When Jeremy Hunt speaks to the nation about general practice, I listen carefully. He admits to successive governments failing to invest in what he calls the jewel in the crown of the NHS. Hear hear.
The recognition is welcome, if he converts rhetoric into reality on workforce and investment. Of course we are with the minister on the need for innovation and “imaginative use of technology”. But trying to tie the carrots to the stick of 7 day working risks upsetting the whole lot.
In the same week that we read of PMCF weekend opening schemes closing for lack of demand, it’s simply exasperating to hear Hunt making 7 day working a condition for his “new deal”. The crisis in the NHS is not one of convenience for patients, but of failing patients because of strained workload and capacity. One in 8 trying to get a GP appointment in hours is turned away.
Every policy must be measured on these yardsticks:
- Will it improve patient safety and quality? 7 days fails, as continuity will be lost.
- Will it improve efficiency? 7 days fails, as it spreads limited capacity into periods of lower demand.
- Will it raise workforce morale? 7 days fails, as GPs don’t want to sacrifice more family time.
Hunt confuses the issues. He wants more continuity, a named GP, and routine appointments available more hours. Please see the myths and the maths. He wants to avoid A&E attendances for lack of a GP, but that is covered by OOH services. Just one in 200 calls to a GP is an emergency.
To help the minister we need to take the lead on “how”. Dozens of practices have shown how in becoming demand led, they can meet all demand in hours and out of hours demand drops. The new lower, emergency level can be met efficiently through a large network of practices. We can even enhance patient choice by digitally routing demand in & out of hours.
Technology plays a part, but new thinking is the key and evidence must be the basis. Hunt quotes W Edwards Deming, “In God we trust, all others must bring data.” We’ll hold you to that if you don’t mind Jeremy.
PS Must show you this new poster we presented at King’s Fund last week on how online access with askmyGP has saved 100 face to face appointments per week.