Thursday, 4 June 2015

Don't just talk - do something.

Have you ever talked about your GP surgery over dinner, sitting in a cafĂ©, standing in the checkout at the supermarket….?

Well you are not alone!

A Million people a day use their GP surgery and most of those will have something to say about the experience.

Most of those experiences are good.

However sometimes us patients have ideas about how to make the experience of talking with a GP or practice nurse better.

There can be problems with the phone service, making appointments isn’t always easy, seeing your own GP can mean waiting weeks, no privacy at the reception desk, access can be difficult for those with disabilities and as for car parking…!

So instead of talking about things on your own – join your Practice Patient Participation Group (PPG) and do something about them.

A patient participation group is a bunch of volunteers who want to make a difference.  They work with the practice to gather information from patients and to make suggestions about improvements.

They look at the surgery and ask:
What works well?
What works less well?
Are there services that are not provided but would benefit patients?

They also run an annual patient survey, hopefully the questions are set by the patients not the surgery.

Sadly General Practice is going to have to change. Being part of your PPG is one way you can help to make sure we keep the best bits of General Practice

Your voice on its own is very quiet.

But the voice of the many people in the PPG is much louder and will be listened to.

Please join your Practice Patient Participation Group.


Ask at reception or look on the practice website.  Maybe there is a social media page?

Monday, 27 April 2015

Has General Practice passed the tipping point?


Is this the future?

Unless something dramatic or revolutionary happens at the Department of Health after the election have we seen the end of General Practice as we know it?

Here are three possible scenarios.

Scenario 1.

GPs become consultants in the management of patients with complex and unsorted symptoms. Everything else i.e. minor illnesses, uncomplicated long term conditions, social issues, work related problems, etc. will be managed by other members of the Primary Care Team: Pharmacists, advanced nurse practitioners and physician assistants.

The GP will assess, investigate and sort out patients presenting with undifferentiated symptoms and look after patients with multiple co-morbidities and complex needs.
Patients will no longer have direct access to a GP.

Scenario 2

GPs will become disease specific consultants working in the community.  All acute patients will be managed by pharmacists, NHS 11, nurse clinics & physician assistants.
 Patients will no longer have direct access to a GP.

Scenario 3

Co-payments. Patients will pay for their primary care, perhaps with government paying for a set number of  consultations per year.


Personally I do not think that civil servants and politicians do ‘revolutionary’!


I am sure there are others scenarios.  Please suggest some.

Monday, 29 September 2014

Possible models of General Practice



Any number of organisations have looked at the possible models of General Practice in England (see below for some recent examples).  They have produced lots of glossy pages describing the issues and possible models.

So we thought we would produce a short list of the possible ways that a local community could get its GP service provided. In no particular order.

“The Status Quo”.  The partnership option.
Under the current circumstances, unless the government changes its attitude this is not a realistic option.

A Salaried service with GPs.
a)    Through Foundation Trust Hospital – Vertical integration.
b)    Through private companies i) groups of GPs, ii) multi-national companies iii) venture Funds etc.

A nurse led service
This would probably be with GPs as community specialists/consultants at a distance. (There would be no doctor as first point of contact, no legal right to a GP).

Walk In centres.
Patients would be triaged and referred onto the ‘appropriate’ Healthcare provider.

NHS111
All access to healthcare would be through NHS111 call centres

Federation
GP practices merge or federate to form a large organisation (Management & Admin merged to save money & probably staff used across all sites rather than based on a specific site).

Investment by Government
You never know it might happen. The government realises that the current system is the envy of the world and invests to support the development and innovation that has taken place over the last 30 years

I may look at the advantages and disadvantages of these options at a future date.

 Further reading

Nuffield Trust

RCGP

Kings Fund

NHS England A call to action