The "extra" £2.8bn is NOT a generous settlement. It is an extra 0.7% per patient when we already are one of the lowest spenders on health care in the developed world!
What about the unauthorised dose of Enalapril that was mysteriously given to the boy an hour before he died that this doctor did not know about? What about all the arguments in her defence by the paediatricians in an open letter recently? This is unfair and everyone above is correct to state that we have to say no to extra unsafe work from now on. Also how come we can;t take Hunt et al to court over the 100 extra deaths PER day due to this Govt's policies and underfunding of the NHS and Social Care? I just hope there is something here about the case that we are not being told that explains this otherwise we are at the end game.
WHY? I don't understand what the thinking is behind this change? Are they someone potentially getting too much in the way of benefits from the scheme in retirement if they take a 3 month break?
I am locuming in a deprived area with high drug and alcohol addiction in a city with massive cuts to Drug and Alcohol service (50% this year), CMHT (2 out of 12 CPNs in post and locum psychiatrists come and go regularly and with little notice, proper psychotherapy takes 18 months to get and pain clinics are overrun. The patients have high levels of historic prescribing of all these drugs. There is no evidence base for the prescribing and today I refused oramorph for a young man on 200mg MST for back pain (on a reducing dose and very cross about it). EACH patient would take at least 30 minutes to see to discuss and plan a reducing programme. It needs a specialist pain addiction team to be formed and properly funded out of new money to help these people. And stop cutting essential services including us!
NHSE states they will produce a high number of trainees? When 20% will not become GPs ro will emigrate, and GP training posts are unfilled. When MEdical school applications have reduced by 11% when GPs numbers have fallen by a 1000 in England between 2014 and 2017. The Govt needs to VALUE clinicians and introduce EVIDENCE BASED policy decisions. If there is any evidence for their policy decisions far it is of HARM to services, underfunding of services that support both patients and primary care, no help and increased costs from 8-8, 7 day a week working, Increased workload from Telephone triage, evidence of money not reaching front line as it is syphoned off by various private providers and administering the internal NHS market (admin costs now about 25% in 1983 4%). Per capita year on year reductions in NHS funding. New larger practices havenot shown to be cost effective. It is all about privatising the NHS as we know and New Labour and the Tories are loving it.
Nishma have you ever spoken to Simon Stevens? Have you seen his speech to delegates at a conference when he was just leaving his job as CEO of Commissioning at United Health (where is currently being taken to court for part of their fraud) stating that he had a plan to open the NHS to US private health firms? Have you seen what is happening in Plymouth where NHSE closed 4 surgeries despite widespread patient and staff protest and now more surgeries are closing due to excess pressure and lack of GPs?
I don't think pharmacists want this any more than we do. And with the cuts to community pharmacies we will have precious few of them left.
I love the article Pete!
I have worked at one of these practices as a long term locum since July 2015. The partner resigned his contract after having health issues but stayed on working. It is profitable to our current contract holder- Access Health Care, is loved by our patients and gets great outcomes/QoF scores. The ex-managing partner complained and fought this, as did the whole patient body of 2800. We called NHS England out on their misleading comments-1)that they were running a consultation on what to do with our practice- the consultation letter was received by patients the DAY before the consultation on the 25th August at 10am! 2) The letter said that they had decided to close the practice- so what were they actually consulting on? 3) The letter said that local practices has space for our patients. Many of the practices have open lists for patients moving in and out of the area but have written to NHS England stating that they do not have capacity for 2800 patients! As GPs we were committed to remain at the practice- hoping for a salaried contract but neither of us had the energy or desire to provide excellent quality care AND run the practice. It is more than a full time job to do both well and I did it well for 9 years then could not do both. The managing partner was reprimanded by NHS England for unprofessional conduct! It is such a shame that excellent caring practices are shutting and it is getting so much harder for everyone else.
GOOGLE "Boarding School politicians guardian" and you will find a useful article for those of us who do not understand the Tories lack of any empathy- it doesn't excuse them but it does explain it
Dear Phil. I hope you make time to fully recover before making any decision to return to work. I am so sorry that it came to this. I am a dedicated and hardworking patient centred GP and went off with burnout at end Sept 2014- I could not go on but not so dramatically as you. I stayed in bed under the duvet for a week. Tried to make my GP and OCC health doctor let me go back after 5 weeks then after 6 months off with great support from our gold standard occupational health service for GPs in the South West (which has now been disbanded) I have resigned my partnership but am working as a locum. It was so enlightening being made to stay off for enough time to realise the impossibility of my returning and staying healthy. Give yourself time. I have no idea how the NHS will survive this Government but we mustn't kill ourselves trying to plug all the gaps.
