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It’s time to play the DH at its own game



I took a certain smug satisfaction when the LMC and the BMA sent round template letters aimed at enabling GPs to ‘bounce’ inappropriate work back to secondary care. The obstinate part of me went all American: ‘Yeah! Woo-hoo!’ High-fives to GPs all round.

It is wrong that general practice has been expected to shoulder more and more extra work without additional funding. Yes, it is often it is easier for us to sort out medication or a sick note, but we no longer have the luxury of time and convenience has to play second fiddle to medical need.

Except I met a consultant surgeon this week. One of the nice ones. Happy to chat and engage with GPs. The conversation came round to letters and the large pile of them on his desk. I felt a little superior as I told him my own pile had shrunk.

He sighed: ‘I agree GPs were being asked to do work that wasn’t really their job. It’s just…’ I recognised the look of defeat all too well.

‘You see,’ he continued, ‘I no longer have a secretary – she cost too much, apparently. The hospital typing pool won’t do the letters. It’s a clinical issue, they say. I could ask medical records to pull all the notes but I’d have to sift through them before I could delegate.’

By now I was feeling less superior. ‘You’re surely not handling them all yourself?’

‘Yes,’ he nodded. ‘It just seems quicker. I spent all weekend doing them but there are still 80 on my desk.’

Cue an awkward pause. I must admit I felt a bit guilty. This is as much a waste of a highly qualified consultant’s time as it was of mine. Bouncing back the work wasn’t meant to make his life more miserable. It was to show the powers that be that general practice is at its limit. I had assumed that if consultants were faced with a deluge of work, they would kick up an almighty fuss and something would change. But it seems they are paid as little heed as us.

I still bounce the work back, but now I also send a silent apology to the consultants at the other end who haven’t yet found a way to bounce it on to where it really needs to go: to the door of NHS England and the Department of Health. I trust they will soon. The age-old hospital-GP rivalry is outdated and only benefits governments trying to divide and conquer. But it continues even now, as GPs hold the purse strings at CCGs, so it’s our fault if hospitals are underfunded.

I would rather put aside rivalries and work with consultants as a team. Maybe then we could play the DH at its own game. Unity is the one thing we’ve never had. But if we did, the medical profession would have the power to take on government threats and posturing.

Our practices are now expanding to include pharmacists and physician associates. Are we all part of the same team? We need to go back to basics, and remember that anyone working with our patients has to be part of our team. The goal is the same. The obstacles too. Why not consider Team NHS? Now, we just need an opponent. Hmm… Team Government seems up for this. Who would you bet on? Game on.

Dr Zoe Norris is a GP in Hull