Give GPs the time to help patients
AS A GP for 40 years, I know the proposal to provide ‘care navigators’ offering patients the ‘right choice of treatment at the right time . . . to reduce avoidable appointments’ will not work. Much of frontline medicine is not straightforward. Often it is unclear (at least at first) why people ask for help. Some complaints are clearly serious, others are more obscure. Many are not ‘treatable’ in the simple sense — e.g. some stress-related, ageing and mental health problems. Most of us have fears or loneliness beyond words. But our better erstwhile family doctors could greatly help when they knew their patients, offering bespoke guided support, comfort and encouragement. this kind of professional contact does not quickly ‘treat’, but helps us heal, cope and positively adapt, and probably prevents more serious illness. however, these consultations require subtle skills and experience — not just of medicine but of the patient’s nature, life and family. these can be provided only from a service that offers easily accessed, personal continuity of care. the better old-fashioned family doctors were able to offer this kind of relationship far more readily than a current Primary care Service Provider (as GPs are now designated). Few patients can even name their GP, let alone see the same one on different occasions. recruiting receptionists to further fragment and deflect our already fragile and poorly accessed personal continuity of care will be counterproductive. It adds even more barriers to a service that is already increasingly impersonal and uncaring. all this will turn out more expensive, more anxiety-prone and more hazardous, too. the authorities will assure us this won’t happen, but it will.
DR DAVID ZIGMOND, London N8.
I HAVE been an advanced nurse practitioner for 25 years and know the need for triage by anybody, qualified or not, is great due to the huge demand for appointments. Of up to 100 calls for same-day appointments, about ten are really necessary. the most common complaints are coughs and colds. Many patients ring up with symptoms they have had for just hours and haven’t even taken an analgesic. therefore, there is a need for sensible triage because of people’s unrealistic and inappropriate demands on the health service. until patients start taking some responsibility for themselves and their children, measures have to be put in place for us to cope.
SHELLEY FOREMAN, Littlehampton, W. Sussex.