"Mustn't grumble …"

Newspapers have merrily been reporting how workshy GPs will be admonished for abandoning their patients by closing early (ie before 6.30pm) on Christmas Eve. Over the last 20 years I have been called upon to cover Christmas Eve several times and no matter where I've worked, demand has never actually been that great. The regulars, for whom the surgery provides a key social touchstone, will always be there, but otherwise there are plenty of other places that our patients would rather be. Even the regulars choose to settle in with a Christmas film, a warm drink and a box of chocolates - particularly those with diabetes …

The 'emergencies' that come in the last preceding days tend to follow certain patterns that will be all too familiar to our clinician readers and I am grateful to my Northern Doc colleagues for their timely observations on this matter.

1. All members of the family absolutely HAVE to be well for Christmas otherwise there will be a complete nightmare, because there is absolutely no healthcare available during the holiday in the UK. None whatsoever.

2. If someone becomes ill it will ruin everyone's Christmas so see us all NOW. Christmas tension can always generate an argument in a family but illness is always a great excuse. When you are ill, it is never your fault and you can always blame it on the useless GP who's done nothing to help.

3. Local nurseries start printing off information leaflets suggesting that any snotty-nosed kid has something awful, so there will be a surge of kids collected from nurseries at lunchtime.

4. Conditions that have grumbled along for years are now presented as life-threatening emergencies because they all HAVE to be BETTER by Christmas.

5. "I have to be better for Christmas …", no matter how minor the complaint.

6. "I would like something just in case ...", no matter how minor the complaint.

7. "I don't think I could manage to work …", no matter how minor the complaint.

8. Home visits that have to happen because you couldn't possibly manage to struggle in to the surgery, but when we come - you've just 'popped out'.

9. "I need this for my holiday and although I have paid thousands for the holiday I would like these drugs for free. I want to avoid paying £100 to see a doctor abroad. Can I have them just in case?"

10: "We are from overseas staying with our relatives for Christmas and happen to have left all our medication at home. We know that if we claim that we are emergencies you will see us for free and if you treat us on the NHS then we can get several hundred pounds of drugs for a few pounds of prescription charges."

As usual our December updates have responded to major guideline updates such as SIGN's asthma guidelines and NICE's guidelines on the management of bipolar disorder. We have also expanded our helpful range of dietary advice leaflets. The full list of updated content can be found here.

A very Merry Christmas to all our readers.

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