With those lines from the terraces of Murrayfield ringing in our English ears, it’s a night to celebrate north of the border.  And there’s more to celebrate for a handful of Scotland’s GPs.

Why are patients flocking to register at Newarthill Medical Practice in North Lanarkshire?

Very simple, the access is brilliant.  Where neighbouring practices are making patients wait three weeks, Dr Ashish Vijayan can sort them out the same day.

You know what I’m going to say next, but there’s a surprise to come.  Yes, he launched askmyGP as a whole system just three months ago and loves it, along with his patients evidently.

The secret is to have time for the patients who need it, just the right time for the right patients.

If you’ve followed this blog for long you’ll know that’s only about one in three, while the others still need help, but it can by remotely and much faster by phone, and now faster yet by secure message.

When Ashish first got in touch in the autumn he was swamped, not knowing what to do with his high demand population, many quite deprived in the ex-mining and steel area.  (you might have seen that North Lanarks is the only place in Britain to offer free school meals at weekends).

But they’ve really gone for it, with a fantastic reception team helping patients to go online, and if they can’t putting them on the system too for the doctor.

They are doing 170 online requests every week, the vast majority of all their demand.  It’s the most unlikely place to be leading the digital revulution in general practice.

While this week’s BMA News is a cover to cover Moanathon, Ashish is positively bursting with optimism.

The surprise:  he’s a single hander, and from 2,900 patients in December, he’s gained nearly 200 since then.

So that’s 50% more than the average fte GP list.  Think about the national shortage of GPs, then think again.

Harry Longman

So you arrive at your practice on Monday morning, looking forward to what the day may bring.  The screen is nearly blank as only one patient prebooked last week, who wanted to wait.

Demand comes in quickly now and about half the patients have kindly written down their problems in some detail.  You can quickly triage them, about a third you’ll choose to see, another third you’ll phone, a third you’ll send a message – they wanted that, not to waste their time and yours coming in.

Other patients have left a message with reception and you phone them, or delegate to another clinician.  The sense of control comes from you deciding as a GP how to help each patient – you’re good at this.

Now after coffee break the first patients are coming down, and you can give each one the time they need.  It feels more personal, you can build relationships because some of them have chosen to see you – which they can, because you’re here today, der.

The afternoon session has less than a third the new demand, so it’s more relaxed with much of the time seeing patients contacted this morning and then catching up on paperwork.  After 5 very little comes in so you take it in turns staying until 6.30 to switch off the lights.

It’s such a difference from before you changed. Back then, you were constantly frustrated about endless extras, 14 hour days, and the diabolical duty doctor rota.  But this is no longer a problem. Every day is pretty much alike, bar the infinitely intriguing variety of patients.

I’ll stop here because at this stage, I’m quite sure that you are laughing your head off.

The idea of a world where you’re feeling in control from the start of the day, able to offer the best professional help to all your patients, and go home with nothing left undone is the holy grail for most GPs.

It’s something which practices we’ve helped take for granted and achieve easily. It seems to come naturally to them.

And yet it seems to fantastical… So preposterous…. So unachievable…. to you, that I might as well have been describing a world where man has landed on Saturn.

Why is this the case?

Many doctors believe it simply can’t be done.  That balance of work and fulfillment cannot happen, because demand is infinite.

I don’t believe that at all, and that’s based on the evidence.

I believe GPs are almost universally making two very significant mistakes when it comes to their operating system – mistakes that are sabotaging their chances of success.

If you overcame them, you would discover that a balanced workload was not out of reach at all.

I’ll tell you about the first one on Monday. Watch out for that email…

Kind regards

Harry Longman

PS by the way, if you are concerned about claims being made for NHS 111 digital, you may be interested in a report which has come to light.

@harrylongman