GP case study: Diabetes
Dr Peter Gregory, MBBS MRCGP DCH, has been a GP for 30 years. 10 years of which was spent working in Sports and Exercise Medicine.
Prior to the introduction of a Phone Advice & Guidance service, Dr Gregory would phone or email a couple of consultants he knew directly if they worked in the right specialism. Otherwise he would use Advice and Guidance on ‘Choose and Book’: “Previously if I had a suspected urgent case, I would have been forced to try to admit the patient or phone a secretary to try to get a message to a consultant (that was often unsuccessful).”
The Surgery has been using Phone A&G, commissioned by South Warwickshire CCG and delivered by Consultant Connect. Dr Gregory says of the service: “The response is immediate and it is always better to be able to deal with the problem, resolve it and tick it off. Sometimes this is clinically crucial too.”
Using the Mobile App
We asked Dr Gregory what advice he would give GPs feeling unsure about whether to try the service:
“I have found it very useful and I would recommend that you have the phone number to hand and use it. It’s also probably worth downloading the app so that you can use it when out on a visit.”
Whilst most A&G is sought via the Phone A&G service, Dr Gregory still occasionally uses electronic A&G with a ‘letter’ dictated and sent through e-Referral when he has more time.
Below is a recent example of how Dr Gregory has used Phone A&G to benefit a patient who possibly had Type I diabetes:
“I was unsure if the patient should be started on insulin or oral hypoglycaemics. Usually I would manage Type II presentations myself, but admit children or teenagers presenting with Type I to paediatrics.”
How Phone A&G helped:
“The patient was anxious to do something about the situation and wanted answers from me straight away. The Diabetes and Endocrinologist understood the difficulty, defining this type of diabetes, and was able to start the patient’s management the same day through the Diabetes Nurses in the hospital clinic. Admission was never indicated, but a referral to outpatients would have taken some weeks at least. It felt good to have the management started within a few hours of the diagnosis. This was a great result.”
Related case studies
A GP in Lambeth used Phone Advice & Guidance to get A&G from the Rheumatology Team at her local trust for an elderly patient with swollen lower legs and joint pain.
One of the most common questions we encounter when discussing Phone Advice & Guidance is “what do the consultants think about it?” We sent a film crew to NGH to ask exactly that question.
Dr Manmit Kaur, a consultant on the National Consultant Network, answers a GP's Phone Advice & Guidance call - avoiding unnecessary referral for a patient with long history of body pain.
A GP in Milton Keynes CCG prevents an emergency situation for an ill baby by using Phone A&G from her local trust, Milton Keynes University Hospital NHS Foundation Trust.
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