- 3 mins read
According to the MCG Healthcare Primary Care survey 2022:
With that backdrop, NHS England is imposing a new GP Contract that sets greater expectations for patient access. At first contact, patients now must be assessed or directed to the appropriate service. That added pressure comes with just 2.1% extra funding, against 9.2% inflation.
In short, the NHS is asking more of GPs and isn’t offering much help. However, some changes in approach could help patients get care more quickly and effectively, without putting extra strain on already struggling practices. In fact, the following approaches could help more patients get seen, while actually reducing the strain on surgeries.
Here are some suggestions that we hope the NHS will consider.
There is no reason that triage should be exclusive to A&E departments. GP surgeries could be permitted to use it as well. They did so during the pandemic, and research published in the British Medical Journal suggests continuing the approach would be more ‘equitable, safe, and efficient’.
It’s absolutely correct to treat every patient with the same level of respect, value, and dignity. However, that doesn’t mean their care is equally urgent. A sore foot should not be given the same clinical priority as complex mental health challenges. Just as A&E would treat a stab wound before a dislocated shoulder.
The best way to triage patients would be through the widespread utilisation of the Medical Receptionist role which is being used across Primary Care. A Medical receptionist can ask the patient what’s wrong, then make an informed decision about the urgency of their treatment.
In the spirit of the NHS’s access targets, that would make sure those in serious need get help without delay, and that primary care appointments are more efficiently allocated. Delays would be rarer, and all patients would be seen in an appropriate timeframe.
It would also have the added benefit of patients feeling listened to. The opportunity to talk to someone about their symptoms at that first contact will make them feel heard and understood. With the current system, there’s a risk that a patient feels frustrated with having to navigate ‘bureaucracy’ to get an appointment.
Encouraging the use of other care sources for minor health complaints
No GP or practice manager should or would discourage anyone from approaching them if they need to. The reality, though, is that some ailments are perfectly treatable with over-the-counter medicines.
Surgeries could encourage patients to approach a pharmacy if their problem seems common or not severe. Suitable treatments are often effective and inexpensive, and could remove some time and administrative burden on the surgery.
For more complex problems, there is a scheme to allow community pharmacists to prescribe treatments, which could save 400,000 GP appointments every year. It’s a welcome initiative, and the results will be incredibly interesting and informative.
Utilising caregivers who aren’t GPs
There will be occasions when an issue isn’t best treated at home, but doesn’t require a fully qualified medic. Triage would complement this approach, and primary care nurses, for example, would be more than capable of offering support, care, and advice, relieving some of the pressure on GPs.
Their time is also less expensive than GPs’ hours, so less of a cost to the NHS. The savings might even offer scope to give patients (where necessary) longer with a nurse than the typical ten-minute appointment with a GP.
Strategic use of remote care
Speaking to someone on a phone or video call can save a lot of time for the surgery and the patient. It can also mean waiting rooms are less crowded and less likely to spread infection.
This approach wouldn’t be there to discourage in-person consultation, but it could be something that surgeries offer. At the time of booking, the receptions can simply ask the patient whether they’d prefer an in-person appointment or a remote one. Patients with mobility challenges or care responsibilities might find it easier not to have to travel to an appointment. Other patients may simply welcome the chance to save a journey, or to avoid sitting in a waiting room. The practice can simply make the option available.
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