Preserved behind your Zoom screens in quiescent Cornwall or the Lake Districts, seeing your homogenous self-protecting and self-propelling warped life unfold amongst excel sheets in the red, lies and cover-ups. Like I said its all shameful, for what is a world-leading workforce.
(1) Whether we(GP) should provide full access face to face consultations like pre-Covid era has triggered a good debate . However , it is not healthy to see two polarities in our GP realm splitting ourselves into two camps .
(2) It was not long ago when Robocop and the Babylonians attacked this GP land. The former had paid a price for a private affair inside his office but the latter will be the protagonists rubber-stamped by the government to develop AI-general practice. Life is so just unpredictable, isn’t it?😳😈
But they both are probably laughing at GPs supporting remote access right now 😈
(3) Obviously, the media , particularly several high-profile newspapers endeavoured to wipe the floor with GPs . There are certainly some patients who dislike the ‘new normal’ in their practices . 100% face to face or total remote access? Like always , the realistic approach is a new hybrid mixing both , appropriate to the circumstances. The answer is always somewhere between the two extremes 😎
Why do I care what these yellow journalists wrote everyday driven by sensationalism?😈
(4) Having said that , it does not deter one from being introspective. Insisting one way or the other , there is a caveat of creating our own hypocrisy of criticising the old model of ‘one size fits all’ .
Ultimately, it is not about us having job satisfaction through FTF nor about new technologies making our lives more convenient .
It is about appropriate to the circumstances, each patient’s circumstances.
The flexibility of a hybrid model is currently essential taking into account of far more workloads and demands dumped to GPs and PCNs , while the number of FTE GPs is dwindling . Oh yes , the sensationalists will say , ‘cut the fat salaries of these bloody GPs!’ . Populism is such a fashionable behaviour right now , isn’t it ?😈
The true feelings of our GP colleagues continuing to leave through the exit door have never been properly addressed by the government .
(5) On the other hand , it is alarming about the comments from a coroner about a few cases of deaths ‘attributed’ to lack of FTF consultation. I had written my comments on this as well .
Personally , I support a hybrid model and consider this as an ‘evolution’ shaping our new normal .
Older GP ,like me ,perhaps prefer more FTF and younger ones consulting online ?Bottom line is nevertheless patient safety and continuity. And they both can be achieved through a hybrid model . In fact , I would argue the model will be more secure, contemporary and sustainable.
And as far as logistics is concerned , may be we should have an open debate to work out a list of symptoms/presentations more appropriate to have FTF , subjected to clinical discretion in individual cases ?🤨🧐😎
And this is my previous comment on the coroner’s comments about those deaths in 2020:
Interesting arguments.
I think there is certainly about the right decision , hence, policy, appropriate to the circumstances at one time during this tortuous journey of last 18 months :
(1) The timing of the two deaths mentioned in the article is essential; April and November 2020 . Am I right to say the global situation was substantially different those times as compared to present time ?
This is in the context of firstly , Covid vaccination was only commenced from late December 2020 and secondly , Covid 19 remained deadly with high mortalities before Covid vaccination was proven effective later in 2021.
(2) Hence , the purposes of remote consultation at those times ( should we call it pre-vaccination period?) essentially include minimising physical contacts to an extent that GP surgeries would not become a public health hazard in the community . The whole country was also going through multiple lockdowns and restrictions .It is pertinent to point out that GPs were still seeing patients face to face but understandably on highly selective basis .
(3) Moving to present day , I agree that the circumstance is different to take on different approach. The incidence of Covid 19 remains very high but with much less fatalities. Indeed , the overall number of face to face consultation has already been increasing.
However , it will be unreasonable to compare this current situation with the old ‘normal’ before there is any Covid 19 infection simply because significant proportion of the population with lesser immunity i.e. extremely vulnerable, still need to be protected in healthcare settings , as breakthrough infection in double-vaccinated subjects have become very common . A controlled fashion in providing GP appointments in a hybrid model mixing up remote and face to face consultations become necessary.
Clearly , one would expect independent consideration of all these points by the justice system before judging medico-legal accountabilities in individual cases .
Why don’t we give them what they want ?
All appointments face to face. No, you cannot get your results over the telephone. No, you cannot email the surgery. No more e-consults. No, you cannot write a letter of complaint, only face-to-face are acceptable (remember, it is a ‘zero-tolerance to violence and aggression’ environment in the NHS !
Each Consultation will be 20 minutes (allowing time for cleaning between), and if Doctor says you need to come back for a longer examination tomorrow, you will accept that.
And we only do normal office hours – so you will take time off work to attend. we only cover emergencies – REAL emergencies before 9, after 5, and during lunch-break.
The waiting list will be 6 weeks within a few days – which will of course eliminate all requests for extra drugs on friday afternoons, and changes to repeat prescriptions, within a couple of days!
Is that what they really want ? Or will politicians and Mail editors just turn to their private healthcare instead?
Yes , the argument is as simple as this ：
You can have one thing or the other but NOT both in full extent .
Come back to earth , present earth , and be realistic about this ‘new normal’ .😈