Named GP for those with MH problems

[sherlock holmes]

I saw my GP today and he told me about a new scheme that I will be receiving a letter about soon.

Those with long term mental health problems will be given a named GP in their surgery who will act as a care co-ordinator (if you have a care co-ordinator in a CMHT then you will keep them too) and help set up a plan of action with you like a care plan.

My GP said it aims to reduce the amount of unplanned hospital admissions and reduce the amount of attendances to A&E. He said to me that if ever I needed to see someone or to talk urgently then instead of going to A&E I can ring the surgery and if he's in he'll speak to me as he's my named GP.

I think this is being rolled out across the country, so look out for a letter or ask your GP. I think it's a good system and I feel better knowing I have the added safety net of my GP.

Apparently if you don't like your named GP you can ask for another, and also having a named GP doesn't mean you can only see them. You're free to see whoever you like at your surgery.

[Imperfect.Star]

It's not just mental health, the same thing is being done for the elderly and complex patients in order to try to reduce hospital admissions. Day to day it shouldn't change anything for you - you can still see any GP at your surgery etc. It should mean however that there is one GP who is more aware of your situation and a care plan for you and can be contacted by other health professionals.

[tiptoes]

I think this is a good thing. The GP I see acts like this already and I have benefited from it, although I think it helped that my GP did a rotation with my psychiatrist when she was a junior doctor. Even though I only see her 3-4 times a year she can tell how my mood is just by how I walk across the waiting room. The GP that is classed as having mental health as a specialism has also said to me I can speak to him etc if my GP is away.

When I was younger I saw a GP I really didn't get on with, I felt invalidated and not listened to. When I came out of the appointment and was making a follow up appointment I requested it to be with any doctor except the one I had just seen and the receptionists were very accommodating and didn't question why I didn't want to see him. So do speak up if your GP isn't right for you.

[Crazy Cat Lady]

I think it's a brilliant idea.

I have a named GP who I see regularly. I have long term mental and physical health problems and it's really good to just see one GP who knows your full medical history. Also, they get to know you which really does help maintain continuity of care.

[Cacoethes]

I think my gp does this anyway. It has been very helpful.

[HildaOgden]

one of my friends has received a letter about this already and told me about it the other day.
I think my GP does this already with me though. But it's good to get it confirmed for continuity of care.

[Ballerina123]

It's a great idea in theory. However will it REALLY work.

My current gp surgery and a one i had a few years ago are really bad at offering appointments with certain GPs. For example to get an appointment at my surgery i have to call at 8.30am for a same day appointment and i don't get to choose the gp i just get "fit in". Sometimes if you miss the 8.30am calling slot by a few minutes they are already fully booked so you wait till the next day and so on.
If you want to make an appointment in advance you have to wait 2-4 weeks. If i was having a mental health crisis and had to wait 4 weeks I'd probably be in hospital/A&E by then. So would many.

This could work with less busy GP surgeries however not with busy ones like mine.

It's always easier to get an appointment with a nurse so they should have mental health training and take up the "care coordinator" job. Saying that however some nurses can't prescribe drugs so no prn or increase/decrease in meds could happen.

Those who get to see a named gp regularly are very lucky.

[Patent Pending]

My GP pretty much does this anyway, but the problem is getting an appointment with him - in the words of the receptionists; his appointments are like gold dust. However IF I manage to get one he books them for me at regular intervals.

My GP has been invaluable in my recovery so hopefully something like this helps others.

x x x

[Snow White.]

I read this and thought "how is this different from what happens already?" (As a genuine question as I'm not from your country!). Here in Aus my GP works like that as well and I'm interested to see many say that their GP does already also.

So I guess Sarah if you don't already have a gp like this what is the alternative? Just seeing any GP?

[mark999]

I'm missing my GP as she is away on maternity leave. I have seen a few others in the mean time but they are honestly useless in comparison. I'd give her 95% (as she was that nice, caring, understanding and seemed like she genuinely knew what she was talking about and that she cared about how I was and anything she could do to help that was within her power) and I'd give one of the others 5% and the other 40%. It is amazing how simply finding a gp that is understanding and will go that little bit extra makes the world of difference and really does help with recovery.

