The future of general practice according to Rutland columnist Allan Grey
It cannot have escaped the nation’s notice that all is not well with our beloved GP practices, writes Rutland columnist Allan Grey.
A trial has been run in the Home Counties and now, following a 30-minute training session, receptionists across the country will be getting ‘a little more nosey’. Using a group FaceTime call, not the old dog and bone, they will be asking everyone a few more intrusive questions.
The good news, however, is that you’ll be able to see the 47 people in front of you in the queue - unlikely to be a pretty sight though. From September they will be undertaking initial triage, trying to determine who deserves a two-minute Zoom consultation with one of the five remaining UK GPs, and who needs to get a life and pull themselves together.
Questions such as, ‘Do you know what day it is?’, ‘How many fingers am I holding up?’, ‘Who is the Prime Minister?’ and ‘Can you spell endometriosis?’, will immediately sort the wheat from the chaff, those in need of medical assessment, and the other 98 per cent known as the ‘worried well’.
Failure to answer any of these questions correctly will mark you down as in need of immediate neurological assessment, and you will be directed to the practice website to search for one of this year’s three remaining appointments. If you answer four out of four correctly, it will confirm there’s absolutely nothing wrong with you, but if you believe you still need help with that broken leg, that dose of salmonella, or those pesky haemorrhoids, then please refer to Dr Google and stop wasting NHS time.
Alternatively, you could be instructed to find your nearest ‘walk-in clinic’ - tough if you’ve broken your leg, in which case you will need to quickly apply a splint, or find some crutches before bothering them.
Recruitment and retention of GPs has become an increasing problem across the whole country. However, advances in global communication technology post-covid means that the five UK GPs will work remotely, including the two non-retiring GPs from their holiday homes in the Caribbean. Based on the remote working approach being adopted by the NHS, the principle of ‘Health and Happiness at Home’ will feature prominently as the future strategy for GPs in Rutland.
Local GP practices are in the process of setting up a number of collaborative ventures, the first being with ‘Men in Sheds’, who have agreed to build Rutland’s first MRI scanner from 100 per cent recycled components. The Men are making good progress, but are a little short of magnetism, not personally you understand, and so are asking all grandparents to scan their fridge doors for any redundant magnets that could be donated. Once completed, the men will offer MRIs down at Oakham Enterprise Park every other Wednesday. Bring your own headphones, choose your own music. If this trial initiative succeeds, they intend to develop scaled down versions of MRI, X-ray and ultrasound scanners small enough to be located in the shed at the bottom of your garden, totally in line with the new DIY principle. You can pop out after breakfast, cut the grass, prune a few roses, and then check for kidney stones or a brain tumour.
One of the five GPs will soon be presenting a video for those that suffer digestive disorders, bloating, constipation, that sort of stuff, in another collaboration, this time with the aptly named ‘YourTube’, sorry YouTube. Dr Sore Rearend will demonstrate the practice of self-administered colonic irrigation therapy in the privacy of your en-suite bathroom. She will let you know how long a plastic tube you need, how to sterilise it, where exactly to insert it, how to calculate flow rates, and finally, how to clear up the revolting mess afterwards.
Apparently regular colonic hydrotherapy has a number of additional benefits, even it is claimed, boosting your concentration, so much so that most recipients can remain awake all the way through The Chase, Emmerdale and Coronation Street, after tube removal of course.
UK practices are hoping to encourage more people to diagnose their own conditions, before uploading the results for scrutiny by the receptionists, who by this time will have at least three hours’ training under their belts. In order to achieve this, practices will be trialling a new NHS app, ‘Patient Heal Thyself’, which is being developed for both Apple and Android smartphones, and will become the normal way to communicate your symptoms to those triage receptionists and the five remote working GPs. For elderly people, and those unable to get to grips with the new technology, either due to arthritis or IQ, a collaboration with Amazon will see all of their 375,000 UK van drivers trained to examine patients, take blood samples, administer B12 injections, take blood pressures, ECGs, and even listen to your chest or heart using just their left ear whilst simultaneously checking their mobile phone for their next appointment. Rest assured, drivers will be kitted out with single use latex gloves for those more intimate examinations, and will immediately email you photographic evidence of the results.
It is expected that when drivers are full trained your front door examination will take less than 90 seconds. Your medication records will be held by Amazon, and individual dosette boxes containing your statins, your blood thinners and your cannabidiol cream will be delivered to your front door in a grossly oversized cardboard box. Dr Rearend is recommending that all patients sign up for an Amazon Prime account immediately to ensure they receive ‘next day’ treatment, most likely between 1.30pm and 3.30pm, something practices see as a significant advance over the current situation.