Haslam D. Haslam’s view:Mobile phones have transformed GP care. Practitioner 2016;260(1789):35

Mobile phones have transformed GP care

25 Jan 2016


Professor David Haslam CBE FRCGP, Chair NICE, Past President BMA, Past President RCGP


For many it would be hard to imagine a world without mobile phones, let alone smartphones.

Mobile telephony has conquered the world. In 2014 it was claimed that there were more mobile phones in the world than people, and during 2016 the number of smartphones is predicted to pass the 2 billion mark.

If your house is anything like mine, with half a dozen antiquated phones lying around in cupboards, waiting for who knows what, then these statistics are all too believable.

When it comes to the world of general practice, I have a strong suspicion that during my professional lifetime the mobile phone is the single item that has had the most effect on GPs’ lives.

It has had more impact than portable ultrasound scanners or defibrillators, electronic thermometers or pulse oximeters, and probably even more impact than computers. It has fundamentally changed so much of emergency and out-of-hours care, and the way that it is delivered.  

Just imagine being on call without a mobile phone. In my case, in the days before out-of-hours co-ops, when a couple of local practices shared the on call duties, this meant that over a duty weekend my wife could not leave the house at all, just in case the phone went. She had to be available to take any incoming calls, to offer advice, and then to try to track me down to relay the message.

 If I was out doing a series of home visits on a Sunday and another call came in, she would then have to phone around all the houses which could have been on my route to ask if I had arrived, and if so to ask them to request that I phone her back. Extraordinarily inefficient, indeed almost antediluvian, but there was absolutely no alternative before the invention of the mobile phone.

It was also no fun at all for my wife, particularly when we had two small children. She always had to stay within earshot of the phone. Long weekends on call were far more restrictive for her than they were for me. At least I could get out around the practice area.

On many occasions, faced with a genuine emergency, she simply could not track me down as I might have been visiting houses without a telephone.

The phone could cause real alarm. I will never forget a call that came at 3 o’clock one weekend morning. It was a call from a child ringing from a public phone box. ‘Please come quickly,’ said a little voice, quivering with panic. ‘Daddy has this terrible pain in his chest.’ Then the phone was put down before I could find out who Daddy was, or where he lived, or anything else.

 These were the days before 1471, or any form of ring back, so all I could do was lie in bed sleepless for another couple of hours, thinking of this poor family who thought I was going to arrive before too much longer, and whose location was a complete mystery.

Incredibly, I never did find out who it had been. There were no hospital admissions that night from our practice, no complaint came in about my non-attendance, and — mercifully — no-one died.

But the sound of that frightened child's voice stayed with me for a very long time.

Would that happen now? I do hope not. Mobile phones have made a very real difference both to doctors’ availability to their patients, and patients being able to contact the NHS.

The Good Old Days? I don’t think so.