Written evidence submitted by Dr George Strang (CBP0023)
I am a retired general physician. I spent 21 years working in the Eastern Cape province of South Africa and after returning and working as a locum for several years, I worked as an Acute Care physician in Wales, at The Royal Glamorgan Hospital. I have written
information on three of the points provided by the HSCC.
1.What capacity is available within the NHS to deal with the current backlog? To what extent are the required resources in place, including the right number of staff with the right skills mix, to address the backlog?
2. How might the organisation and work of the NHS and care services be reformed in
order to effectively deal with the backlog, in the short-term, medium-term, and long-term?
3. What can the Department of Health & Social Care, national bodies and local systems do to facilitate innovation as services evolve to meet emerging challenges?
I worked as a general physician throughout my professional life and believe that there is a great and urgent need for more general physicians, who can turn their hand to anything in the field of medicine. Specialist colleagues told me that they could not do the work that I did because their work was too specialised and required all their attention.
I started and developed Ambulatory Medicine at The Royal Glamorgan Hospital and showed that it was safe and effective in reducing hospital admissions.
With the anticipated increase in workload, the need for general physicians will be
Similarly, Nurse Practitioners will have a major part to play in managing the backlog.
We worked with Nurse Practitioners, who were experienced and skilled in particular areas of Medical and Surgical practice and whose help was invaluable. They were supervised by consultants. The training of more Nurse Practitioners from current staff would be quicker than training doctors. Unlike many junior doctors, who tend to stay in departments for six months, nurse practitioners acquire knowledge and experience in their chosen specialty over years.
Ambulatory Care, which will be essential as part of the management of the backlog,
is described in an article by me, published in a publication of The Royal College of
Physicians of London in 2008; ‘The Concept, delivery and future of medical ambulatory care’, George Strang, Clin. Med. 2008;8: 276-9. It is particularly important for doctors and Nurse Practitioners to recognise patients who can be managed safely at home and for the appropriate resources to be available to support this.
For the past few years I have written to many people in positions of authority, including The Rt. Hon. Jeremy Hunt MP, about recruiting Health Professionals from the Iraqi exiles in Jordan and I think that this deserves serious consideration, in view of the increased
workload which is likely to last for several years.
In summary, I believe that particular attention should be given to increasing the numbers of General Physicians and Nurse Practitioners. Unless the workforce is staffed in this way, the backlog resulting from the Covid-19 pandemic will be difficult to manage. Regardless of the backlog, General Physicians and Nurse Practitioners should have a major role in future medical practice.
J.I.G. Strang, B.Sc., F.R.C.P., retired consultant physician.