The NHS crisis continues to see hospitals at breaking point and GP surgeries busier than ever before.
Medics from across the country have sounded alarm bells that the health service needs major changes in order to carry on. It needs more staff, more space and more money.
In the immediate term there are small changes that can be made, says Dr Zahid Chauhan, a GP in Greater Manchester. Writing for the Manchester Evening News, he uses his expertise to explain simple ways to help the NHS.
Emergency wards full of patients on trolleys. Difficulties getting an appointment to see your GP. Waiting a long time for that procedure that you know will change your life for the better.
We all know the myriad of problems with the NHS. They can seem insurmountable.
But I believe small changes could make a huge difference to the speed and quality of care we receive. At the same time, these changes could also improve NHS staff retention, reduce costs and create a true “one health system” fit for all.
These alterations are mostly in the relationships between primary care - including GP surgeries and community services - and secondary outlets, such as hospitals or urgent care units.
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Getting enough medication on the day
A patient called Janet* recently suffered a heart attack, she was so grateful for the emergency care she got in hospital.
Medics were worried about how much medication she was taking, largely for angina, but also for the menopause and brittle bones. They reviewed it top-to-bottom and gave her new blood thinners to prevent another heart attack.
Janet was concerned though - she was only given a week’s supply along with a note referring her to her GP to provide more medication. Her GP surgery is so busy that it can take weeks to get an appointment.
Janet could tell them it is an emergency – but that would still mean a couple of hours on the phone, and could prevent someone else not getting the support they need.
Why couldn’t Janet have received four weeks of medication, prescribed by the very professionals who treated her so well? Why did the whole process have to be delayed, passing the responsibility for her medication to her local surgery on an urgent basis?
Inconsistency leads to delays
Some hospital trust policies do stipulate that medication upon discharge must be for at least a week, but others will give you a longer course than that. This inconsistency is something that Mike, 43, knows all about.
Mike* gets migraines that are so painful his doctor was worried about there being something seriously wrong with his brain. Where Mike lives, his GP was able to send him directly for a scan, which ruled out serious problems like a tumour.
This allowed Mike’s GP to sort out the patient’s treatment and deal with Mike’s pain himself, but also to save money for the health system by not sending Mike to see a specialist which would have asked for the same scan. However, Mike’s sister, who lives in a different part of Greater Manchester, was facing similar problems.
Her doctor was not allowed to request a scan, so instead had to do a referral to a specialist. She is still waiting to hear back about the scan eight weeks later.
Some parts of the NHS in Greater Manchester are allowing GPs to request certain scans directly. It does cost money, but not as much as waiting to see a specialist. By providing easy and direct access to certain diagnostic appointments, and removing postcode lotteries we can improve waiting times and patient care significantly.
‘Hospital procedures mean patients can’t just walk down a hospital corridor and get the treatment they need’
Ahmed* recently had a fall. The hospital tended his cuts and bruises, then scanned and X-rayed him. During his time in hospital, 72-year-old Ahmed mentioned to the doctors that he was suffering from ear pain that had been going for three months.
The man was examined by a doctor on the ward and told that he needed to be seen by a specialist in the same hospital. But here’s the rub - he will have to be discharged and then contact his GP for a new referral to the hospital.
Ahmed would have to ring around, find an appointment, repeat the full story before finally getting his referral. His GP would have to write a letter and surgery staff would have to process it.
Ahmed would be forced to call the booking centre. Then, a few weeks or months later, drive down to the same hospital again to see a specialist - if he was lucky enough to find a parking space in constantly full hospital car parks. Some hospital trusts have a policy that if you are more than 15 minutes late for your appointment you will be classed as ‘Did Not Attend’ and won’t be seen.
Small changes will make a huge difference to sick people
The NHS wants to become ‘integrated’, with all parts of the system working together. But such integration would have seen Ahmed treated for the ear pain when he was first admitted to hospital for his fall.
He was not able to travel down a few corridors and see a specialist because of hospital procedures and the flow of money across the NHS.
We need better communication between different parts of the health system if we want it to be a truly integrated national health service. The next time you are given an instruction by a healthcare professional to contact this service or that service, question why different parts of the system can’t talk to each other in a more efficient way, which would save time spent on all these cases.
That change will happen only when we start questioning why things are done in certain ways. And these small steps need to be taken to get the likes of Ahmed, Janet and Mike - and the NHS itself - back on their feet again.
* - Names have been changed to protect patient identity.
Dr Zahid Chauhan OBE, FRCGP, is a GP, campaigner for health and social care equality and the creator of the Homeless Friendly Charity. The charity works with surgeries, hospitals, hospices, charities, councils, and businesses to ensure people experiencing homelessness get the best possible health care.
Learn more about him at www.zahidchauhan.co.uk/ and follow him on Twitter @ChauhanZahid.
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