Most GPs are very aware of the importance of good communication with colleagues involved in our patient’s care and the principles are very well laid out in Domain 3 of the GMC guidance to all doctors. We need to share all relevant information with our colleagues, and we need to be clear about where clinical responsibility starts and finishes.
Most GPs are very aware of the importance of good communication with colleagues involved in our patient’s care and the principles are very well laid out in Domain 3 of the GMC guidance to all doctors. We need to share all relevant information with our colleagues, and we need to be clear about where clinical responsibility starts and finishes.
Ideally, we would send a quick note to the NHS GP each time we see a patient who is registered with an NHS practice. This will include any problems that have been raised, any data from examining the patient that might be relevant and details of medication prescribed. The NHS GP will then be aware and will hopefully enter the data we send; they may be pleased if this forms part of the QOF data, but they will prefer to receive itin a form that is easy for them to transfer to the record. It will also reduce the risk of management issues such as double prescribing or drug interactions. And any important diagnoses will hopefully make their way onto the summary care record.
There are a few problems that private GPs can encounter in the process of transfer of this data the first being that often patients don’t tell their NHS GP that they are seeking GP care from a private provider; they may not want to jeopardise their relationship with their NHS GP and feel disloyal going elsewhere. Or they may have other reasons such as wanting to avoid revealing certain diagnoses to the family doctor. It is quite common for patients to decline an offer for the private GP to send a summary to the NHS GP for these and other reasons.
There are a few other practical issues that make communicating with the NHS GP quite tricky. For a start some software packages make printing or exporting a single consultation summary almost impossible though anyone using EMIS knows that on the bigger systems this is pretty straightforward. If you can print consultation notes one option is to hand this to the patient if you are seeing them face to face, or if seeing them remotely export the consultation printout and send to the patient. This avoids all the consent for sharing of information. But you do need to find a secure way of emailing if this is what you choose to do.
The GMC are keen for us to avoid using anything that is unencrypted. The ideal is a PDF attached to a SMS text message which has some security so that it can only be opened by the receiver – and ideally it will be deleted after 30 days so that it can’t sit on your device and be opened at a later date. Failing that you can use encrypted email which is not without it’s frustrations especially if you are used to using NHS email which makes life a good deal easier.
And by the way every independent GP can request an NHS mail address and if you are sending to another NHS doctor there is no requirement for additional encryption – so this is ideal.
Some practices have found a way to use Docman Connect which sends messages directly into the NHS software task system. That is a pretty good solution as it is safe and direct. It requires patient consent and an NHS number but works well.
The absolute ideal which many private GPs are hanging out for is to be able to write back into the NHS record. Certainly in the patient’s best interest but various independent forums have been pushing for this for a while without much joy. But who knows? If GMC standards are to be followed there is a real case for making this an option for private GPs.
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