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GP into A&E doesn’t go



GPs in A&E? Is that still a thing? Yes, I know, it was a promise, back in 2018, to have a divert and treat GP in every acute trust.

But I’ve heard about 6,000 promises which have come to less than nothing, so I assumed it never happened.

Apparently, though, not only is it still a thing, it’s even more of a thing than it was before.

Because, after vague and unsubstantiated claims of ‘success’, the Government is planning to expand the service.

Let’s run though it one more time, shall we? Whichever way you dice and slice this, it can’t work. If the triaging GP treats the patient, then all patients learn is that they can access quasi primary care on a walk-in basis by attending A&E: the very opposite of what is intended.

Oscillating between the services in triage limbo, until the inevitable happens

And if the triaging GP bounces patients back to their usual GP, then patients will point out that they have attended A&E because they can’t get an appointment with their GP, on account of a workflow crisis exacerbated by frontline GPs being directed to A&E which, on many levels, is the very definition of irony.

And if you want some more of that, let me tell you that my day duty GP triage (this is getting confusing: what I mean is the GP day job triage that I’m supposed to do as a GP, in my own GP practice where I work as a GP) is increasingly troubled by patients with A&E problems such as trauma or chest pain who are reluctant to go to A&E because of the long wait.

So how about we have a reciprocal arrangement whereby some spare casualty officers are seconded to general practice to triage out the real casualties and redirect them to A&E?

This is a logical, sensible and pragmatic solution which could (I’m guessing) reduce our workload by about 10%, the only flaw being the unfortunate cohort of patients who on being directed from general practice to A&E by the general practice based triage casualty doctor get directed back to general practice by the casualty based triage GP, and continue in this manner, oscillating between the services in some kind of triage limbo, until the inevitable happens. Or maybe it’s not a flaw.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield