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My solution to the crisis – get the patients to do the work

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Well Nigel has asked for it, a great GP debate and some ‘groundbreaking ideas for the profession’.

It’s not that easy though is it? Most ideas in the NHS have some previous, they are simply rebadged and sold with a shiny new package. Genuine new ideas to save the NHS? Few and far between.

Let’s just do it.

I suppose we could start by identifying the problems but they are so widespread and far reaching that we could be here all day just drawing up a list (and after all, what would NHS England then do for 2017?).

In no particular order we could seek to address: secondary care problems, social care, lack of beds, lack of funding, front door, back door, avoiding admissions, recruitment and retention of doctors/nurses/pharmacists/paramedics/managers and everyone else who keeps the NHS ticking over, demand, access, out of hours etc. All this has been looked at and debated throughout 2016 and before, with pockets of unobtainable funding appearing every now and then to keep us onside, dangled in front of us by the DH but deliberately kept ever so slightly out of reach. If we have learnt one thing this last year, it’s that we cannot rely on our government to get things right for the NHS (or anything else for that matter).

For now, we need to go it alone.

So what resources do we have, in endless supply, and eager to get involved at our health centres up and down the land? Patients of course. Whilst we suffocate under increasing demand, the answer may just be sitting staring at us.

Patient-led triage. Yes, let the patients do the work. We have lots of them, all fully trained patients, parents, grandparents, sensible everyday people full of common sense. I would love to see how this could work – they can advise on all the stuff our ancestors used to deal with without recourse to the NHS. Self-limiting illness, childhood viral infections, breast feeding problems, looking after elderly gran, how to get a blue badge, meals on wheels, letter for housing, tongue tie, verrucas, the natural weekly fluctuations of mood – let’s mobilise the knowledge base that is our patients and open up a walk in daily clinic. I’m sure the public will get sensible, timely advice the vast majority of the time as well as meeting a few friends and enjoying some fresh fruit courtesy of the local greengrocer (I haven’t asked them yet).

Of course, there is no evidence base for this project, so that will appeal to NHS England, and there will be no recruitment problem either as the patient base is replenished as quickly as it is diminished. I suspect we will have no shortage of volunteers, but failing that we can ask the Red Cross for help.

So, I suggest we don’t apply for funding, or set up a working group, or pilot the idea, or create an enhanced service. Let’s just do it.

Sustainable? Yes. Transformational? Definitely. Plan? Better than any others I’ve read.

Great – that’s primary care sorted for 2017 and it’s not even February yet.

Dr Richard Cook is a GP partner in Hurstpierpoint, West Sussex. You can follow him on Twitter @drmoderate

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