Andy_W
Well-known member
Doctors still can be gatekeepers, but they don't need to be gatekeepers for all of it, and the aspects they do, some of that could be done online to streamline the process.What Stretting is referring to as doctors being gatekeepers is what’s called the single point of access. The problem is some areas have self referrals already in place for things like physio which is what he and Starmer are referring to
Let’s put it this way if a patient needs a new hip and an online referral is sent in you’re already legally responsible for that persons medical care. Secondary care won’t accept those referrals NOW without the patient being seen and a pharmacist is never going to have patients. They’re just not, nor are they going to be able to be qualified to do any investigation work such as XRs for the patient that secondary care may request before accepting the referral
They can say see a Doctor or Physio which happens now which means we’re actually not getting anywhere with pharmacists being a solution to the problems in the NHS
I'm not saying for a pharmacist to have a register of patients, I'm saying anyone should be able to go there for very basic care, anyone from any area to any pharmacist who signs up for it, and if it's treatable with basic care, treat them, give them some drugs and send them on their way. Put the liability on the patient, I'd happily take liability if I thought my problem was basic, if it meant easy in/ out. If I thought I had a big problem I'd go to the GP, or ideally someone who specialises in my problem, or a department which covers it.
Nobody is saying send someone who needs a new hip to a pharmacist, but equally, maybe they don't need to be seeing a GP if they're old and know they have a hip problem, things like that are so common we could have someone dedicated to that role alone, bypass the GP, or people just go to a department handling that and wait (straight to musculoskeletal, X-Ray dept or whatever). Same with many other things.
The system just doesn't work (as well as it could, even with low manpower), but it's just as much a policy, high-level management, organisational and waste problem as it is a staffing problem for those on the front line. It's also an education problem for the public, most don't know where to go for what, so go to the wrong place, taking up resources and appointments from people who went to the right place.
Here's one recent example (I've got a few). I had an impact injury to the outside of my knee, which for some reason caused foot problems, which was odd, rang 111, got passed onto someone else and within an hour I'd spoken to a specialist over the phone who talked me through some tests and said I've almost certainly got nerve damage, and need to get an MRI and see a knee & never specialist ASAP, but need to start via GP. 1 year later after getting passed around from the GP, physio and other areas (maybe 20 appointments, loads of drugs and various equipment), I finally got to see the knee & nerve specialist and it was confirmed I needed that MRI and some nerve tests and they would arrange an appointment. For some reason that never happened over the next year, and I got a call asking if I had my MRI, said no and the specialist went banana's (not at me, at their systems). Had the MRI the next week, the damage was confirmed, yet hadn't been treated for two years. It made the whole thing a waste of time and resources. I should have just been put straight on the MRI list. I'd have even went at 3am out of hours, or driven 100 miles for it, and done away with most of the 20 appointments in between. Almost every appointment said this isn't my speciality, and was all about dealing with the symptoms, not the cause. I feel guilty for how many resources I took up, by going to the wrong place over and over, before they let me go and see the person I knew I needed to see on day 1.