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Digital solutions to the challenges of primary care

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The effects of technology in primary care settings

The QNI is in a fortunate position to hear from nurses about the challenges and the solutions of working in primary care.

One of the most satisfying aspects of the role are the relationships that are built with patients, families and carers over many years, enabling the consultation to be the continuation of a conversation which started months or years previously and which has had many detailed and nuanced episodes along the way.

What patients say they want – in addition to a competent, knowledgeable clinician – is the continuity of care, with a practitioner with whom they have built a rapport. The challenge can often be securing an appointment with that person in a timely way.

The new digitally enabled services provide a novel way of accessing GP services. This service may not be ideal for every patient: as the website states, there are some people for whom a local GP service may be preferable.

Arguably, this excludes a large percentage of the population from registering to receive this service in place of their local GP surgery. It is important to consider however that there is a percentage of the population for whom this is a more suitable service. The young, fit and generally well young adults, for example, may value this easy access service, utilising digital technology which is already integrated into every aspect of their lives.

The initiative to increase access to GP practices in England with extended opening hours in the evenings and weekends is popular with commuters and people working full time over the same hours when their GP surgery is open. I am fortunate to have recently moved to an area where the local GP surgery offers ‘commuter clinics’ on three out of every four Saturday mornings, in addition to booked telephone consultations – one of which I experienced recently on a weekday at 7.30pm.

I was once told that the NHS was created to accommodate the majority of the population – like building a pair of shoes for only those whose feet are the most common size – so, size 6 for females and size 9 for males. For those members of society who have feet smaller or larger, the experience is uncomfortable and there will always therefore be a need to adapt the shoes to fit the shape of the person in need.

GP at Hand is providing a service to meet the identified need and over time, both this and extended hours will become a part of what we expect in society when accessing the knowledge and skills of the clinicians in general practice. We should never underestimate however the strength of the relationships and the trust that is built with face-to-face consultations for some – one of the joys and rewards of a career as a general practice nurse.

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