It was one of those stories that had you checking the date. And yes, the first of April was suspiciously close. But I have it on very good authority that the piece about GPs being asked to treat patients in hospitals is kosher.
Indeed, I know it to be so – it has happened to me. It was a few years ago, now, but the event is seared into my memory. I received a message from one of my receptionists so ridiculous that I berated her for having obviously transcribed it incorrectly. It said, ‘A psychiatric staff nurse from the local hospital has a patient of yours on their ward who’s constipated and she wants you to send over one of the community nurses to do an enema.’
So I thought I’d phone this psychiatric nurse to share the laugh with her. ‘Oh, thanks for ringing, doctor,’ she said, ‘I’ve got a patient of yours on our ward who’s constipated and I’d like you to send over one of the community nurses to do an enema.’
Now, apparently, we’ve progressed from being asked to arrange to disimpact an in-patient bowel to being responsible for monitoring blood pressures, treating diabetes and prescribing painkillers for hospital patients. Marvellous. We can forget about the workload angst involved in potentially losing practice boundaries – it’ll be a drop in the ocean if we’re seriously expected to provide GMS to local in-patients.
According to a comment in the story, it’s a ‘grey area’. No it bloody isn’t. It’s absolutely black and white. There are utterly compelling practical, clinical and ethical reasons why we cannot and will not provide GMS to in-patients.
And if some clever dickie ignores all that and says there’s no contractual reason why we can’t remain responsible for, and therefore visit, and therefore manage, our patients while they’re in hospital, I’d say this: our contract only requires us to visit our patients within our practice area. Most DGH’s aren’t within the average practice’s area, so, if this is to be taken seriously (and it isn’t, but bear with me), the practices that are near to the DGH are going to be awfully busy with temporary residents. It just doesn’t figure, does it, and you know why? Because it’s monumentally stupid.
Why is this even an issue? Why haven’t GPs involved in these scenarios simply dealt with it as I did the great psychiatric enema incident? You just resolve the situation with two words – the second one being ‘off’.
Dr Tony Copperfield is a GP in Essex