PS ever so pleased to hear about your morning erections DR Jatt! My husband is pleased I am not a GP partner anymore too! :)
anonymous at 1.53pm. What are you talking about? "Most of us voted for what's coming....." Did you mean most GPs? Is that actually true? I certainly didn't and would never and am more and more glad that I am a Locum noe and not a partner any more! Our patients do not want to see their GP at weekends OR late evenings. Maybe some areas do but they don't. They want to see a familiar face during the normal working week. I have no faith, nor ever have done, in any of the Tories plans being honest- after the travesty of the NHS and social care bill we cannot trust them about ANYTHING! Within a day of regaining power thy sold an NHS contract to a private provider with..... Tory MPs on its board! And as they are doing the same to Education we only have a less resilient and less informed patient group to look forward to. But they may know how to pass SATS papers! It is so so very sad.
As Churchill said "a lie is halfway around the world before the truth gets its pants on". While I agree that Miliband is terribly misinformed about how to sort this mess I take issue with the Conservative party and its adoring press constantly going on about how appallingly the Labour managed our finances when they were last in power. Before the GLOBAL CRASH and stupid decisions to prop up the corrupt failing banks and quantitative easing (which went to the banks and stayed there whereas if it had gone to everyone- £6000 per person- it would have made a difference) Labour's record was much better than the Tories! http://www.independent.co.uk/news/uk/politics/labour-wants-you-to-trust-them-with-the-economy-again-7-charts-that-show-how-they-coped-last-time-they-were-in-power-10173328.html
I also love 9:15pm comment thank you! This really feels like another nail in the coffin- can they not see we have a recruitment and funding problem that will only get worse if they continue to demotivate us and make it harder to do our jobs? Politicians whether MPs or in CQC etc should listen to real facts and evidence not what they want to hear. Remember the recent Commonwealth Fund report- we are cheap AND effective!
Oh help! NICE ARE SO UNBELIEVABLE. And statins increase the risk of diabetes too. I think I have done more good by recognising that statins have caused someone's: sleep disturbance or depression or memory loss or generalised weakness and feeling old!! Should we start reporting EVERY time we stop it for whatever reason? I shall start immediately even if not life threatening. Maybe we can get NICE to back track like they have with paracetamol. I give up.
I thought that all the "care management" studies had not shown any reduction in admissions for these vulnerable groups but had increased morbidity? As usual I am left asking "Where is the evidence for any of these changes?" I am thoroughly disheartened.
Thank you Dr Small- so correct! We HAVE to open for extended hours already and all the patients I see are those that would normally see doctors at normal times but want to see me and can't get an appointment at other times as I am only parttime. They are always surprised the surgery is still open. It would be even worse on Sundays. Politicians are SO IGNORANT of the real situation in general practice and we are their scapegoat for all NHS problems whereas THEY are the real cause. If this comes in and I am expected to work weekends then I will retire aged 46!
I am dumbfounded by this man's article! AND TOTALLY AGREE with my colleagues comments already stated- get him off!
We were asked to review our frequent A&E attenders recently. We found noone who we could have done anything different for after careful consideration for their reason for attendance. All the elderly who attended were entirely appropriate attendances that resulted in admissions. We have good liaison with our district nurses and appropriately involve our LTCMs. Studies repeatedly show that none of this makes any difference to whether people attend A&E or are admitted or elderly patients long term health sadly! A&E is just a resource that is needed by patients sometimes it is NOT that we are not giving them care/visiting them/fitting them into duty clinics in our already packed days- we are! The only people that we could possibly have influence on, and reduce the A&E attendance of, are the students whose halls are right next to our local A&E whereas our surgery is 3 miles away! If A&E were allowed to refuse to see them and could direct them to us, ignoring their claims that they'd tried and we hadn't offered them an appointment, then that aspect of A&E attendance maybe reduced. It is so sad that stupid politicians are in charge of the country
I am a caring GP who is strugglling with my increasing workload and have previously done letters for patients but many many times now have been told by these patients that the appeals panel didn't even look at my letter. I am now much more reluctant to spend this unpaid time (Often 30+ minutes of an overstretched day). Can someone tell me the true facts about how much notice is taken of the GP evidencefor appeals as opposed to what we already write for the DWP on their complicated forms? Is it really worthwhile? We also have more and more unpaid ESA forms to do and these take ages to do properly in order for the patient to properly assessed and the ATOS reports often come back with huge errors. Get rid of political interference and let us get back to our key role-- All VERY SAD