PRIMARY HEALTH CARE SERVICES: SOME QUESTIONS TO GP (GENERAL PRACTITIONER)
Being independent the services offered by GPs will vary. There is great debate at the moment on whether or not GPs should be allowed to advertise. I think advertising could improve the standards of many practices and give some people an element of choice, depending on the services offered. The elderly as a client group and carers looking after the old should ask a GP some fundamental questions.
Does the practice use an age/sex register?
This allows the GP to be aware of the elderly population in the practice and develop schemes for their benefit.
Does the practice do its own house calls out of hours?
The elderly especially need continuation of care. The use of deputizing services often means inappropriate measures being taken and poor communication.
How does the practice arrange the special services for elderly people?
Who does the screening?
Is it available if you are under the age of 75?
What does it cover and include?
Does the practice follow up if you miss the first request?
Some GPs offer well woman clinics which may welcome elderly women. I do outpatient clinics in GPs surgeries enabling specialist opinions to be obtained without the necessity of a trip to hospital.
Does the practice offer regular (once every six months or year) visits to the elderly house-bound?
Does the practice regularly review medication and give cards or printouts of drugs being taken?
Many practices by using the age-sex register are able to identify the elderly in their practice and make arrangements for them to be seen regularly.
District nurses are fully qualified nurses who have undergone specialist community nurse training. Their job is a particularly hard yet rewarding one. A group of nurses usually work out of a GP practice, allowing good communication between the two groups of professionals. Their work is extremely varied, from tending to ulcers and wounds, supervising medication, giving injections, helping the frail and sick in and out of bed and generally giving them rehabilitative care and nursing attention. They are also one of the main contact groups giving a kind word, making a quick cup of tea and just being there.
In many areas nurses are being less generalist and more specialists. Thus, there are some nurses who specialize in the advice on and treatment of diabetes. Terminal/palliative care and incontinence are other areas where nurses have become highly skilled specialists involved in all aspects of that particular problem. Some of the less skilled parts of nursing have been given over to other groups such as bathing attendants. This service should be available at least weekly, and more often if there are special problems such as incontinence. Bathing someone involves skills of its own, however, and these attendants perform a very special job.
Access to the nursing services is usually via the GP but direct access can be made through the district nursing headquarters, the telephone number being in the book under Health Authority.
Whatever services visit an elderly person, they and the carer should keep a note of the person's name and a telephone number where they can be contacted. The services concerned are usually very conscientious and aware of the need that is placed upon them. However, sometimes things go wrong (especially in these times of financial constraint), and then there can be nothing worse than not knowing if a service is going to appear or not. A phone call may solve the problem or at least it should afford a means of communication. If a complaint is justified, never be afraid to contact the manager concerned.
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GENERAL HEALTH
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