General Practice has become the backstop for many other services. Patients are often seen elsewhere – A&E, hospital clinics, Urgent Treatment Centres, Minor Illness & Injury Units; or by other professionals – Community Nurses, Pharmacists, Physiotherapists, Podiatrists, Dentists and Opticians.
Frequently they are told to “follow-up with the GP”, often without much thought as to whether this is actually needed or whether the GP is the appropriate person.
Other agencies such as Schools, Social Care and many Community Services also frequently tell patients to ask the GP for something.
Often this is appropriate, but sometimes it is not.
General Practice is in crisis. GP appointments are in very high demand and put simply there simply aren’t enough appointments to go around. Therefore it is important that every single appointment is used appropriately.
Frequently we have patients presenting in General Practice with needs that could – and should – have been met by the person who advised them to speak to the GP in the first place.
This is waste of both your time, and the GP’s time and contributes to the lack of available GP appointments for everyone.
There are lots of examples:-
If you have an inpatient hospital stay meaning you are absent from work for more than 7 days, the hospital team looking after you should provide a fit note covering the admission plus any anticipated period of absence following discharge.
You should not be told to ask the GP for a fit note.
When discharged from hospital you should be given an adequate supply of medication to take home with you.
You should not be told to contact the GP for an urgent prescription.
If you attend a hospital clinic and the doctor there suggests some time off work, they should provide a fit note for the duration of anticipated sick leave.
You should not be told to ask the GP for a fit note.
If you attend a hospital clinic and the doctor there organises some tests, it is the responsibility of that doctor to give you the results and take any follow-up actions needed.
You should not be told to ask the GP for your results, or for the GP to act on the results.
If a hospital doctor suggests some new medicine, they should give you a prescription for the initial supply.
You should not be told to contact the GP for the first prescription.
If a hospital doctor thinks you need to see another hospital specialist for a related problem, they should refer you directly themselves.
You should not be told to ask the GP to refer you.
If you miss a hospital appointment, the hospital should liaise with you directly about re-arranging.
You should not be told to speak to the GP about being re-referred (unless you have repeatedly missed appointments for the same problem).
If you have a query about your inpatient or outpatient hospital care, the hospital should respond to your query directly.
You should not be told to ask the GP.
If a Dentist feels you need hospital treatment, they can refer you directly.
You should not be told to ask the GP to refer you.
If a Dentist feels you need sedative medication for a dental procedure, they can arrange for a prescription and appropriate, safe monitoring themselves. If they do not have the necessary expertise at the dental practice, they can refer you to a dental centre that does, including hospital dentists.
You should not be told to ask the GP to prescribe sedation.
If an Optician feels you need hospital treatment, they can refer you directly.
You should not be told to ask the GP to refer you.
If you attend A&E or the Urgent Treatment Centre, often they tell you to follow-up with the GP, almost as a knee-jerk, no matter what the problem. Most illness is self-limiting and will get better with time. Often, GP follow-up is not needed at all. Sometimes it is needed if things do not improve. You should ask the person advising you to follow-up with GP how long you should wait before contacting the GP, and what you should be looking out for in the meantime.
You should not normally need to see the GP the same day, or usually for a few days/weeks.
If a child is absent from School due to illness, a fit note or doctors letter is not needed.
You should not be told to ask the GP for a note.
We desperately need to push this work back and protect General Practice.
The NHS Hospital contract was changed in April 2017 and placed new requirements on hospitals to reduce inappropriate bureaucratic workload shift onto GP practices.
Despite this, we are still frequently seeing patients asking for things that should already have been sorted elsewhere.
Patients can play a really important role in this by having conversations with the person telling them to contact the GP, to check whether this is really appropriate. Please always ask:
- Why do I need to contact the GP?
- When should I contact the GP?
- What action is being asked of the GP, and is it appropriate?
We are working really hard to try and improve GP services. More and more is being asked of us all the time with ever diminishing resources and chronic staff shortages.
Freeing up appointments that are currently being used for work such as that mentioned above, will mean more appointments are available for those who really need a GP’s help.
We are always happy to help anyone who really needs our help and it is important that you do contact us if you really need us.
But … please help us to help you and if someone else tells you “Speak to your GP” think “Do I really need to?”.