The British public ( or their politicians) don't want to pay a sum at the point of care unlike in France Germany Netherlands Spain etc, then they cannot really complain if there is not enough money for ambulances and doctors at the point of care.
It is a good thing my surgery has a block contract with the NHS and we will see all patients as often as is needed or wanted , regardless of if we have capacity in our surgery hours. We will just expand our staff and hours of working to accommodate any extra work sent our way because after all , we are responsible for all care out of hospital. Thank you our negotiators.
Our GP partners will not vote for any deal unless there is 100% funding for the extra staff ( not 70% ) because we now see that the extra staff will only have time for DES work , not GMS work.
On a wider point , personal General Practice with continuity of care will only survive if there is some form of payment per consultation. Otherwise might as well delegate everything to digital triage , non Partner workers and non medical staff. The really ill people will just go to A/E. It will be good for Part time workers I suppose.
At the moment we have a visiting paramedic service supplied by the CCG but I think it will end next year . It works very well. The paramedic can visit about 8 patients per day for about 40000 patients. The GPs don't pass on all the visits . We keep the palliative care and ones where the paramedic has been before and there is no improvement. Once the paramedic is booked out for the day then GP has to decide if to visit any further requests. The number of home visit requests is definitely going up because people are getting older and more housebound/ residential homes. What would really help would be if NHS England would fund a visiting paramedic per PCN. It would probably pay for it self in reduced ambulance call outs.
The job is fullfilling and interesting but any new recruit should understand that in this country , the workload and clinical risk are potentially unlimited and the tax burden is high. So if you want to work a couple of days per week and have a nice life then it is good ( but not good for the Health Secretary). If you want to be a full time partner/ full time earner , you may burn out, with not that much higher take home pay.
Don't worry. One social prescriber, one pharmacist and one physiotherapist per PCN will make up for the experienced GPs reducing their hours.
I suspect this hands off way of practising general practice can only survive when the tax payer picks up the cost of indemnity insurance. Funny that.
Shefdoc why aren't you proud to be British? I am a 2nd gen immigrant. The UK on the whole looks after all it's citizens equally regardless of income or race or disability , which is a proud achievement. Of course , this very fact may have led to brexit when the money got tight but that is something which the politicians should have recognised earlier.
why would patients buy an otc statin ? they can get a 2 month supply from the GP.
This is brilliant. Why fight it? Of course it won't save the NHS any money , but does Joe public care about that anyway.
Kailash , don't EU countries need their own doctors and nurses?
1st generation immigrant. Vegetarian. Mother cooked everything from scratch and we were made to eat our beans to 'get our protein'. We did go to Mcdonalds about twice a year for a treat but this was 40 years ago ! The nearest one for us was in Croydon. The liberals won't like it but I think child benefit should be paid on an electronic card which can only be accepted for healthy fresh food , meat or veg. Not takeout food and fizzy drinks. It would be good for the health of children and good for british farming.Free cooking classes included. ie the home economics of before. How many times do you see a young mum bringing a young child to morning surgery, both drinking a fizzy drink for breakfast.
Best Wishes David. I always enjoy reading your articles.
Whoaml. in general , when the patient has seen you a few times and know you have got it right before, and also you have treated their family and friends and they know from experience that when you have needed to , you have referred to hospital , then they will begin to 'trust' you. In other words , continuity of care. The very thing they are destroying and of course hospital referrals will go up. Never mind , rant over.
Privatise the profit , let the tax payer ( ie national debt ) pick up the cost. Same old same old.
Everyone is shrugging their shoulders and just aiming for retirement.
Do they have a problem getting a dentist , pharmacist, optician in this town? Dear MP , see where this is going?
Why isn't there any goodwill value in GP practices? I am filing my blood results from home today ( and every weekend ) because I don't want to cut down on clinical time spent with patients next week. And of course this is how GP partners keep General Practice running. And why GP partners leave. No incentive to stay.
In Sept 2015 , didn't Jeremy Hunt aim to get an extra 5000 GPs in 5 years? What concrete actions did he take to try and achieve this goal? What policies did he initiate to improve recruitment or retention? Just increasing medical student numbers will not help if no one wants to be a GP in the NHS.
Agree with David Banner above.