A GPs Voice

Primary Care
  1. Pressure to not admit  people –  fair enough – but can be overdone and mean people are not admitted who should be
  2. Bad experience  esp for elderly frail in hospital, especially A&E,  so they wont go back even if that seems the best  course for them
  3. Lack of capacity in emergency social care – so people  have to be admitted as there is no where else for them to go
  4. Lack of community social care so people end up stuck in (sometimes dying in) hospital when they  would rather be out
  5. Slow response of  social care from council  so that  realistically most of our referrals for social care  are emergency ones
  6. Ambulance service overwhelm so that sometimes people  wait for  hours on the floor  or even with chest pain and  we get called to cover 999 calls they can’t get to
  7. Housing crisis- I  dictate  1-2  letters a  day re people’s  problems
  8. Stress and anxiety caused by benefits  reviews and assessments. We don’t have a great deal of input strangely now into the original benefit application  forms so we tend to only see the fall out eg the distress in anticipation or  after the assessment
  9. The common finding that at review benefits assessments are reviewed in favour of the claimant but financial issues common whilst in the process of assessment
  10. Consequent low morale in the medical ( and other associated professions ) associated with the sense of failure to deliver adequate care  when resources  do not permit ,but where provision of adequate care is seen as a personal / practice responsibility
  11. Increasing complexity ( age new treatments etc ) and increasing cohorts  with multiple morbidity /  age  – but no increasing resource to adequately serve that need
  12. Short sighted  cost cutting choices – eg  health visitor numbers  district nurse numbers  GP numbers – all below full complements –tendency for the loudest voices to be heard and consequent further entrenchment of the “ inverse care law”
  13. Removal / scarce resources for independent  housing/benefits  advice – bht are  good. CAB now very hard to get appointments  – but my experience is  successful benefits  appeals  need you to be very switched on or have  support from  an organisation with experience of what “ boxes to tick”

First published by the War on Welfare blog