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My solution to secondary care workload dump



The pledge to stop hospitals dumping work on GPs has made a big difference, hasn’t it? In the sense that it’s made the situation about ten times worse than it was before.  Specifically, the promise that consultants should make relevant onward referrals themselves rather than delegate the task to their default community houseman, aka me, which featured in the GP Forward View and was consolidated via a letter from NHS England sent to all hospital providers.

Then I started to sprinkle in some expletives

It’s almost as though consultants got wind of this and thought, oh yeah, dump on GPs, hadn’t thought of that, good idea, and clubbed together to buy a huge skip of excrement which they’re laughing about even as they watch it being tipped over us.

It’s not all bad, though. I’m actually rather enjoying composing letters which bounce back those bouncebacks. I started with the standard BMA template, which is authoritative and clear, but polite and long. Then I started to adapt it, using an increasingly abrupt and assertive tone which has now moved through abrasive to frankly aggressive. Then I started to sprinkle in some expletives, judiciously at first but now more liberally.

Astonishingly, none of the bounceback bouncebacks have bounced back and, even more astonishingly, none of the consultants have complained about them or me. There surely must come a tipping point where they will either alert the GMC or stop sending me this rubbish in the first place. And I’m trying to find it. Hence my most concise and refined version yet: ‘Dear Dr X, Re your attempt to delegate to me the onward referral of patient Y for Z. F**k the f**k off. Kind regards, Dr Copperfield. PS Dickhead.’

If that doesn’t work, I think I might pop over with a skip.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield