NHS Hot Topics Flashcards
What are the consequences of increased demand on GP/Primary care services?
An increase in wait time to see GP, leads to illnesses going untreated which leads to more A&E admissions
Patients go to A&E because they can’t see their GP
Unsafe patient levels, some GPs seeing 60 patients a day leads to a fall in quality of care, more inaccurate diagnosis and missed diagnosis which causes a knock on effect on secondary care etc.
Exacerbates understaffing issues as it discourages foundation doctors from going into GP training seeing how they work and how they are treated.
What are some of the reasons behind the increased pressure on primary care?
Understaffing + under recruitment- struggle to convince foundation doctors to enter GP training, schemes like the ‘Golden Hello’ are needed to encourage them to work in areas that desperately need GPs.
Unnecessary appointments- following COVID there has been a huge increase in number of appointments, partially because of people going without care and partially because of people’s increasing healthcare anxiety/paranoia, become increasingly reliant on the GPs and leads to many unnecessary appointments
Aging population- higher proportion of people living with chronic illness, need more frequent care to support their living
Can you think of any strategies to reduce strain on A&E departments?
Inclusion of primary care within A&E departments so following triage they can be sent to either main A&E or an on-site out of hours primary care facility, will not only reduce waiting times but also improve quality of care as they have specialist.
Increased primary care funding- more primary care staff means fewer patients go untreated which leads to fewer A&E admissions as well as unnecessary appointments because they cannot see their GP, this reduces waiting times and means more A&E departments can meet the 4 hour target
More beds + A&E staff- finally the most direct approach is to hire more staff and have more beds, because a lot of the waiting in A&E is as a result of beds being full as there are more chronically ill patients in hospitals as well as a general decrease in number of hospital beds over the last decade.
How can policies and technologies reduce strain on GP practices?
Increased staffing- policies such as the ‘Golden Hello’ to try to encourage more FY doctors to work as GPs especially in areas where they are needed most
Funding for more nurses, physiotherapists and HCAs- reduce the number of appointments that could be better handled by other staff but are given to GPs
Social prescribing link workers- 1/3 GP appointments don’t require a nurse or GP, instead by implementing social prescribing they can give a higher quality of care as well as freeing up GP appointments for patients who need them more urgently
Social prescribing can also free up NHS funding so it can be redistributed into other areas where it is needed.
Telephone consultations- reduce the number of unnecessary appointments by performing triage remotely and only inviting patients that need to come into the surgery in
Government agreed to extra £4.5 billion in funding into primary care by 2023/2024
Can you explain some of the main issues facing the NHS at the moment?
Ambulances- ambulance response times are not being met, average for category one is 8:36 which is still a minute and a half slower than the target and category 2 is 40 minutes when the target is 18. Mainly caused by hospital beds being full as paramedics have to stay with patients while they wait to get them into A&E.
Backlog- COVID meant that elective procedures were canceled so there is a huge backlog for elective care, also a silent backlog of patients who went untreated and results in more A&E admissions
Care- shortage of care staff especially after Brexit as a lot of care workers came form the EU and a lot of current care staff were deported or chose to return to their home country
Doctors/Dentists- shortage of staff, massive GP shortages struggling to recruit new foundation doctors into GP training. Also struggle retaining doctors and dentists as many are retiring early or leaving to work abroad. 9/10 dental practices are not taking on new patients, so it is a whole NHS issue not just in primary care or A&E.
Does AI pose a threat to confidentiality and/or patient autonomy?
The implementation of AI requires giving private corporations have a greater role in processing and obtaining NHS patient information and this is a threat to confidentiality, an example is when a radiology clinic in London implemented AI from a company called DeepMind but then it was bought out by Google which meant that Google then owned the NHS patient data which was a big issue, so regulations must be implemented regarding the sale and storage of this data for the sake of confidentiality. Furthermore patient autonomy is at risk because AI changes what is uses data for and may use patient data in machine learning without the patient’s consent as it evolves, patients may also not be adequately informed when their data is going to be used by AI.
On a practical note the implementation of AI would also require the transfer of a lot of paper records into digital files of a specific format for the AI to use which could lead to issues in processing and make the data vulnerable to leaking and damaging confidentiality when making this kind of mass scale transfer
