What are we queuing for?

GP Waiting Room 'Apologies if I keep you waiting' Poster

Recently I read “What I’m really thinking: the GP”, a great article by a Doctor who has worked for 20 years as a GP and has clearly no intention of following the half baked advice of the GMC advising Doctors against posting content anonymously. It gave me the idea of making up the above waiting room poster as a talking point for a workshop I’m contributing to next week.

The article makes some great points but I think it’s critical that we appreciate the 2,000 year old healthcare model is no longer sustainable and that in 2015 the NHS makes no sense if we stick to the idea that the product being made is office appointments. In 2015 it’s no longer enough to just manage demand we need to expect it and plan for it. Here are some thoughts I had on reading the article:

Time is the enemy. Ten-minute slots run over as I greet you, listen, ask questions, formulate a plan. I may examine you, if you can unbutton your shirt and talk at the same time. If you are 90, with four layers of underwear, I know the game is up

Patients are telling us the waiting time provides the opportunity to move beyond today’s model where Patients are pleading for 36 seconds to tell their story. It provides us with the opportunity to ask questions and have the answers documented by Patients/Carers. It provides us with the opportunity to plan for the consultation and share with the Patient our plans that may well be that we will be meeting with them in the consult room eg. Patients want to know in advance that this might be an ‘unbutton your shirt’ type of consultation.

I am humbled by the stoicism I witness, and exasperated by parents who bring in a child with a cold

I think this is sadly a very predictable outcome of our failed attempt to try and force fit everything through office visits. Does anyone think exasperated Parents really want to take time off work to attend a GP with their child or is it just a failure of how the NHS allocates it’s £95.6 billion budget that this access point is all that is being offered to them to find a solution to the problem that they face?

Before tackling the London Marathon (in aid of MSF) last week Harry Longman, Founder/Chief Executive at GP Access, made this brilliant blog post trying to identify exactly what patients are queuing for. It’s a must read: “They want to see their GP, today, now”.

The queue that shames britain

Political parties using GP queues to score points over one another

*** UPDATE * 5 June 2015 * UPDATE ***

Some research from Citizens Advice provides insights into how much time NHS GPs are spending on non-health issues. The central finding is that GPs in England spend almost one fifth (19%) of their consultation time on patients’ non-health issues. This translates to an implied cost of nearly £400 million to the health service.

Does the publication of information like this change our opinion of a sign like the one above?

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