Yup - spotted here. I'm also out spotting non Spec, non DES potholes as there is more to the 20/21 deal than just the rotten specs. There's the rest of the package including your pay award. And to my mind it all has to work, it has to support your core work, and your practice bottom lines - not just your top lines have to be in healthy surplus not deficit.
DT - tomorrow is the England LMCs conference - I'm guessing Tea Time might be a good time to check it out - they always save the best til last.
yup - THAT
The problem with the formula approach to allocating money from an inadequate fixed price cake (apart from the fact that the total cake is inadequately funded obv) is that however you cut the cake it will remain inadequate. In particular it is inadequate in that it doesn't take into account the sums needed to meet the fixed costs of safely delivering our core contractual demand we daily face. Switching to an item-based contract alone won't solve that. There has to be an elements to cover fixed core practice costs, an element to cover the number of patients either as capitated or as payments for specific services, or a combo of both.
It sucks in so many ways. See Paul Cundy's post.
Problem: Demand Supply;
Bleeding obvious solutions: 1.Stop Stoking Up Demand; 2. Increase supply.
Problem: Reducing supply;
Solution: Stop stoking up demand;
Problem: Demand stoked by politicians; Politicians stoke consumerism; Corporates love consumerism as it makes them money; Corporates love consumerism when politicians stoke it as corporates have a protected market; Politicians love corporates as they deliver consumerism and that delivers votes. All this also applies to other organisiations like FTs who like to behave like corporates and believe they will become them one day.
Solution: Get the consumerism out of health NOW
Nigel - correct analysis as usual. 3 successive governments have repeatedly and systematically destroyed any of the potential that could have come from the 2004 contract - remember high trust, low bureaucracy? remember 'no new work without new money? agreements repeatedly reneged? And now, a token reimbursement of expenses yet to come - no mention of expenses past. Meanwhile It is now patients who surely are paying the penance, as well as us. It is not so different from the juniors argument. Exhausted GPs can't do or take any more. Its not safe and its not fair. We must get that simple message out and harness their power. Not just national patient groups, but in every SoMe forum, in every patient participation groupie every surgery, in every waiting room, and yes, in every consultation. One message, One Profession All patients.
"TDo not trust LMC ever. They are all part of CCG and hunt promoting 7 days and privatising of NHS "
It certainly isn't true.
Proud to have strong and resilient GPs giving voice to their concerns and fighting for the future of the profession
Go Naomi :)
Just unbelievable. Words fail me.
Good God Vince Ho, Read what I said again! No money up front , no work done. No people to do it, no work done. If GPs on the ground don't do it, it won't be done. That was the message. By the way I'm chief exec not chair. And I was the GP trained in a certain practice in W6 the year befpre you! So there ;) . Michelle
Paul Shenton is right for all the reasons he states above. Charging is a bad idea. - beware what you ask for. This would not be money to GPs. It would be a treasury tax collected by GPs, equivalent to a prescription charge, and would add to practice bureaucracy. It would also be a green light to the medical insurance industry. The way to deal with GP demand is to massively reduce bureaucracy on practices, invest in GP infrastructure and staff, and on the right services in the community for those that should have them. A mass media health literaqcy/ education campaign from NHSE/S/W/NI and DH on how to use and how not to use the NHS would also be the right thing to do, but that would require ministers taking risks, which of course they hate. But above all, someone needs to nuke the DM. Any takers?