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Gold, incentives and meh

Brian Fisher

  • Patient online access to GP record may come to exclude historical notes

    Brian Fisher's comment 20 Jul 2018 5:17pm

    In all systems, any practice can set a date before which the patient cannot have access. This is flexible: per patient or for the whole practice. For consultations or for letters, for instance. Also, clinicians can redact consultations if they don't want them seen by a patient.
    So, there's no reason not to offer full access going forward. You have to write notes according to IG requirements. But you'd do that anyway, right?
    Go for full access. Both the practice and the patient gain most.
    Brian Fisher

  • PSA-based screening reduces deaths from prostate cancer, finds new review

    Brian Fisher's comment 07 Sep 2017 6:17pm

    Does anyone have any evidence on screening high risk groups specifically? African Caribbean men, for instance. Maybe the outcomes of screening would be better.

  • GP funding to be boosted under Labour, reveals leaked draft manifesto

    Brian Fisher's comment 11 May 2017 12:42pm

    At last a health manifesto that meets real needs. We can afford this. Labour is committed to a National Investment Bank as well as tax rises. This is straightforward Keynesian economics and we should applaud it. Let's hope it doesn't change too much from this draft.

  • GPC to announce mass resignation ballot decision next week

    Brian Fisher's comment 12 Aug 2016 4:04pm

    I agree with the last comment. I think a work to rule would easier to offer and to keep clinicians involved. Mass resignation carries the risk identified by Dr Eggitt in the article. It may play into the govt's hand. This an important move. I hope GPs will work in solidarity.

  • NHS chiefs spend £1.2m on publicity drive to expand use of personal health budgets

    Brian Fisher's comment 18 Nov 2015 9:02am

    Dear Nurse 1155. I am interested in your comments: "I work in this area in the West Midlands - the PHB's are taking up huge amounts of time to set up. Also the one's I have set up work out considerably more expensive than using traditional services. Relatives as paid carers can exaggerate how many hours of care are needed or hours they are alteady providing. Staff are too busy to monitor these packages - CCG's beware!!!" Could you please tell me more? or 07949595349. I am a London GP interested in PHBs. I see real benefits for pts but am very worried about their impact on the future of the NHS.

  • DH revises competition rules to include opt-out to preserve integration

    Brian Fisher's comment 12 Mar 2013 11:20am

    I agree that these are cosmetic changes and remain very dangerous for CCGs and the NHS. The provisions will be almost impossible to meet. CCGs will still need to do a huge amount of work whether being forced to compete or demonstrating why only a single provider can perform the tasks. Monitor still rules and CCGs will still be open to challenge from corporations. No more freedom, more cost, a lot more fear - and almost certainly worse services for patients.

    And this is now combined with a EU/US trade agreement which will bring international companies even more easily directly into the NHS.


    Brian Fisher

  • Less than a third of doctors think online access to records is a good idea

    Brian Fisher's comment 15 Feb 2013 6:56pm

    Look at the reality, folks. Record access is available now in all EMIS practices and InPS is beginning to offer it too. There is no database as in the C4H model. About 60 practices are offering it in the UK and we have quite a lot of experience from patients and practices. It takes up little time (in fact there is evidence that it would save up to 11% of appts if 30% of patients used online access). There are not loads of extra clinical queries. Relationships improve, evidence for better self-care and shared decision making. Records can be shared with A+E and OPDs - so much safer. There is no simple fix, however, for coercion except for switching off access if it happens.

    As for messaging the practice, we need more evidence and experience before we know whether this is easy to manage and what the benefits and costs are.

    Online access is safe, convenient and probably will save you time if you use it wisely. Go for it!