The increasing case for interface

6 November 2020

The need for robust public messaging

No one can be in any doubt that we are in the midst of the second wave of the COVID-19 pandemic. Rising case numbers; rising hospitalisations and tragically rising deaths. 

It is hard to find positive news as a GP, or indeed as any health worker in the current climate. We are all aware of increasing frustration and criticism from some of our patients, from the media and from politicians.

There appears to be a disconnect between public expectations and the reality of the pressure the service is under on the ground. The College has repeatedly pressed the need for realistic public messaging to be delivered to the public on this and continue to do so in all interactions with MSPs, the Scottish Government and the press.

Understanding that the health service needs to prioritise its efforts to ensure that those most in need of care are able to access it has never been more important and coupled with the message that general practice remains open (and indeed the service has never closed) must be heard.

To help deliver this message to patients, Carey has recorded a short video for patients on how they can access general practice over this time which is now available on the NHS Inform website and YouTube

Yesterday, the College launched a new UK-wide ‘General practice is open’ campaign and there’ll be a range of further activity over the coming weeks. You can read more on the website and on Twitter.

Green shoots of improved communication

One of the positives I have noticed in my area, are the first green shoots of improved communication between primary and secondary care.

Right at the beginning of the pandemic our local GP leadership set up a regular weekly, now monthly, Zoom meeting.

Run by GPs, but with input from Public Health, Respiratory, Paediatric, Palliative care and other consultant colleagues it became the go-to for updates and information.

One of our secondary care Respiratory leads when presenting COVID-19 care at a hospital Grand Rounds credited this communication channel as one of the major reasons why the region was able to muster a good response to the pandemic.
Professional to professional conversations about patient care and use of software and systems such as Consultant Connect to facilitate this are going to be increasingly important as we try and manage the rising tide of cases without one sector or another becoming engulfed.

Improving the primary, secondary care interface

The RCGP along with the BMA continues to make the case for initiatives that improve the primary/secondary care interface and we should be in a position to share with you very shortly a shared set of principles for interface working. Persistence is starting to bear fruit.

In May in a letter to Health Boards regarding remobilisation, Professor John Connaghan, Interim Chief Executive NHS Scotland wrote: "It is strongly advised that all Boards formally establish interface groups with primary/secondary care involvement to support whole system recovery."

We need these groups now not just for remobilisation, but to discuss and manage how the whole health and social care system copes with the burden of care that the second wave of this pandemic is bringing. These may be new groups, or as John Connaghan intimated, built on existing foundations.

I was visiting a practice in Orkney recently and was struck by how universal the concerns about interface in our health service are.

Different areas are likely to have different causes for the difficulties. Here they told me they felt they had a stable and committed primary care workforce, but they found themselves trying to communicate and interface either with secondary care departments based in different mainland Boards or with secondary care departments based on the islands but with high consultant turnover.
This is why local groups who understand local needs and services are so important.

Enhanced communications with a shared understanding of the pressures on each system can only be a positive help if we are to weather this storm.

Post written by

Dr David Shackles, RCGP Scotland's Executive Officer for Interface and Out of Hours

David is a practising GP partner in Perth, where he has worked for 26 years and also works as a GP trainer, helping to build the future general practice workforce.

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