I’m not known for being a drama queen, (stop muttering at the back!) but I’m getting increasingly edgy with Primary Care strategy planning, so perhaps a little drama is actually required.
This morning opened with Jeremy Hunt’s vision for the future of General Practice.
10,000 new clinicians
New data to highlight under-doctored areas
And that piece de resistance, 7 day access
All day, the Twitter feed and Facebook page of ResilientGP has been buzzing with angry, disaffected GPs venting their spleen at this charade; calls to arms, suggestions of mass resignation, genuine despair.
Examples abound of 7 day access pilots shutting their doors because of limited interest in weekend appointments, surgeries closing because of inadequate funding, story after story of the dumbing down of Primary Care Services. I’ll share one with you…..
“It would appear that my locum services and that of my three GP colleagues are no longer required at one surgery that we work at. We have been replaced by 2 (yes 2) Nurse Practitioners who will apparently do the same work, charge less and have agreed to sign the lease to the building.
News of this came ironically after I had just been reviewing a patient who our Nurse Practitioners had been dealing with for the past 12 months – normal spirometry but on Spiriva, Symbicort and theophylline for ‘chronic cough’. After loads of scripts for steroids, expensive inhalers and antibiotics, the patient came to see me as she had been told by said Nurse Practitioner that she needed a referral to the allergy clinic as nothing is working. (Even had the name of the allergy consultant written down that I ‘had’ to refer to).
After 1 year of inappropriate management, she has now been sorted with some omeprazole.
Nurse Practitioners and Physician Assistants – really the future of General Practice???”
Now, don’t get me wrong, nurse practitioners are highly skilled professionals in their own right and I’m all for skill mix, but how can this be right? We have seen the chaos that has been created with 111 by taking clinicians out of the triage process; inappropriate use of the ambulance service, increased waiting times in A&E, ramped up demand in Primary Care and reduced self-care, (after all, you can’t be too careful!)
Do the public realise that the official strategy to the future of the NHS is this dumbing down?
It takes years of training and experience to practice medicine effectively, safely and cost-effectively. Patient safety will be compromised, costs will rocket, the Secondary Care system will collapse with the lack of risk management.
And what’s with this extra marketing business? That’s like standing on the deck of the Titanic after it had hit the iceberg saying “Roll up for the most amazing cruise of your life, sign up, sign up……” The only people coming aboard this Titanic will be the treasure hunters after it has sunk!
I feel like standing on a soap box on Hyde Park corner, I’m no soothsayer, but the end of the NHS is nigh.