I (@CraigNikolic) often post about the NHS's "Same day" plans for in-hours general practice hubs being dangerous, and why ICBs are misusing them to fill an unfunded gap, I rarely take time to explain WHY. So, here we go
They forgot to ask what patients really need. 1/28
If you were to take the NHS of a quieter time, with low waits and no decade of year-on-year cuts to services downstream of general practice, it may be something to consider.
We're not there though, and austerity general practice patients need GPs, not quantity of appts. 2/28
Let's start with an example:
A patient needs a hip replacement. In a non-austerity system, the only time they'll see their GP is when the GP refers them as it'd be refer > outpatient appt > surgery > home with follow-up care. Patient freed of pain and gets on with life.
Over the next few days, I will explain the PCN DES in General Practice.
Buckle up for an education.... 1/x🧵 ⤵️
The PCN DES (Primary Care Network Direct Enhanced Service) is a funding program aimed at improving primary care services in England.
It was introduced in 2019 as part of the NHS Long-Term Plan, which outlines the government's vision for the future of the NHS. 2/x
The goal of the PCN DES is to support the development of Primary Care Networks (PCNs), which are groups of GP practices serving ideally populations of 30-50k people.
The aim of PCNs is to provide more integrated and comprehensive care for patients in their local communities. 3/x
Are you aware from 1st Nov most patients will have access to their GP records and see all communications & letters you send automatically?
Follow these 7 steps to make your's, the GP practice, and your patient's lives easier 🧵⤵️
1. Assume the patient can see everything you have written.
This should be the norm, and applicable if the patient had requested a subject access request (SAR) anyway.
This is good medical practice anyway.
2. Also do not assume the patient WILL see the letter
Although patients will have access automatically from 1st Nov, do not assume ALL patients will be checking their GP record for information. If you need to inform the patient of something contact them directly as well.
Three consultation types but only one of each to use and you must use each one:
✉️ Online (text/photo only)
📱 Phone/video
😷 F2F can be clinic or visit.
Justify your answers if you can...
Your cases are below🧵⤵️
1️⃣ 25y old ♀️ asking for the morning-after pill. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay.
2️⃣ 29y ♂️ asking for a nasal spray for hay fever. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay. 🧵⤵️
3️⃣ 35 ♂️ sprained wrist last week asking for ibuprofen for pain relief. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay.
If you think seeing a GP is tough, unfortunately it is about to get so much worse...
Here is a thread why, and spoilers, it is going to be controversial as it goes along 🧵⤵️
1/x
Firstly, General Practice was in a difficult place before COVID happened and pivoted overnight to create remote access to keep patients safe.
It then delivered the majority of the national 'World beating' vaccination scheme. 2/x
There were definitely changes in access, much of it dictated by @NHSEngland and infection control policies which are still in practice still in some way, and vilified by certain parts of the media 3/x