Dr John Havard: Don’t blame the patients...
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It seems NHS professionals are always going on at patients about using health services appropriately. “A&E is only for serious accidents and emergencies” and “don’t waste GP appointments with self-limiting minor illnesses” are examples of the messages that have been going out. Locally we confused the message even more recently with the Minor Illness Unit at Riverside which has now closed. The service used to be advertised introducing another choice for patients that made it all bewildering. The strategy of diverting patients from A&E to Riverside Minor Injury Unit failed because A&E still saw similar numbers while the total numbers inflated enormously. This tells us the demand for health is immense and there is loads of unmet need ready to consume NHS funds. It is a similar situation with caring - thousands of people are looking after loved ones without any help from social care or the NHS. If this unmet need was addressed then the NHS and social care would be bankrupted overnight.
What is the solution?
We heard this week from the NHS chief executive who outlined the need for more money than is being proposed by all the political parties. We cannot do anything about the population getting older and medical science offering more and more expensive treatments. That represents proper and praiseworthy growth and more money being needed to treat people better. However there is still a lot of waste in patients attending the wrong places and often when they do not need to go anywhere but do need information and reassurance. The demographic changes have meant that there are often not older family members to ask. Communication changes mean you only have to reach into your pocket for a smartphone to access NHS services and this simplicity means it can be done without putting your brain in gear. That same smartphone can give a hundred causes of death from a temperature without any discriminatory perception. Now if you had to walk into the village on a cold night and put some coins into a phone box then it needs to be worthwhile…
How can concerned patients be reassured about self-limiting illnesses without them being seen?
We need to take a leaf out of the younger patients’ book and reflect some of the urgent need with instant information. And we need to provide this in a video format for a smartphone rather than a lot of text. There is great capacity to talk through different common conditions and to use the video element to show a GP discussing coughs, sore throats and other minor illnesses as would be done in a consultation. Maybe rashes and sore throats could even be shown so patients can learn if it will be mutually worthwhile making a GP appointment.
Doing nothing is just not an option and we need to explore more innovative ways of working with our patients to keep the show on the road.