I agree that some outpatient appointments are not needed. What would help the GP and patients is if the hospital doctor stated in their clinic letter what things they would look for in the follow up and what things would need hospital treatment. Then the patient and the GP would be able to have the review in primary care and only send the patient back to hospital if there was a problem.
I agree prevention of illness and disease is what we really have to focus over the next 5 years. Our practice is diagnosing large numbers of patients with Diabetes mainly due to Obesity. We need to encourage Lambeth people to take more exercise and eat more healthy foods. We need Public health to to work with Lambeth council and make bold decisions as creating more cycle paths, having less off licences selling alcohol, free play areas, making supermarkets provide cheaper healthy food, less fried chicken shops on high streets. There is lots of Public health evidence on what works but it needs the political will to make it happen.
I think we need to find new ways for people with Diabetes to look after themselves better. I see so many patients who do not still understand their Diabetes and do not realize the dangers of high sugar levels and the terrible complications they will suffer if they do not have better control of their Diabetes. I would invest more in community Diabetics nurses and doctors, patient education groups and peer support as primary care is struggling with the huge number of people with Diabetes we are having to support.
I think commissioners and NHS England should get together and make contractual changes and create incentives to all health care providers to stop talking about integrated care and to start to provide it for patients.