AIBU to think we should just get rid of GPs and triage in ED or MIUs instead?

[Blueskydrink]

So many threads here and elsewhere, so many articles and so many complaints that no one can see a GP. Not enough GPs anyway and their job is either gatekeeper or refuser.

Throw health centres over to nurses to do baby clinics, flu vacs, smears, blood tests, adult health checks etc and everything else straight to the hospital to be triaged.

Would save lives and a fortune too.

Absolutely agree!

Agree! Don't know why it hasn't been done already. Probably because of vested interests.

But how do you propose routine referrals for further investigation and/or secondary services?

Or Fri those with complex needs e.g. older people, learning disability service users, complex mental health patients? There needs to be someone overseeing needs.

I agree it's not ideal but it's the best we have.

Fri=for

What about getting prescriptions though? I don’t think it makes much sense to go to the ED if you need, say, something for your skin or antibiotics or something. Seems like overkill.

Absolutely not. One of the most ridiculous ideas I've heard in a while.

Who's taking care of people's chronic and routine conditions and med refills? Do you know why GPs 'gatekeep'? Because not everything needs referral to the hospital or a consultant! If anything it'd be easier for them to do so but it's not always necessary and very importantly there are absolutely no where near enough specialists for the amount of people who would want to see one!

Or for those with complex needs e.g. older people, learning disability service users, complex mental health patients? There needs to be someone overseeing needs

My GP surgery has effectively abandoned doing this. It's horrendous.

Prescribing pharmacist. We already have them 24/7. FABULOUS service.

Who's taking care of people's chronic and routine conditions

It certainly isn't my GP, more's the pity.

@DoTheNextRightThing

What about getting prescriptions though? I don’t think it makes much sense to go to the ED if you need, say, something for your skin or antibiotics or something. Seems like overkill.

Apologies I tried to reply to this question with my second post.

This just shows a complete misunderstanding of the complex role of a GP and the purpose of an ED.

Lol. Just no. No way the system could cope, even if it was a good idea, which it isn't. A&E is not the place for the VAST majority of things that GPs see, they're totally different specialties.

There are big flaws with GP provision at the moment, but this would not make anything better at all.

@Spidey66

But how do you propose routine referrals for further investigation and/or secondary services?

Or Fri those with complex needs e.g. older people, learning disability service users, complex mental health patients? There needs to be someone overseeing needs.

I agree it's not ideal but it's the best we have.

Agreed. But I think all these things can be done, indeed are done, better by specialist nurses imo.

Routine referrals done at hospital triage. My hospital already doing this for some cancers with much better outcomes for patients.

@LemonRoses

This just shows a complete misunderstanding of the complex role of a GP and the purpose of an ED.

Does it? Why? Come to my ED anytime and I will show you 80% of people there because they can't see a GP. Why not cut out the GP altogether?

I would politely suggest you have very little clue as to what GPs actually do.

Fuck me, can you imagine the queue at A&E?

My GP surgery is great. No problem getting an appointment for tomorrow, in person, booked about a week ago on the nhs app. I’m in London by the way, so not exactly lacking in patients.

"Does it? Why? Come to my ED anytime and I will show you 80% of people there because they can't see a GP. Why not cut out the GP altogether?"

That's a damning indictment of GPs.

Suppose someone is on heart medication and needs regular reviews. That doesn't fit into emergency or minor injuries.

YABU. I've had good service from my GP several times during the pandemic. In none of those cases would A&E have been the appropriate place to sort the problem, and not having someone coordinating the care of my several complex conditions under a variety of hospital consultants would be an absolute nightmare.

@Sidge

I would politely suggest you have very little clue as to what GPs actually do.

Tell me then! What do they do which can't be replicated in a hospital based triage unit? (Which is what I really want not queues at ED!). A one stop shop no less.

I've no objection to reform of the NHS
I'm just a bit baffled how this idea would work.

X post
When I was suffering with depression and on meds, at the start I was seen every fortnight.

Let me guess OP, you're a nurse?

Your responses show a complete lack of understanding of the GP role.

Are you going to refer every case of depression to psychiatry? Bring back every ear infection to ED in a few weeks if not resolving, or ping them all over to ENT? Are you going to replace home visits and advanced care planning with a referral to the palliative hospital team?

This suggestion is bizarre. ED and hospitals cannot cope with the patients they already have. It is thanks to GPs managing mild cases of illness, mental health, elderly care and "social issues" that the whole system hasn't already crumbled.

As I was taught during my ED rotation, consultants ask: is the patient unwell? Do they need to come in? Which team should they be admitted under? They are not GPs and have nothing like the broad experience and training GPs have in identifying pathology.

ANPs etc. can't compete with GPs when it comes to diagnosis, they just follow algorithms and work within their niche.

But we'll done for trashing an entire specialty, adding to the GP hospitalist rivalry and stoking more anti GP sentiment when so many are burning out and leaving.

Suppose someone is on heart medication and needs regular reviews. That doesn't fit into emergency or minor injuries.

This is my DM, she's not getting reviews & has ended up in A&E & short of medication. Fab pharmacist though.

Not sure how it would work if you cant get to a hospital. GPs are meant to be in the local community.

Unless I was dieing I dont bover with my gp anymore. I need to change my BP meds but it's all such a hassle now. It took me about 6 years to get diagnosed with sleep apnea. If I had that time again I would go private to see a gp.

@Sidge

I would politely suggest you have very little clue as to what GPs actually do.

I would say it too. But not politely.