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Hark, for I have witnessed the holy grail of GP correspondence



Sit down. Take a deep breath. And suspend credulity. Because I have some big news. Bigger even than the current hot potatoes about medical indemnity, GPs going private, mass list closure and so on. News that really does represent something of a miracle. And, like many miracles, it occurred on an ordinary day, in a nondescript place, during mundane activity.

Specifically, it happened in my surgery as I was ploughing through the day’s mail. This is usually about as far from a spiritual experience as you can get, evoking feelings which, if I was sitting on the other side of the desk, would have the GP speed-dialling the Mental Health Crisis team.

Yet there it was. Sitting in front of me: a discharge letter from the local hospital about an elderly patient who had been admitted with falls, who had been diagnosed with a ‘UTI’ and who had been discharged on loads of drugs. Yes, I know, I’m drifting into a coma, too, even as I write these words.

And yet. Something leapt out from that discharge letter. Something that hit me in the face with a force so physical that I actually emitted a strange cry somewhere between fear, incredulity and joy. It was a simple sentence, but it was also an epiphany.

This is what is said: ‘GP action: there is no GP action required for this patient.’

I re-read this several times. I tested my visual acuity on the Snellen chart. I slapped myself in the face to make sure I was awake. But even as my eyes watered with pain and emotion, the words remained: ‘THERE IS NO GP ACTION REQUIRED FOR THIS PATIENT.’

I ran, wielding the letter, into our common room, interrupting the usual caffeinated post-surgery catharsis. Soon, my colleagues were clamouring around the letter, some laughing, some weeping, all sharing my joyous disbelief.

For here, for the first time, was a patient for whom I was not obliged to chase up an MSU, repeat the electrolytes, arrange an appointment for memory assessment, send to the falls clinic, repeat a scan to monitor a renal cyst, kindly refer under the two week rule for a lung opacity or organise domiciliary chiropody. I was, instead, expected to do nothing. At last: I was liberated.

Cynics among you may view this blog as a complete fabrication. I understand. There will always be disbelievers, and it is an incredible story. All I can say is that there is now a corner of my surgery which I will always view as holy. And it does look like a shrine, with that framed discharge letter, the candles, the flowers – and the GPs who come from far away to witness it for themselves, entering as burned out shells and leaving as bright-eyed doctors on a primary care mission.

Admittedly, it was disappointing to get a revised discharge letter two days later asking me to sort out the patient’s ear wax. So I’ve just hidden that in a drawer.

Dr Tony Copperfield is a jobbing GP in Essex