A GP’s voice

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 switch on or have  support from  an organisation with experience of what “ boxes to tick”

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