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Looking after our patients… and the NHS
In the first of a series of blogs looking at how the NHS is coping with winter pressures, a GP in York reports from the front line of primary care:
I write this blog post on a Thursday evening after a long day seeing patients in our urgent care clinic, that is same day appointments.
It is the first week in January and we are well and truly in to cold and flu season. The majority of patients I have seen today with a cough, sore throat or sinus pain have been diagnosed with a viral illness after a good check over.
Today’s clinics got me thinking not only about how we can help our patients feel better, but also how we can help the NHS as a whole this winter.
One observation is that some patients seek medical advice quite early after the onset of their symptoms. It is useful to remember that the majority of sore throats, coughs and runny noses will resolve within 7-10 days. If you don’t have any pain killers or lozenges that will help at home then do go and see your local pharmacist who can give advice about medication that may improve your symptoms.
Most viral illness are what we call ‘self-limiting’, in other words they will resolve on their own in good time, but they can make you feel dreadful at their peak. Being diagnosed with a viral, rather than bacterial, infection doesn’t mean we aren’t taking your symptoms seriously, it just means that antibiotics will not make you feel any better.
For those patients I did prescribe antibiotics to, the majority were over 70 years old or had an underlying condition such as asthma or chronic obstructive pulmonary disease (COPD).
I had a discussion with one patient with COPD about what she could do to prevent herself getting poorly over the winter. I recommended keeping her house warm, wearing layers, eating well, ensuring she doesn’t run out of inhalers and taking up the opportunity to get a free flu jab.
We want to keep our patients out of hospital if we can, and early recognition of infections in patients with chronic conditions can be helpful.
I always finish a consultation with some ‘safety netting’ – this is where a clinician will explain when a patient should seek further medical advice if symptoms get worse or don’t improve. I try to set a specific time frame and who to contact – NHS111, A&E or the GP surgery – and when. NHS 111 is a really useful resource both in working hours and ‘out of hours’ as they can signpost patients to pharmacies, the out of hours GP or an emergency dentist as appropriate.
The NHS is here to help us all, we need to protect it and one way we can all do this is by seeking advice from the right service at the right time.
While I applaud the thought of being directed to Pharmacy 111 etc. it does concern me that people dont know the difference between a viral or bacterial infection and that is why they seek your advice if people with copd think I wont bother complications could set in. Surely a paramedic or pharmacy based at practice be better than adding to the added pressures at pharmacy. With people gradually learning to adapt to Pharmacy or 111 as matter of course.