Lucy Johnston in The Express Sunday 29th June reports (exclusively!): Nurses to the rescue! Radical plan to save our overstretched doctors’ surgeries
There is one thing a Doctor does that no one else does: make a diagnosis. To get to a diagnosis efficiently and with minimal risk is the main skill of a GP. Was there ever a bigger admission of failure and implosion than to have too few? If you were asked to look after the crown jewels of the NHS, would you fail to plan as badly as this…? Who will provide the medico-legal insurance cover for this “routine” work, and at what price for these nurses? Will they be absolved with a no-fault compensation scheme? When there is vast undercapacity, those who are available will move to the desirable locations. Thus the poorest areas of the country will be the worst served: The North East and Wales. In addition many GPs are not good at delegation, (or triage) and only feel comfortable if they see the patients themselves..This is rrationing by neglect, deliberate undercapacity, political cowardice and denial….
The controversial proposals will be discussed at talks between doctors’ leaders and Health Secretary Jeremy Hunt next month. The crisis, caused by a shortage of family doctors, has led some overstretched surgeries to axe thousands of patients from their registers.
Maureen Baker, chairwoman of the Royal College of General Practitioners, said: “This is an extremely distressing situation for patients and for GPs. Every patient should be able to see their family doctor when they need to.
“Unfortunately, what we are seeing is a sad consequence of the desperate shortage of GPs in many parts of the country.
“Many practices are finding it difficult to find replacements for those doctors who have retired. This is leaving general practice teetering on the brink of collapse.
“Family doctors are heaving under the strain of increasing patient demand due to a growing and ageing population and plummeting investment.
“Over the last decade the number of patient consultations has risen to an all-time high and there are now 40 million more consultations in general practice than there were even five years ago.”
Under the rescue plan nurses would take over routine tasks such as check-ups for chronic conditions. This would leave doctors free to focus on where their expertise is needed most.
Nurses and health care assistants would also be asked to look after vulnerable, sick and elderly people in their homes.
Incentives for GPs to carry on working could include flexible hours, reduction in workloads and more support staff.
Dr Chand Nagpaul, head of the British Medical Association’s GPs committee, has already had informal discussions with Mr Hunt.
The group will also hold talks with MPs about the package next week.
Dr Nagpaul said: “This is not just a rescue package for GP practice. It will support the rest of the system.
“An investment in GP services will reap huge savings that will more than make up for the amount lost in the increasing numbers going to A&E, which is far more costly.
“We are also calling for greater support from nurses and health care assistants who may do some of the work, including managing chronic diseases such as asthma, lung disease, high blood pressure and diabetes.
“GPs need support to provide proper care, particularly for some of the most needy in our population. Older people with chronic conditions need more care and trying to provide care in 10 minutes is impossible. We need a system where we can provide time.”
A spokesman for the British Medical Association said: “The Government urgently needs to invest more in GP services or else it faces collapse.”
Clare Gerada, former chairwoman of the Royal College of General Practitioners, said: “I welcome these plans. There needs to be a rescue package to address the huge problems we…..
The multitasking implicit in care of the elderly in the community is denied by this simplistic suggestion. In addition the standard of GP education and examinations needs to be raised to address the future needs of the ageing population. Medical Education: Competency based training is a framework for incompetence
“Every patient should be able to see their family doctor when they need to”