By Dr Surina Chibber, GP Columnist
With the election looming, there appears to be an outbreak of delusions of grandeur as each political party promises to 'save the NHS'. When trying to decipher the verbal diarrhoea of the pre-election debates, it seems that no politician has grasped the real problems facing the NHS, let alone how they can be solved.
No-one seems to have realised that that frontline NHS staff may have a better idea of the real issues and solutions than MPs who are swamped trying to win votes while trying to work out what expenses they can claim for next.
So, what needs to be done? In the last few weeks, I asked colleagues and GP groups on social media about what they think needs to change. Here’s what they had to say.
More money in the right places
Headlines are filled with promises of GP practices opening for seven days a week, guaranteed appointments within 48 hours and same-day slots for anyone over 75. But any doctor or patient will agree that currently it is barely possible to run a five day service let alone try to stretch it more.
In addition, over the last five years the government have used consultancy firms who charge up to £3000 an hour to 'advise' the NHS on saving money. In the face of service cuts to patients and staff pay freezes this is a shocking figure.
Why not ask for advice from doctors about where to make savings and investments in this NHS? Why not allocate funding directly to surgeries and let them channel that money into patient care? Why not invest in improving the five day service rather than trying to stretch it to seven days?
Why not invest in creating a clinician lead 111 service that compliments and supports primary care rather than adding to the workload?
These would be by far the most efficient and effective ways to improve primary care.
More doctors
Doctors are leaving the NHS because it is getting harder to cope within the current system. There are not enough hours in the day to get through the sheer number of patients or paperwork, to deal with micromanagement from CCGs , meet deadlines from NHS England & CQC and to jump through the hoops of revalidation.
It's not an easy decision to leave a profession that takes years of dedication to join. A third of GP training posts are currently empty and there is a national shortage of GPs. Instead of promises to instantly provide 1000s of doctors (it takes 10 years to train a GP) why not tempt doctors back to the NHS? Tackling the unmanageable workload, decreasing bureaucracy, improving resources and allowing them more time with patients would all help retain staff.
Tackling patient demand.
A survey by Resilient GP collated a list of requests from patients that could clearly be dealt with elsewhere. Patients are approaching their doctor for help with non medical issues such as writing their CV or because they feel they are addicted to crisps.
Many feel that some people are using primary care inappropriately for their social, personal and professional problems, exacerbating the problem of demand.
Re-education is needed on the remit of a GP.
Why not promote self-care? Why not consistently charge for or discourage non-NHS work such as requests for completion of forms, letters for employers or schools requesting sick notes for children with colds? Surely there is a better way to implement sick certification ? Surely certain services should be accessed directly?
Many also feel that providing over the counter medications on prescriptions is exacerbating the problem and increasing costs to the NHS.
These simple measures would enable GPs to provide more appointments to patients who need them and ultimately give them more time.
Morale
Negative press and scaremongering has left the profession demoralised and disempowered. Patients are unaware of how hard GPs work and at what personal cost in order to prop up the NHS. The public have been fed a constant media diet of propaganda on the myth of excessive pay, that doctors are negligent and that they can expect the health service to live up to the culture of ‘want it now.’
The impact that this has on the psyche of the profession and the morale of dedicated doctors is saddening to say the least.
What are GPs doing to counter this? Resilient GP is a group with a growing membership which is starting to challenge the status quo by raising awareness about inappropriate use of the NHS. Practices such as this one are writing newsletters to inform their patients about the true state of general practice. Everyone should circulate this. Doctors such as Zoe Norris and Alan Woodall are also openly challenging inaccuracies in the media and raising awareness of the real underlying issues.
So there you have it - a summary of the problems and solutions as experienced first hand from GPs on a daily basis. It's clear that current political manifestos fall short of addressing these very real problems. Perhaps it's time for politicians to hand primary care back to GPs. After all, as GPs are dealing with the problems of the NHS on a daily basis then surely they are best placed for providing the solutions?
Links: GPs need to inform patients about false election promises
