Clicks not bricks…

Training Primary Care NHS GPs Clicks not bricks...

News and Comment from Roy Lilley

The demise of Thomas Cook, the holiday company, is a tragedy for people who have lost their jobs, a disaster for people who have lost their holiday and very worrying and an anxious time for people trying to get home.

You have to feel for them all.

It’s easy to be a smarty but let’s face it, you don’t have to be a business guru to have see it coming.

Holidays are still selling well but the industry is compressed by DIY travellers, Air-BnB, the fluctuations in the pound and the ease with which you can book a holiday on-line.

Add to those trends, the manacle of a high-street network of shops, rents, heating, lighting, staff, managers, regional managers, costs and pensions and the upshot is obvious.

I well remember the first port of call, when deciding on a holiday, was going to the high street to collect an armful of brochures, taking them home, deciding where to go and back to the travel agent and booking a holiday with the advice of someone, who I bet, couldn’t show you, on a map, where you’re going.

Now, from the comfort of the sofa, I can find a place, see what others have said about their stay, read reviews, watch a video, make a booking, check-in, save the tickets and what-not in my iPhone ‘wallet’ and the jobs a good-un.

It’s easier, quicker and cheaper.

Progress is no respecter of the past and new technologies have no allegiance to what has gone before. Holidays, like a lot of other things are now about clicks, not bricks.

You know all that. There is scarcely a nook-and-cranny of modern living that has not been touched by technology. And, you know what I’m going to say next…

GPs have the high street shops of the NHS. They are the travel agents. The first port of call.

Of course comparing a visit to a GP, to a travel agent is bonkers but it is the same manacles, overheads, staffing and back office costs that are dragging primary care backwards.

We have to wake up to the fact that surgeries are closing and as the pressures mount, doctors are leaving and young doctors turning their backs on the pressures.

Health planners are papering over the cracks by telling us we don’t need to see a GP.

An unregulated care-navigator can send us, with our backache to a Zumba class or physio and that’s OK.

How many times will they miss a metastasised breast or prostate cancer? I dunno but one is too many.

The general rule of medical care is; see the most qualified, experienced person you can, as soon as you can. It works in A&E and I see no reason for primary care to be any different.

The solution to the crisis in primary care, and crisis it is, is not for us to see a different person to a GP, it is to see a GP, differently.

You can buy a Virgin holiday on-line and in the high street, you’ll find them, a store within a store. Usually a department store. It’s cheaper and adds to the footfall. Everyone wins.

Primary care? Of course there will always be a need for a face-to-face consultation.

With an electronic health record, owned and accessed by the patient (a-la Australia), it doesn’t have to be somewhere with huge overheads and costs, it can be in a store, in a supermarket, in any of the places we go everyday.

For the rest of us, a video consultation, on our phone, on a lap-top, will probably do the job.

It means the end to the complexity of how we reimburse GPs, and the beginning of a new way of training them, to be confident on-line.

It means a different approach to our healthcare, reflecting the way we live our lives now and not the way we lived our lives in the 50’s and 60’s.

Progress is no respecter of the past and new technologies have no allegiance to what has gone before.

Holidays and healthcare, like a lot of other things are about clicks, not bricks.

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Reproduced at by kind permission of Roy Lilley.