Shropshire medic tells A&E patients to 'get a grip'

GP Dr Simon Chapple is an associate member of Shropdoc and also works at Telford's Princess Royal Hospital.

He says he sees at first hand the pressure created by patients who do not need emergency care.

"The NHS is so overstretched I think it's high time for people to start being socially conscious. We live in dark times and we've got to do something to reverse the decline in social responsibility. Folks have gone soft. I say, 'get a grip'," the GP said.

Dr Chapple said he was frustrated by delays in the Future Fit review of A&E and action must be taken now to prevent a winter crisis – but said it should start with people using NHS services responsibly.

He urged the public not to rely on their health services being "safe" as it continues to struggle under the weight of "unprecedented and often inappropriate demand".

Dr Chapple today said the public has a bigger role to play in helping to break the "vicious cycle" of factors that continue to contribute to the "mess" of the NHS.

The doctor, who emphasised that he was talking as a GP rather than in his Shropdoc director role, warns the NHS in Shropshire is in "chaos", with winter in A&E set to be "disastrous" once again.

But he says the onus should be on patients to help relieve the pressures.

He says people should accept some responsibility for their own health and wellbeing, by avoiding A&E departments unless a true emergency and to make use of other services, such as Shropdoc, a local out of hours GP service, or 111, an NHS non-emergency number, instead.

"When the NHS works, it works beautifully but that is often down to the tenacity of staff working in the system rather than the system itself," Dr Chapple said

He today told of his frustrations at working in a "failing" system as the health economy plunges further into debt, the staffing crisis worsens and hospitals battle with exit-block due to a lack of community care beds, along with failing A&E targets and the knock-on effect of overworked GP practices that remain in need of real investment.

This, he claims, has become a crisis worsened by those who visit A&E when they don't need to and the ongoing delays by the Future Fit programme.

• Take responsibility for your health.

• Ensure you have sufficient medication to cover the holiday period.

• Know your own GP practice opening times and contact details.

• If you have a long-term condition like, for example, chronic obstructive pulmonary disease, have a written plan for what to do if you become more unwell. If this involves ‘just in case’ meds then make sure you know how to use them.

• Write down a summary of your normal state of health including medication and key readings such as best ‘peak flow’ in asthma. There are some apps available, for example healthfabric.co.uk.

• If you do have to go to hospital, make sure you take as much information as you can about your condition with you. Think ‘pharmacy first’ for minor ailments.

• Treat minor symptoms with simple remedies.

• Phone first for advice before going to A&E and think who you could phone first, friend, family, GP, dial 111, Shropdoc.

• 111 is the NHS non-emergency number. Shropdoc can be reached on 0333 222 66 55.

• Shropdoc is for things that can’t wait until your own surgery is open again.

• Trust common sense. If you don’t think your relative needs to go into hospital, especially if they are frail, then say so, as hospital is not necessarily a safe place.

• You’re much better off at home with a support network around you if possible.

• It is a myth that hospital staff can see your GP records.[/breakout]

Future Fit will determine how accident and emergency should be organised and is likely to lead to the closure of one of the existing units in Shrewsbury and Telford. The decision, which will eventually lead to one A&E unit supported by a series of urgent care centres, has been delayed until next summer, but Dr Chapple says the county cannot afford to wait for a decision.

He said: "Why should we wait to do something so obvious? Future Fit has become a complete dinosaur and feeds this idea that in Shropshire we need to consult everyone and their dog about 'stuff' to make it fit. Take the conversation about urgent care centres as an example. We should replace parochialism with established national evidence."

Dr Chapple, who hails from Shawbury and served as a military doctor in the RAF for 18 years, said: "The NHS was founded on patients' needs, not wants and it's still funded based on need.

"The NHS is so overstretched I think it's high time for people to start being socially conscious.

"We live in dark times and we've got to do something to reverse the decline in social responsibility.

"It's high time we started looking after each other better in our communities. If you have an elderly neighbour that you've not met before then knock on the door and say 'hello' and get to know them a bit; ask them how you can help this winter.

"Folk have gone soft. I can cite numerous examples of the trivial conditions some patients present with and in this day and age of vast amounts of information being available on the web there should be no excuse for it. Or maybe it's the sense of entitlement that some people feel. I say, 'get a grip'.

"The NHS is not responsible for your health, you are. I'm not having a dig here, I'm just speaking honestly as I see it having worked in the system for a while.

"Wouldn't it be great to start a new revolution in Shropshire and Telford & Wrekin where the tenacity and hard work of our predecessors produced the industrial revolution. Our revolution could be to recognise that we've all gone soft due to successive governments, not to mention TV talent shows, telling us we're entitled to pretty much everything. We must regain some fighting British spirit. I love Shropshire and I think folk here have got what it takes.

"This winter, once again, will be a disaster. I cannot believe how this keeps happening, it is a flawed system. Patients need to be open and honest and use the NHS safely this winter.

"Trust your intuition, ask a friend, phone 111, talk to your GP practice but temper their advice with common sense. If you are told to go to A&E and you think that's ridiculous advice then challenge that advice – use your gut instinct.

"There is an excess of minor cases at Princess Royal.

"Nationally it is estimated that 20 to 40 per cent of patients in emergency departments could safely be seen in the community – not to mention crowding in these units is unsafe."

Dr Chapple's comments come after the organisation responsible for healthcare in Shropshire was placed into special measures after it forecast a £10.6 million deficit.

Shropshire Clinical Commissioning Group is already receiving help from external experts who will work with the senior management team to tackle the deficit. Dr Chapple claims more could be done to tackle problems across the system, including the ambulance service, care in the home to hospitals and GP surgeries.

He added: "The communication between primary and secondary care is broken. There are not enough general physicians in hospital and too many specialists. The royal colleges recognise this. Hospital doctors can't be blamed for feeling anxious about patients as they are often too far removed from patients' normal state of health and when they find things wrong, through doing test for example, they feel they have to act on them. There's an erroneous obsession with illness versus function.

"I've witnessed so many times the frail and elderly being inappropriately conveyed to hospital because nobody was available to advise the ambulance crews about a safe community alternative.

"I could go on but I've probably said too much already. I thought it was about time someone 'in the know' said what's on everyone's tongues and warned the public to start looking after themselves and each other a bit while the NHS works out how to sort out the almighty mess they're in."