Dr Ellie’s prescription for the ailing NHS:
WHO is to blame for the tragic state of the NHS? Cuts, women doctors who don’t work hard enough, greedy and lazy GPs, immigrants, the Conservatives, Labour, and incompetent telephone helpline operators have all been in the firing line over the past few weeks. Of course, there is no single answer to righting the various wrongs.
But today I am going to be bold and highlight a growing problem we must address – one that politicians and many healthcare workers never will in public because they fear it will make them unpopular. There is a large elephant in the room that is contributing to the downfall of the health service we care so much about: the patients.
It may be a bitter pill to swallow, but from my view at the front line, sadly it’s the truth.
I’m not saying: ‘It’s all your fault.’ But if you, as patients, can take some responsibility, then you can also be part of the solution. Here is my five-point plan for what to do:
1 STOP THE WASTE
There was outrage last month after people were pictured queuing outside a GP surgery at 6.30am just to get a routine appointment.
Yet almost every day we have patients who simply don’t turn up for appointments. At my practice last month, out of a total of 2,057 appointments, 193 – almost one in ten – were no-shows. That’s the equivalent of two-and-a-half days of GP time wasted.
More than six million appointment slots are wasted annually across the entire NHS. I don’t want to see a system where we fine patients for not turning up, but the numbers are staggering. Likewise, we see an enormous amount of waste when it comes to drugs. Once a medicine is issued, it cannot be reused, even if sealed, so I urge patients to only ever order repeat medications that you need. Unused prescription medicines cost the NHS an estimated £300million every year – that could pay for 11,000 more community nurses.
There is no need to stockpile medicines ‘just in case’. Always tell your pharmacist if you have stopped taking something, and be honest with your GP if you do not want a medicine.
2 LEARN TO LOOK AFTER YOURSELF
One day a week I am the emergency doctor at my practice and field calls from patients requesting an urgent appointment. One in ten of those calls are from people who should know better: young men who have had a sore throat for a couple of days, teenagers with a blocked nose, and many people with common colds. Sadly, Accident & Emergency staff see a similar phenomenon.
More than 51million GP appointments a year in England and Wales are for minor ailments. By learning to ‘self-care’, we can focus resources on people who really need them.
Older generations would not have bothered the doctor with such things but tacit knowledge has been lost. It’s probably partly due to the scattering of families and a loss of community, but also because of unrealistic expectations.
I’m afraid we still do not have a cure for a common cold, so the best advice I can give will be the same as that from mum: rest and drink plenty of fluids. The NHS Choices website and patient.co.uk in particular give excellent advice on treating coughs, colds, and simple sprains.
3 ASK THE CHEMIST
British pharmacists undertake five years of training before they can practise. They are healthcare professionals but many patients see them more as shopkeepers.
A patient survey commissioned in 2012 found there are about 40,000 GP visits per year from people who suffer dandruff, while a further 20,000 go to their local surgery for travel sickness, and 5.2million with blocked noses.
These are all ailments which a pharmacist can treat with their vast knowledge of over-the-counter medicines. They are open at weekends and you can see them without an appointment.
4 STOP EXPECTING THE IMPOSSIBLE
We live in a world of now-nownow and me-me-me. The Google generation expect answers and solutions in a second.
Frustratingly, this culture has permeated the NHS, but it is simply unrealistic in a public health system. There has been a political pandering to a culture of choice. Patients deserve respect and care but some demands are unrealistic. I witness patients who shout at receptionists and demand emergency appointments because they are ‘going on holiday tomorrow’.
Urgent prescription requests come in, not because of an imperative clinical need but because someone has forgotten to order their medicine and has run out. People go to A&E on a Sunday because it saves them taking time off work during the week.
And yet an elderly patient apologised for bothering me last week when in fact she had pneumonia. It is a common scenario: vulnerable patients who do not want to be a burden or inconvenience are usually those who desperately need help.
5 LISTEN TO ADVICE
The NHS offers everyone a fantastic array of preventative healthcare measures that are scientifically proven to work and are all worth heeding.
Exercising, reducing your alcohol intake and quitting smoking really do help us avoid illness. And I’m not just talking about cancer and diabetes either.
Smokers visit their local GP surgery with coughs far more often than non-smokers, and A&E departments across the country would be positively tranquil without alcoholfuelled injuries to deal with.
Likewise, cancer-screening programmes diagnose the illness at an earlier stage when cancers are not only easier but also cheaper to treat.
The same can be said for vaccinations: the new ones introduced for children against rotavirus and flu do not simply prevent serious consequences – they also help avoid costly hospital admissions.
Look after yourself and you can help look after the NHS.