Responder 2–14 (R2-14) is a male GP. He has cared for patients with type 2 diabetes for 19 years at the same practice, where diabetes services are ‘mainly nurse led’. Responder 2–14 explained that ‘historically’ they reviewed every patient with diabetes in person, but as the population has grown they have had to ‘let go’ and ‘make way’ for multidisciplinary staff, though continue to have ‘oversight’. The practice nurses and healthcare assistants review the patients with diabetes and would ‘alert’ R2-14 if there were any ‘complex patient who needs a GP input’. This will often include discussions about medication changes or further referrals. Responder 2–14 felt that these reviews still ‘take up too much time’ and is considering extra training for the practice nurses to ‘free-up’ the GPs’ availability for other tasks. Recently, R2-14 had been trying out ‘virtual clinics’ in which he reviews the records and blood results without the patient present and is able to electronically record a plan for the nurses to relay to the patients when they attend. Responder 2–14 feels that this is probably the ‘most efficient way of keeping an eye on the patients albeit unknown to them’. The GP also explained that they have had to be flexible with new approaches to care otherwise they would ‘drown in chronic diseases’. Responder 2–14 further describes the increasing number of patients with type 2 diabetes as ‘overwhelming’ because of the ‘associated never ending administrative and payment tasks’. |