No-one who reads a daily paper or listens to the news can fail to be aware of pressures in all areas of health and social care. Primary care services have been one of the focuses of attention in the media recently. It is often difficult to equate our own personal experiences of receiving care from GP’s and their colleagues with what is said in the press but our experiences in the Trust recently provides a couple of good illustrations of the pressure in primary care and its impact on the people who live with us and on the staff.
One of the senior staff was rung by a GP in a local surgery a few weeks ago; his call was to warn us that they were withdrawing the specialist nurse service that they had previously provided and that they would no longer visit the Home unless the individual was ‘bed bound’ or ‘at the end of their life’. His words, not ours.
They gave us two working days notice of this change. Interestingly, this surgery started providing a weekly nurse visit a few years ago at their own volition, not at our request. I was concerned at the time that it provided a reason for them to ‘put off’ requested visits at the beginning of the week with the response ‘well, they could see the nurse on Thursday’. We seemed to get used to this new regime but it is now gone and although the GP’s have subsequently sounded less bullish, it has provided new challenges.
As always, in a ‘can do’ organisation we have tried to respond positively. Several residents have been pushed down North Hill (and back up) to see GP’s or nurses in the surgery. We have purchased and will trial a motor which can be attached to a wheelchair to give the member of staff more control up and down the hill. We hope that the GP’s will work on improving their disabled access which is, at the moment, stunningly unsatisfactory. The impact on our own staffing is obvious as the return trip and consultation means that at least one (or two for some residents) people are out of the building for at least an hour. A further reaction to the pressures in primary care was a different GP from a different surgery asking whether we were being paid separately by the NHS for end of life care. We responded ‘no’ as we are not, and the GP proceeded to explain that they were struggling to meet the demands of this group of people. I have no doubt that primary care services are struggling (as much as we are) with the needs of an increasingly frail and medically unwell group of people who are now being cared for in the community and not in hospitals as they would have been previously.