Bury Good News

And it came to pass on the last Thursday before Christmas recess, the government published 424 documents, and lo, said the three hundred wise men, they are burying bad news.  But verily I say unto thee, there is a greater sin in the land of UK,  burying good news.

The truth is that almost everyone has an interest in bad news.  The Daily Wail sells newspapers with crisis, and NHS providers get money for crisis.  Jeremy wants more winter crisis to squeeze cash out of George.  The RCGP wants a workforce crisis to get more of a slice of it (looks two faced when trying to recruit, but hey).  The Patients’ Association exists for crisis.  The BMA are past masters at crisis.

Moans have fallen, moans on moans, yet right there in their very own BMA News, buried in a story about unmanageable workload, is GP Dr Toni Hazell saying, “the system has hugely improved our access and is beginning to go down better with the patients.”  They have introduced a fully GP led telephone triage system.  “When patients know they can get a same-day appointment, they are more prepared to wait and see… it’s really nice when I can say to patients, yes, let’s see you today.”  And she is pictured in print, affirming “unsustainable demand reduced by triage.”

I’ve been to BMA House twice and had a nice cup of tea.  Same at Richmond House, same NHS England.  They’ve done nothing.  They will try everything and anything that doesn’t work, when the good news they all mortally fear is right under their noses.

We didn’t work directly with the featured practice, but it’s similar and I love it when people discover good news themselves, although we know that most need help to change quickly and reliably.  We were delighted when another outfit discovered Clarendon in Salford and made a video of it.  Worth five minutes to see Jeremy Tankel saying how safety has improved.

None of this takes reorganisation, regulation, incentives or shaming.  It means opening your eyes to good news.  The crime of burying it keeps millions of patients suffering, and thousands of GPs at the end of their tether.

Good News at Christmas?  There’s a lovely carol you will probably sing, think on the words

“How silently, how silently, the wondrous gift is given.”

Dr Sara Cowell

PS  If you don’t fear dying of laughter, @jtweeterson’s Christmas gift ideas are unmissable.

Planning a meeting for your locality, federation, board or CCG?  We’ll be sharing some very good news early in the new year, would love to come and tell you.

3 responses to “Bury Good News”

  1. David Evans says:

    Sensible and appriate management of demand by a triage process which provides timely service delivery is the only show in town.

    Patients trust it because they know it provides safe and timely care from health professionals they trust.

    Health professional like it because the patients they see after triage clearly need a consultation.

  2. narsh says:

    The big problem with telephone triage is the psychological damage and burnout that it puts on the GP. It also does not allow work planning when people are on leave etc.

    Is it at least partially responsible for the GP crisis? When we advertised for a new GP, 6 of 10 applicants were wanting to leave a triage practice due to the brutal workflows.

    • Dr Sara Cowell says:

      GPs tell us consistently that they feel in greater control of their day, and while it isn’t easy, it is a better way to run the practice for them as well as patients.
      But there are ways of doing it badly, mostly because of hybrids or simple mistakes. For example, having a duty doctor do all the phoning is a very bad idea. Sharing the load works well, and means GPs usually see the patients they spoke to earlier if they need to.
      Of course it allows for planning leave - demand is highly predictable, so it’s easy to plan how many sessions you need. If you put on too few, the demand will still be there, whatever system you have.
      Many have tried and failed to introduce a tel triage system, and taking months failing. We do it very quickly and give GPs the confidence to do it right.

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