Repairing “frayed and broken” relationships between primary and secondary care

Published: 29th October 2015


The spotlight of national news fell on General Practice yesterday, as Jeremy Hunt promised to get to grips with unnecessary bureaucracy in Primary Care.

This was just one of the recommendations made by a paper published earlier this month by the Primary Care Foundation and NHS Alliance, Making Time in General Practice. What the paper is trying to do is find ways that resources can be freed up or used more efficiently in Primary Care, encouraging healthcare commissioners to create an environment of “whole system” efficiency.

This article looks at how one of the key recommendations of the paper can be achieved – improving the way the healthcare community learn from each other and communicate with one another.

Relationships between GPs and consultants have become frayed and broken

The writers of the paper were struck by how far the links between clinicians working within the health community had “frayed and broken”. Traditionally, GPs and consultants would spend time together at educational sessions and shared events, helping to foster a sense of being on the same team. Today there is little of this. By reducing investment in time for GPs and their consultant colleagues to talk and learn together, they argue that the NHS has missed a huge opportunity for all sides to reduce their workload.

To address this, the practical step recommended in the paper is for commissioners to require providers across the country to develop “local systems allowing GPs to discuss a case with a specialist and for hospital clinicians to speak direct to a GP, within hours not days.

Commissioners urged to introduce local telephone Advice and Guidance service for GPs

Not surprisingly, the authors of the paper believe that the key to improving communication between GPs and consultants is a service whereby GPs can discuss cases with hospital specialists “preferably by telephone and preferably on a telephone number where either party can be sure of an answer.

This supports one of our key beliefs at Consultant Connect – that verbal communication is more efficient and effective than written communication. As one of our colleagues says, if written communication was so good, we’d all write things down and show it to each other rather than speaking! During a spoken conversation, the important facts can be easily elicited and questions answered instantly. In writing, this takes much longer – even if both participants in a conversation respond immediately by email.

In fact, the shift towards email correspondence over the last few years is arguably one of the main reasons for the breakdown in communication between GPs and consultants. We’re not saying that it doesn’t have its place – it does. Just not at the expense of people actually speaking with each other.

Consultant Connect as part of how commissioners can implement changes

Consultant Connect provides a simple telephone solution for GPs to discuss patient cases with consultants. Calls are typically connected to local hospital consultants in under a minute, with around 90% of calls being answered.

Our own research has shown that Consultant Connect can help build relationships between primary and secondary care. In a survey of Consultant Connect users carried out this month, 100% of GP and consultant respondents said that Consultant Connect helped them to work better together. They also agreed that Consultant Connect was good for healthcare in their area.


If you would like to know how a local telephone Advice & Guidance system can be rolled out in your area in just 2 weeks, please call Consultant Connect on 01865 261451 or email

A link to the paper discussed above, “Making Time in General Practice”, can be found here . The paper was commissioned by NHS England and is signed by the chairs of the BMA, RCGP, NHS Clinical Commissioners, NHS Alliance, NAPC, the Family Doctors Association and the Practice Management Network.

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