What do patients want? What do they need from the National Health Service? How can we improve Patient Experience?
I had previously written: A common complaint I hear about is Inadequate Access. The more appointments are created, the bigger the problem gets. Decades ago, it was just the GP and Nurse in primary care. Now we have Patient Champions, Health Care Assistants, Social Prescribers, Healthy Minds Practitioners, Counsellors, Mental Health Practitioners, Clinical Pharmacists, Advanced Nurse Practitioners, Physiotherapists, Occupational Therapists, Paramedics, Dietitians, Midwives, Health Visitors, Physician Associates…
Patients require the following from “their GPs”:
- General advice on healthy living
- Education on selfcare especially for Long Term Conditions (LTCs)
- Management of Minor Ailments
- Access to the Practice / Signposting to other health and care services
- Consultations (Face-to-face or Remote)
- Investigation
- Prescription
- Referral
- Communication with others (family members, health and care services, etc.)
- Reports
- Fit Notes
- Letters
- Home Visits…
This non-exhaustive list is our service to our patients. There are other duties – to our staff, other practices, the local community as well as Commissioners (who oversea the ever shifting goalposts) and the powers that be, all the way to Department of Health and #10.
As Independent Practitioners GPs may do things differently but the basic principles are the same: Keep your patients happy; keep your staff happy, keep the CCG (now ICB)/ NHSE/DOH happy. A mission impossible! Over the next three months, I will write a weekly blog examining each of the areas of service to our patients. We run primary care businesses simply because there are patients. I will highlight what good looks like for the patient, the practice and the wider health and care system.
Everyone of us currently requires a level of care, along this continuum of health:
- End of Life (EOL)
- Palliative Care
- Complex Health Care
- Frail Care
- Multiple Morbidity Care
- Long Term Condition Care
- Minor Ailments Care
- Self Care
- Healthy Living
The least demand on primary care is made by those at the base of the pyramid. The more we are able to keep people who need treatment for minor ailments, skills for Self Care and confidence to live a healthy life away from GP appointments, the more GPs can meet the care needs of 1-5 above. Working together with patients and communities, we can all hear a happier tune from the piper.
On 5th July 1948, Minister of Health, Aneurin Bevan, unveiled an NHS to meet the needs of everyone, free at the point of delivery. and based on clinical need, not ability to pay. This right to health is a fundamental human right and should not be abused – not by patients, not by NHS staff and surely not by policy makers in high places.
Dr Abiye Hector-Goma is a Leeds-based GP with interest in people, processes and technology in health (but not in reverse order).