Tuesday, 15 April 2014

Extended hours.

So the BBC have broadcast that the pilots for extended hours have been announced even though earlier the health secretary announced their results. The BBC also proclaims that these will ease the pressure on A&E. 

Well you do not have to be a rocket scientist to realize that these will make not a tad of a difference to A&E attendances in the same way that a former Scottish prime minister thought that extending the standard 10.5 hour GP working day would allow all those busy commuting pensioners and toddlers to be seen when they were not busy at nursery or the Darby and Joan club. That worked so well now children didn’t it?

A few observations from the doctors at ND Central are being reported on here. From experience when you have a lot of doctors available surgeries do not always get full and there are sometimes free spaces especially if that coincides with periods of low demand like work shut down periods (when the former PCT was on holiday).

Under such (rare) circumstances someone ringing up with an urgent emergency, all general practice consults are for precisely this, for example an itchy scrot of 6 months duration, then receptionists are able to say: NHS free at the point of need and abuse sir/madam? That will do nicely I can fit you in straight away.

Now the converse also applies for example during school holidays when doctors who do not see much of their families during the politically determined minimum 10.5 hour day plus extended hours might want to spend some time with their children and so there is a shortage of surgery slots.

As a result there are rarely gaps in surgeries and so when the above emergency, extremely urgent MUST be seen NOW that day case rings up and is told we have no spare slots today we can fit you in tomorrow, next week or you can play Blair appointment roulette and see if you get a lucky on the day appointment what does the punter do?

They use NHS Choice and after a torrent of abuse to the receptionist (abuse is always free at the point of care on the NHS) and how they pay their taxes they march off to A&E comfortable in the knowledge that there is no come back for abuse or wasting an Accident and Emergency department’s time for something that is rarely if ever an accident and even less so an emergency. Increasing A&E is a general practice service with x-ray for those who cannot get what they want, when they want it and it is always NOW – regardless of true (medical) need.

Now using the above experience at a surgery level can anyone see a possible way of improving things? Will a few extra appointments for a few extra hours in a few locations with no extra doctors make any difference?

The issue here is the number of doctors that are available and the politicians are ignoring the elephant in the room and the fact that this elephant is getting bigger year on year. However, they conveniently ignore this and try to stretch a very thin film of puncture repair material over an increasingly large puncture hole they have created at the same time that they are increasing the pressure of demand in the tyre they are trying to fix.

Anyone who has been a cyclist will know what will happen under these circumstances. Do any of the politicians who cycle know this or can work out what is wrong?

Praise be to the Party who whenever they do not provide enough always blame the workforce for not working hard enough. There are 2 one day bank holidays in May this year can you guess how many days the politicians won’t be working in May? No wonder you can never see a politician when you are ill.


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