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As you already know, GPs are really struggling to keep up with the rising numbers of face-to-face consultations in many parts of the UK. In theory, the answer to this problem seems so simple - push for greater use of phone, email and Skype consultations to make GPs more accessible to patients.
Surely, that’s going to work. But, according to a recent study of 42 practices published in the Lancet, doing so does not save money, does not decrease burdens on local surgeries and may actually increase workload.
The study found that telephoned patients needed further contact with their GP. It was hoped that using shorter phone consultations would reduce some of the burden on GPs, but the British Medical Association (BMA) said, “doctors might be falling under more pressure from surging patient demands.”
On average, surgeries typically deal with 20 patients who need to see a doctor on the day. At the University of Exeter Medical School, researchers analysed the impact of having a nurse or GP call patients back in the first consultation.
Far from easing workloads, patients being dealt with by surgeries increased by 33% when doctors called back, and by 48% when a nurse did. If the first meeting was in person, only 50% needed a second visit whereas that number rose to 75% when GPs called. Professor John Campbell, lead researcher, said, “calling patients is not the silver bullet to easing workload.”
The deputy chair of the BMA’s GP committee, comments: “Growing patient demands and lack of funding means there are not enough doctors or nurses available to meet patients in addition to managing their present workload.” It’s important to get the balance right, ensuring that direct examinations in the GP practice are not completely replaced by phone consultations. There are many conditions that can only be treated by seeing the doctor face to face, such as cancer related conditions and serious hospital treatments.
If patients have successfully used a form of medication to treat a recurrent problem in the past, they can easily collect their prescription after a short phone call. In all cases, it is imperative that a thorough history is taken and documented. When done correctly, patients can be managed in a clinically safe and effective way.
According to a spokesperson for the Department of Health, 7.5 million people are being offered Skype, email and weekend slots to have their consultations. Some surgeries and out-of-hours providers record incoming calls to form part of the patient’s records. These can provide further information to help diagnose patients.
Currently, GPs are working harder than ever before, dealing with 340 million consultations a year, but surgeries require a lot more funding to help them address the growing number of patient enquiries and consultations.