Virtual primary care concept

[Aindriu]

I have no issues with that damus. The NHS is not perfect but they do have a bloody good primary care system. Our GP's are not much more than glorified triage nurses for the A & E depts!

[damus]

I have no issues with that damus. The NHS is not perfect but they do have a bloody good primary care system. Our GP's are not much more than glorified triage nurses for the A & E depts!

We could do with the primary care system and some of the clinical expertise of the NHS in Ireland.

[Tweek]

Number of problems with this. Main one is that outside of rural or poverty stricken areas, GPs generally own their building* rather than use a HSE health centre, so any other HSE disciplines would have to rent rooms there. Also, they often do not have any spare space at all

For out-of-hours, the only service going at that time anyway is GPs, and the vast majority of areas of the country have a full-coverage OOH co-op. Except my town, which appears to be a freak of admin in lots of things.

On the software side of things, both the main GP providers have PCT systems, at least one of which has full inter-referral, restricted sharing, etc and would allow scheduling. But deploying this to allow people to use multiple locations for a PCT would require merging data of multiple private businesses (the GP surgeries) and a massive IT investment (centralised servers or "cloud" which is realistically the same thing with a buzzword)

*there are a very few exceptions, but most of the believed-to-be-exceptions are cases where the HSE rents space off the GPs in the same building, e.g. Kilcock, Letterkenny, Mallow, etc.

[patslatt]

"The government should get VHI and insurers to incentivise prevention with GPs." WTF have insurers to do with this? Just stop patients having to pay to use GP services FFS!

Insurers and HSE medical card service could play a bigger role in preventing illness if they contracted with doctors on an annual capitation fee for the insured instead solely on fees for services which encourage cures over prevention. Part of the capitation fee contract should include health checkups on patients,the frequency of which would be determined largely by age and by medical history. Checkups should be accompanied by a simple questionnaire on diet (focus on frequency of consumption of fast food,fizzy drinks,cakes,crisps), exercise (daily minutes walking,cycling,gym attendance,sports participation),alcohol consumption and cigarette smoking and some advice on healthy habits.

[patslatt]

I have no issues with that damus. The NHS is not perfect but they do have a bloody good primary care system. Our GP's are not much more than glorified triage nurses for the A & E depts!

What do Ireland's PCT's lack?

[Tweek]

What do Ireland's PCT's lack?

Buildings, generally.

GPs in some cases (there are PCTs where no GPs have joined).

We get people on here screaming that GPs need to be "competitive", PCTs ensure they aren't by making them work very closely together, often to the point that surgeries merge because they need to be able to access each others records.

[drzhivago]

The government's plan to create primary care facilities to become the core of the health care system seems to largely aspiration rather than action as is typical of many government plans over the years.See Primary Care - Executive Summary The slow rollout of primary care may reflect lack of financial incentives for group practice, unwillingness of GPs to work in teams that provide a 24 x 7 service and over reliance on expensive A&E units for out of hours service.

The concept of virtual primary care could provide an alternative to primary care in lightly populated areas with good road systems and light traffic outside rush hour. With the use of software for primary care team scheduling,team members could be scheduled to work at various intervals in GP offices or called in to work within short periods when on call for emergencies. Of course,such an unconventional set up would be accepted reluctantly at first,just like working from home instead of the office.

Couple of thinsg to consider here Pat

Firstly am not a GP so my opinion is not slanted by fear of this being my work

Second in the primary care Universe the only person who will be available 24-7 will be the GP and no one else

The only person not funded to attend meetings to plan the primary care developments is the GP and yet they are slated for non-participation - who exactly will be seeing their patients while they are attending these meetings????

[patslatt]

Buildings, generally.

GPs in some cases (there are PCTs where no GPs have joined).

We get people on here screaming that GPs need to be "competitive", PCTs ensure they aren't by making them work very closely together, often to the point that surgeries merge because they need to be able to access each others records.

Ireland is awash with surplus commercial property,so costs of leases on vacant property have dropped drastically.

An investment in digitised copying machines could solve the problem with accessing records in different locations. The copied material can be uploaded automatically to networked computers.

[tokkie]

Buildings, generally.

GPs in some cases (there are PCTs where no GPs have joined).

We get people on here screaming that GPs need to be "competitive", PCTs ensure they aren't by making them work very closely together, often to the point that surgeries merge because they need to be able to access each others records.

Got a flyer in the door tonight. The family can join a GP scheme for 30 per month that grants us unlimited Doctor's visits.

[Tweek]

Ireland is awash with surplus commercial property,so costs of leases on vacant property have dropped drastically.

A warehouse or office block is not suitable for use as a PCT centre without serious investment. There also isn't even semi-suitable vacant property in every town in the country and generally, the areas which have had the most businesses leave, will already HAVE a PCT centre - they generally went in to poorer areas first.

An investment in digitised copying machines could solve the problem with accessing records in different locations. The copied material can be uploaded automatically to networked computers.

That requires consent to be given and most importantly, a person to do the "copying" and at the end you still get left with effectively paper records - a scanned record is a photo, not an EHR.

That's not a "solution", its a horrendous additional burden.

Also you don't seem to realise that at least 60% of GP surgeries are either completely paperless or paperless after a certain date - they don't HAVE paper records to photocopy for someone.

Got a flyer in the door tonight. The family can join a GP scheme for 30 per month that grants us unlimited Doctor's visits.

Guarantee you that the place offering that doesn't take medical cards. I can probably also guess who and where it is...

€30 a month is significantly more than a medical card GP gets for a couple (that's closer to €10 a month) and I think its basically the same as they get for a family of 2+2