[sherlock holmes]

Amy, actually me and my GP did say yesterday that this new scheme doesn't really change much for us, because he's been my GP for a few years now as it is and has been in the background looking at my care.

Though the new information that he told me was that I could ring and speak to him whenever he was in the surgery, which previously was never mentioned to me and I wouldn't have dared ring and ask, I would have rung my CMHT instead or gone to A&E.

But I think it's only been about 3 years that I've seen my GP on a fairly regular basis as before that he wasn't at the surgery and I didn't get on with any of the other doctors. Each time I saw a GP it was a different one and so there was no continuity of care.

I guess it does all depend on your relationship with your GP, and what your surgery is like. For example my surgery is very large and busy, but we have an online booking system that removes the need to ring at 8am and spend ages in a queue. I can book appointments online for next week and the week after, or from midnight I can make a same day appointment. It really works well!

Though in a crisis I suspect it's where the scheme may fall apart a bit as Ballerina said if my GP was in he'd be busy and probably not able to see me face to face, but I think possibly the longer term management of mental health and making a care plan is probably the thing that will work the best.

[Snow White.]

Mark mine is on maternity leave too! Thankfully I've found a supportive counselor but I do miss having my regular GP so I feel your pain.

Sarah Thanks for explaining that made sense :)

[MissAnonymous]

My gp is pretty good but he is the CCG lead for MH in my area and works at the partner practice across town so his appointments are gold dust. I think it's a great idea but I can see a lot of problems for cases where gps work part time or in more than one practice. I have asked in the past and I am not allowed to see him in the other location which is fair enough. I find talking on the phone about my mh to a gp I have never met f2f very hard. It means if I cant get an appointment I just dont see anyone. Obviously for a lot of people that ends badly. My surgery is in the process of testing out new formulas of appointment bookings and its currently a mess. I think some surgeries will make it work and some wont, basically.

[random.swirls]

I've gone through the care plan and the first thing the gp said was this will be largely irrelevant to you and it was!!

I was asked things like can I walk up stairs and had to do a memory test. It's for anyone who has a long term health condition that may result in unplanned admissions so that would be trips to a and e so day to day I can't see things changing!

[noodlzzz]

Got a letter about this too.

Do you live in London?

[whirlpools]

I think this is a good idea. I'm very reluctant to go to A&E when in crisis anyway and it would be useful to have a point of contact before it got to crisis stage when the CMHT staff are unavailable. My CC is off sick a lot and only works part time anyway, so having a named GP would be good. I'm quite lucky as I know all four GPs at my surgery (though I don't go often) as have been with them a long time and I would be able to trust any of them with my mental health. Locums are a different matter though!

[sherlock holmes]

I don't live in London, I live in Essex.

[LegoGirl]

I also got a letter about this. I'll be very interested to see how it work in practice as my surgery is very very busy.

[earthbound_misfit]

This is interesting, and seems like a good idea - although as people have pointed out there could be issues with it in practice.

I suspect it's aimed at the group of people who have mental health issues but are not seen by secondary services (eg. no care co-ordinator, no access to CMHT etc).

Rather than automatically referring people on to specialist mental health services, more and more people are being 'managed' (!) by GP's. This is really bad, imo, as the threshold to access mental health care can be very high, and GP's are not trained in mental health. It's not like physical problems where you might just need medication and someone monitoring you, especially when a lot of the people needing support but not involved with the CMHT have complex issues that need sensitive handling - I'm thinking of people with complex reactive depression/anxiety, BPD etc. where the interpersonal skills really matter and a GP used to physical ailments might not be very helpful. (Mind you, plenty of CMHT staff seem to lack these interpersonal skills/skills to interact with someone in distress!)

If GP's were being trained in mental health this new measure could be very useful. Perhaps it could be an option so you have certain GP's with the extra training, GP's who are interested in mental health and want to do something about the large amounts of their patients struggling. It's probably not a good idea to foist it on all of them (someone ignorant and dismissive of mental health issues won't necessarily be changed by being forced onto a course...) although I think their should be more mental health training, in general, as part of becoming a GP.

My own GP is the only NHS professional input I have. He's great - but sadly this means he's also usually booked up at least two weeks ahead. Not very useful as in a crisis I'm supposed to see him. The stupid thing is, if I end up in A&E, or try to contact the crisis team or CMHT, I usually end up being given an appointment with my GP the same day or next - it's just I have to do this silly runaround to get there. To have him in a named care co-ordinator type role, so I could just call the surgery and get an appointment, would be much more efficient. So would being able to speak to him on the phone - another thing that's 'allowed' when I've been through the crisis team route but normally isn't accessible.

Just to add, I can get appointments on the same day if I call at 8.30 am, but as others have mentioned it can be hard to get through on the phone, or my GP is already fully booked. In addition I ALWAYS feel in crisis when I wake up, it's just if it goes on longer than a few hours it starts to get risky/needing support.

[noodlzzz]

This is interesting, and seems like a good idea - although as people have pointed out there could be issues with it in practice.

I suspect it's aimed at the group of people who have mental health issues but are not seen by secondary services (eg. no care co-ordinator, no access to CMHT etc).

Rather than automatically referring people on to specialist mental health services, more and more people are being 'managed' (!) by GP's. This is really bad, imo, as the threshold to access mental health care can be very high, and GP's are not trained in mental health. It's not like physical problems where you might just need medication and someone monitoring you, especially when a lot of the people needing support but not involved with the CMHT have complex issues that need sensitive handling - I'm thinking of people with complex reactive depression/anxiety, BPD etc. where the interpersonal skills really matter and a GP used to physical ailments might not be very helpful. (Mind you, plenty of CMHT staff seem to lack these interpersonal skills/skills to interact with someone in distress!)

If GP's were being trained in mental health this new measure could be very useful. Perhaps it could be an option so you have certain GP's with the extra training, GP's who are interested in mental health and want to do something about the large amounts of their patients struggling. It's probably not a good idea to foist it on all of them (someone ignorant and dismissive of mental health issues won't necessarily be changed by being forced onto a course...) although I think their should be more mental health training, in general, as part of becoming a GP.

My own GP is the only NHS professional input I have. He's great - but sadly this means he's also usually booked up at least two weeks ahead. Not very useful as in a crisis I'm supposed to see him. The stupid thing is, if I end up in A&E, or try to contact the crisis team or CMHT, I usually end up being given an appointment with my GP the same day or next - it's just I have to do this silly runaround to get there. To have him in a named care co-ordinator type role, so I could just call the surgery and get an appointment, would be much more efficient. So would being able to speak to him on the phone - another thing that's 'allowed' when I've been through the crisis team route but normally isn't accessible.

Just to add, I can get appointments on the same day if I call at 8.30 am, but as others have mentioned it can be hard to get through on the phone, or my GP is already fully booked. In addition I ALWAYS feel in crisis when I wake up, it's just if it goes on longer than a few hours it starts to get risky/needing support.

I have schizophrenia and see EIS weekly and was given a named GP. Not sure it's just for those who don't see secondary mental health teams.

[sherlock holmes]

I agree ^, I was given a named GP and I've been under the CMHT for 8 years.

My GP said it was to reduce the amount of crisis hospital admissions.

[earthbound_misfit]

Well yes that's why I said AIMED AT those people, not JUST for them.

Budgets are being cut for secondary mental health services, and demand is increasing. At the same time they are trying to improve mental health care (apparently).
This new measure will be a 'continuity of care' thing (or some such buzzword!). So as people are discharged faster (even if taken on again later), or not seen by secondary services at all, the only constant for them will be a GP.
Now I think about it, "the group of people who have mental health issues but are not seen by secondary services" is almost all of us at some point!

Basically a good idea though, although I am sceptical at the general measures to improve things whilst the obvious stuff is glossed over. Sort of like the system is being held together by sellotape, and the tape may be excellent stuff but actually we need to fix the system properly!

[Nayy]

Strange. I had a phone call from my GP surgery this morning, saying they were having a trial of named gps offering longer appointments approx 30mins to try and come up with care plans and manage long term conditions. And would I be part of it?!?
I have had pressure from a couple of gps saying I need to see a regular one. But when you need to see a GP for meds in a crisis you can't pick and choose. I did see one GP regularly but then she left but handed over to another GP but that stopped as I was in hospital for a while and she went on maternity leave. Just trying to find a GP I feel comfortable with again.