You may have heard some misinformation in the media lately about medical practices in Scotland. All practices continue to work differently at this time following guidelines from the Scottish Government, Health Board and Health and Social Care Partnership on Social Distancing, limiting footfall, PPE and infection control. These measures are in place to protect patients, limit infection and most importantly, ensure that practices can remain open.
We wish to reassure our patients that we are open, and always have been open, right through the pandemic performing significantly more patient consultations than ever before. Our systems have had to change significantly however in order to ensure we can continue to provide a safe level of care. This is on a background of major changes to the way General Practice is provided. These changes have not always been explained well to patients. In the past, if you wanted to see a GP, you simply made an appointment. Now we have another method of contacting us: askmyGP or if you telephone you will be asked questions about what you require from the practice by our administrative team. Your request will then be assessed by one of our GPs and they will decide how best to help you – this may be advice on contacting another service such as a Community Pharmacist, the Minor Injuries Unit, an appointment with another health professional, clinical advice from one of our clinicians or a telephone or face to face appointment. Below is an explanation of why these changes have been necessary.
‘But why can’t I just see a GP?’
Background to Why General Practice has Changed
The changes that have happened in general practice began long before covid. Patients are living longer with more medical problems and are taking many more medications to manage these medical problems. The complexity of general practice has vastly increased. But the number of GPs has significantly declined. One solution has been to introduce specialist roles within the practice, such as Advanced Nurse Practitioners, Prescribing Nurses, Practice Pharmacists, Mental Health Practitioners and Physiotherapists. New services have also been set up locally such as Minor Injury Units, the Community ‘Pharmacy First’ scheme for treatment of minor medical issues such as urine / throat / skin infections, Opticians to treat eye problems and the Podiatry Service for foot and ankle problems. The GPs role is to manage the most complex cases and support the whole practice team. If patients continued to choose who they see, GPs would be fully booked and would be unable to deal with our most unwell patients. This simply isn’t safe. The pandemic has increased the demand on our services significantly. We are dealing with many more patients each day than we did pre-covid. This has happened for a number of reasons: many patients delayed contacting us last year, lots more people are waiting longer on hospital care and are therefore being cared for by the Practice until they can be seen at the hospital, as well as the increased workload from covid-19 related illness itself. The complexity of maintaining social distancing within the practice, as we are legally obliged to do by the Scottish Government, makes things even more tricky. As well as all of these factors, we continually have staff off work isolating or unwell with covid-19.
Triage of Clinical Requests
Our absolute priority is maintaining a safe level of care. This requires us to prioritise the patients who need care most urgently. To do this, we need information from you about your problem. We ask that you contact the practice by using askmyGP if possible. This is the most efficient way of us getting information from you about what we can do for you and keeps our telephone lines free for those who do not have internet access. askmyGP opens at 6am each weekday morning (apart from on public holidays) until around 8.45-9.00am and is open from 6-10pm each Sunday evening. The DUTY Doctor, who is not booked with appointments, will look at hundreds of these requests each day and can often respond and complete your request in a few minutes. We know that this can feel impersonal, for you and for us, and we would all rather that we were speaking to everyone or even better seeing everyone. The sheer volume of patient contacts that we get through each day though is several times higher than we could achieve if we spoke to or saw everyone. So, although there are lots of things we (and you) don’t like about these systems, we have had to introduce them to ensure we are getting to care for those that need help most urgently.
Feedback
We know these changes have been quite sudden and it can all feel unfamiliar. We care deeply about the service we provide and all our patients and are constantly looking for ways to improve and make things easier for everyone. We have had lots of positive feedback recently and we are so grateful for this. The team are honestly working harder than we have ever worked before and a small word of encouragement really makes a difference. We know that some patients are unhappy with how things are though and we are sorry when we hear that. We listen carefully to all constructive feedback and would encourage you to continue to help us to improve with your suggestions, which are often really helpful. Each time you submit an askmyGP request you will be emailed a feedback form – please do pop any suggestions on the form and send it back to us.
Thanks for taking the time to read this – we hope you have found it helpful.