What a con
You cannot prescribe a "blacklisted drug on an FP10", so why is everyone worrying? This would actually help us.
@Jo Smit 10.24
If drugs are blacklisted then GPs cannot physically prescribe on an FP10. There would be no grounds for a patient to complain or the GMC to investigate. If this happens then it would be one of the few examples that NHSE/DoH takes direct responsibility for demand management.
"Dr Green said the GPC's stance on DH blacklisting of drugs would be determined by LMC conference policy, but that the GPC would only accept any ban if backed by legislation."
Blacklisting IS backing by legislation. GPs can then tell the patient that these drugs cannot be issued on an FP10 with no comeback whatsoever. But I will believe this only when it actually happens.
Who will enforce these contractual terms? No one. It will be left to GPs to send template letters. @4/52 is spot on, if GPs breach their terms, enforcement action begins. My rent review was due more than a year ago. After multiple phone calls and emails, I had an acknowledgement from NHSE yesterday that they are looking into it. Can I enforce a penalty charge? Of course not.
Authorities are happy to spend money on inducements and ancillary staff such as "advanced" nurse practitioners, PAs and paramedics. Why not just make it attractive for GPs to work? The idea is to shrink the GP workforce and fill the gap with other staff.
GPs time is "free." What is "free" will not be valued.
Modality appears to be a genuine "super-practice", rather than a federation. It would be helpful if any GPs working in it could enlighten us on benefits and problems they have experienced.
'The clinical pharmacist programme is a clear win-win for patients and GPs."
Is it? The pharmacists are employed and paid by practices, directly on indirectly. GP partners will have to manage the contract, including employment issues. Pharmacists will refer on to the on-call GP for queries. In short, be prepared for a drop in take-home pay and no overall reduction in your workload. The subsidised funding is only for 3 years. NHSE or CCGs will not employ them directly. I wonder why?
Contracts of this size and complexity can only be won and managed by corporations with deep pockets and bidding experience i.e. Capita, G4s, Serco and Virgin Health. The process may be open to all but I would be amazed if a GP led federation secured the contract.
The government could easily raise finance directly by issuing a 30 year bond in the open market. Devolving even the funding to the private sector is the next step in separating the NHS from government.
These tin-pot "demand management" schemes are doomed to failure. It is akin to unlimited meals being available in a restaurant for £80 per year and the owner tempting customers with bags of peanuts to prevent them going for another meal.
Those calling for a co-payment model will be disappointed. No government will sanction something that is political suicide.
This is about more than just a "failed" CQC inspection. General Practice salaried or partnership is simply unattractive for many doctors, hence the exodus to locum status. Make it attractive and they will join.
The DoH are more in need of a reference panel of GPs to advise them. For some unknown reason they keep asking surgeons to advise about primary care.
All going to plan for NHSE then. Create an regulatory environment that forces closures and mergers. Once primary care is at the required scale in the regions, franchising is possible similar to rail operators. Funding it well will prevent closures. This would be very inconvenient.
This can't be called a "super-practice" as each constituent practice holds on to their individual contract. This is a federation of practices. Nigel, the headline is misleading.
Hearing examples such as this makes me thankful to be an owner occupier. Building maintenance can be done at cost although agreed that the partners have to ensure that it is done. Another example of how the rush to become larger increases cost.
Excellent suggestions. However, implementing these would support the current model of GP which is the opposite of what the DoH wants to do.
The independent contractor model is without doubt the most cost-effective. It allow unlimited workload to be heaped on practices without the protection that would come with an employed status. The DoH know this but will not admit it in public. I will be amazed if a salaried service was to emerge.
There are some excellent and not-so-good locums around just like partners. Let us not criticise each other. Some locums choose to work in this way. However, increasing numbers are seeing it as a way out of the demands and liabilities of partnership. If NHSE wants to stop the dominoes of collapsing practices, it needs to make joining a practice more attractive.