Men’s use of General Practice: A 10-point improvement plan

Monday, February 18th, 2013 |

The NHS Confederation has published an excellent new briefing, Health and Sport – a winning team, which outlines how the NHS can work in partnership with local sporting bodies to harness the expertise, profile and attraction of sport clubs to reach greater numbers of people and promote sport as a way to improve people’s health. The briefing includes numerous references to men’s health and reinforces other studies that have also made a strong case for health services working more with sport to engage men in health.

In recent years, the idea of taking services to ‘where men are’ (workplaces, pubs, betting shops, faith settings, sports stadia) has become a regular feature of men’s health work. A great deal of innovative and effective work has now taken place in these settings and the potential for more is clearly significant. But we must not also neglect the importance of making traditional primary care services as accessible for men as possible. After all, for the foreseeable future, these will remain the most important entry points for men into the health system.

In this blog, I will focus on what needs to happen in general practice. But there is also a need for similar changes in pharmacy, dentistry, optometry and other areas of primary care.

There has never been a study that has explored and tested how men’s use of GP services could be improved and there is certainly an urgent need of one. There’s certainly good evidence that men have a problemmatic relationship with GPs. They use GP services less often than women and the difference cannot be accounted for by women’s attending for reproductive health issues.

Men delay seeking help for many – although not all – problems, including urological cancers, malignant melanoma and mental health. They are also less likely to respond to invitations for Health Checks. This is not just about men’s reluctance to seek help. It’s also about practical barriers such as opening hours and difficult-to-use appointments systems which cause particular problems for men in full-time work.

My hunch is that the following 10 actions would almost certainly help (and many of them would benefit women as well as men):

1. Extending GP opening hours. Despite recent extensions in hours, they generally remain limited, especially at weekends.

2. Introducing online and automated telephone booking systems on a nationwide basis.

3. Allowing patients to communicate with their GPs and practice nurses by phone and email.

4. Improving the marketing of the NHS Health Check service so that it attracts larger numbers of patients overall and an equal proportion of men and women.

5. In larger practices, ensuring that one doctor has specific responsibility for men’s health (and that should not mean just urology).

6. Making the clinic appear more ‘male-friendly’, e.g. with male-interest magazines in the waiting room, posters and leaflets on men’s health issues, etc. Information on men’s health should also be included on practice websites.

7. GPs and practice nurses should ensure that their knowledge of men’s health issues is up-to-date and that they attend appropriate training.

8. Encouraging GPs to make ‘every contact count’ with men and to take opportunities to ask about embarrassing issues (e.g. all men with diabetes should be asked regularly whether they have erectile dysunction).

9. Incentivising GPs to address men’s health issues through QoF

10. Requiring GPs to audit and report publicly on their actions to tackle health inequalities, including those relevant to men.

And, in the longer term, we need to improve boys’ understanding of health and health services. For example, no boy should leave school without knowing when and how to make an appointment with his GP.

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