There needs to be someone in A&E to deal with inappropriate attenders: true. That someone should be a GP: false. It should, in fact, be someone mad, bad and dangerous to know, who gives patients who are neither accidents nor emergencies a well-deserved bollocking, plus advice to get to the pharmacist, get a GP appointment or get a life.
So let’s be bold
Someone, in fact, a bit like me when I was doing A&E as part of my VTS and encountered a grown man attending with earwax. At least that gave me permission to shout at him. And what I shouted was in response to his claim that his GP’s number was ‘always engaged’ and that he had no money left to try again (note to readers whose names don’t end in ‘asaurus’ – back in the day, pre-mobiles, we had to rely on payphones). After shouting, I marched him to the nearest phone, paid for the call myself, secured that GP appointment, walked him to the exit and waved him a cheery goodbye. Before shouting some more.
I like to think that this kind of approach might actually change behaviour. What won’t is parking a GP in A&E to vindicate all those inappropriate attendances by providing instant GP-ratification. As for those who bleat that much of A&E abuse results from inadequate primary care appointment provision, I say, don’t make me laugh. It’s mainly about geography and illness behaviour, with those nearest and dearest – as in habitual NHS resource-abusers – most likely to form a disorderly A&E queue.
And even if GP appointment provision is a teensy part of the problem, you won’t solve that by taking GPs out of the practice frontline to man the A&E trenches, will you?
So let’s be bold. If A&E must give feckless timewasters a warm welcome, how about using a flamethrower?
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield
