One Small Change: A daily phone-in hour for GPs to contact hospital consultants

Dr Velma Harkins: One thing I would like to see in our health system

As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear from doctors, nurses, paramedics, medical secretaries, hospital porters, canteen staff, and others, about one change they would like to see in our health system.

It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone.

Dr Velma Harkins

GP in Banagher, Co Offaly and chair of the quality, safety and standards committee in the Irish College of General Practitioners

“The paediatric department in Ballinasloe, Co Galway has recently launched a daily GP phone-in hour where GPs can speak directly to one of the consultant paediatricians about managing a child who is ill. This is an excellent development, and a similar system set up with various consultants linked to their local hospital would be very helpful for GPs.

“Lack of direct communication between GPs and consultants is a source of daily frustration for both GPs and consultants. Often, as a GP, I need to talk to a consultant directly about a particular patient to work out whether I can manage him/her in the community or whether he/she needs to go into hospital. When we have a difficult case, it would be very beneficial to be able to phone a hospital consultant to ask specific questions, to help us decide whether a patient needs to be transferred to hospital urgently or not. When we do get to speak to our hospital colleagues, they are incredibly helpful but often, we only get to speak with a senior house officer or an intern who may not be experienced enough to answer our queries or may not understand the urgency of a situation.

“Experienced hospital consultants know immediately when you speak with them if a patient is in need of urgent hospital treatment or not. After speaking to them about a case, sometimes they will arrange an urgent review or hospital test when they hear the background information directly from us, or sometimes they will provide us with guidance on the best and most appropriate course of action for a particular patient who is causing us concern.

“Hospital consultants are extremely busy, however in my opinion, they should have some protected time each day set aside to speak with GPs. Setting aside one hour each day for phone calls with GPs could then become part of their working week. GPs are so busy that they will only phone a consultant when it’s absolutely necessary – when we genuinely don’t know what to do or when a patient is very ill. It would benefit patients by avoiding unnecessary admissions and unnecessary presentations to A & E, and ensure that the most appropriate and cost-effective referral pathways are followed.”