Needed one


Liverpool bound.  Well, I was…

The Widnes Vikings game, to thank them for their ‘Beat the Scrum‘ campaign.  The players and the club have an enormous influence.  They reduced inappropriate shows at A&E by over 7%.  They won our Academy award and another from The Chartered Institute of Marketing.

Health planners take note…

I was going to Liverpool.  Now… to Leeds and hope to fiddle my way across to Liverpool.  Someone jumped in front of a train near Milton Keynes… the Saturday afternoon trains, out of Euston, came to a grinding halt.

Thousands stranded, rerouted or turning around, to say nothing of the poor stranded soul, whose life needed rerouting and turning around.

Suicide takes courage.  More courage than it takes to live, perhaps?   

Slipping away quietly with a bottle of scotch and a box of pills is one thing.  Standing in the rain, on a cold bleak railway station, watching the light on the train get bigger, as it comes down the track.  Inching closer to the white line on the platform edge and then in a single moment of clarity, the decision is made… step into what’s next.

They say train drivers never recover.  I doubt families do, either.  What would it have taken for the lifeless soul laying in pieces under the train to put the pieces of their life back together…

Loneliness is a sad affair.  A job, a safe place to live and someone to love…

Events had me distracted; I was intent on reading the latest from the Nuff’s; ‘Divided We Fall‘… getting the best out of general practice.  

Is there anymore to get?

In my bag I still had Friday’s London Evening Standard with an unintended precursor; a survey from YouGov, saying; busy Londoners expected work pressures and suspected difficulties in seeing a GP, would delay them getting a cancer check.  One in five said they’d prefer to do a Google, first.

The Nuff’s; it’s a funny old report.  They claim to be looking into ‘the impact of ‘recent policy’ to segment general practice, into different types of services tailored to the needs of different patients’.

I wasn’t aware there was a ‘policy’?  There is certainly more than a few ideas to put GPs in A&E, get them visiting care homes and talk to you on the phone.  The Nuff’s claim this ‘risks undermining doctor’s ability to manage people with complex needs…’

It’s an argument that is easy to frame as nonsense.

Unless… unless you think about the fact we don’t have enough GPs for the day job, never mind anything else.  GPs have spent the last few years telling us how exhausting it is.  GP leaders, regularly regale us with shortages, the neighbours tell us about not getting appointments this side of Michaelmas.

Curiously the report condemns the one thing business will tell you works.  Segmenting the customer base.  Sorting out who wants what and where and making it easy.

I don’t want a GP I can’t see before I get on the morning train, or a GP that closes before I hit the hometown station.  Neither do the 800 people on the train and the quarter of a million at Waterloo.  On the the other hand, The Duchess would only see one GP, if it meant she’d wait a fortnight.

Families, increasingly, want reassurance or advice on FaceTime.  There and then.  And, the evidence is, they’ll pay for it.

GP business are going broke.  A business based on buildings in a world that is seeing the closure of the high street, big-name brands shrinking and corner shops disappearing.

Unless the GP contract is demolished and rebuilt around a fluid, digital, innovative, flexible, segmented, on-line, off-line, in the high street, at the train station, care homes, community centres, pop-up, hospital based, run with Nurse specialists in the front line and the back-office run by CRM systems… it’s a Ford Anglia in an Audi world.

Primary care is too important to fossilise.  

We need our GPs when we need them, where we need them.  My guess there was someone in Milton Keynes, last Saturday, who needed one.


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Reproduced at by kind permission of Roy Lilley.