I am totally puzzled by the attitudes of many GPs and also Mr. Vautery, regarding their lack of knowledge about the GMS regulations. No body, CCG or otherwise, can legally block any referral or prescription written by any GP. The only way, illegally, would be to impose a physical block ie., to stop referral letters reaching the hospital referral receiving agency. This can be circumvented by GPs by hand delivery to the appropriate dept. The CCG can legally instruct a hospital not to receive any referral letter. This can be partially circumvented by sending referral letters by registered post where receipt may be refused. All that GPs are required to do is to send letters and be sure they are received. A signed letter from the CCG telling GPs not to refer ( not "suggested "by the CCG), or a postal receipt from the post office saying "refused delivery" is enough to protect a GP. In my practice all referral letters were followed up by my receptionists and practice manager, to ensure they had been received by the appropriate hospital, and records marked with date and time. One of the causes of complaints and grounds for breach of contract is. "failure to refer". If letter blocked by any body, then GPs must proceed to treat themselves , in conjunction with the defence Union. If even semi urgent, the same referral can be converted to urgent, explaining the circumstances to the consultant. Our leaders, especially the BMA are actually useless. What was done about the 2004 first imposed contract by Kenneth Clarke. I now hear the MPIG has been withdrawn. Any reaction? Of course, the BMA represents us GPs and we get the government we deserve.
General Practice will change. Change is the law of life as in human society. Just as bad changed to good when the NHS was formed, good will change to bad when confederations are formed. Someday this will again change to good. If you cannot beat STPs, join them, to survive.
GPs have a contract. They are all required to follow that contract, or risk being in breach of contract. There is no public or private body that can stop a refferal. The only way a CCG can block a GP referral is by returning the referral letter. If this happens, the patient should be informed and the letter filed in the records with the comment "returned by hospital".You cannot directly tell a patient to complain, but they can be subtley pointed in that direction. The. BMA, RCGP, LMC, and worst of all, the GMC, will not do anything for you. So ,follow your regulations, keep patients on your side and contact the MDU for advice each time.
I have the greatest sympathy for Dr Gibson who is facing a potential £800,000 bill. This is the fate of unlucky GPs, bankruptcy or death or imprisonment.. A salaried contract is a better option in times of distress.. The BMA should be trying for a massive change in our contracts to protect GPs from such occurrences.
The alternative for Dr. Gibson was to keptrunning the practice somehow eg by becoming singlehanded and using locums and nurse help , for the next 8 years. My friend who works here is doing just that.
Dr. Gibson, contact me for a solution. My email is firstname.lastname@example.org I am confident it can be rectified.
The RCGP and the BJGP , Never been a member. Nor the. BMA.. Survived for 32 years in the Welsh valleys. Retired now. Why be insulted?
Save your money friends.
Congratulations CQC, job well done.
As far as I am aware, there are no terms and conditions for the CQC to fulfill (unlike us).
About informing the Information Commissioner, it is a job which will be overlooked due to human error.
And pigs may fly.(no offence to pigs intended).
Comparing and then changing indemnity providers will reduce costs for a short while only, as all such costs will eventually catch up. There seems to be a misunderstanding amongst most writers that we are a part of the NHS. We are NOT. We are officially, INDEPENDENT CONTRACTORS. We are like the electricity providers, the gas providers, the cleaning providers etc. Under these circumstances we are NOT entitled to any crown indemnity cover. The options are, change the contract or resign. We are like the builder who builds your extension or your home under a contract. We are like TESCO or SAINSBURY but without any tills. Only when all GPs become desperate will there be change. At this moment the general GP attitude is " I'm all right Jack, thank you".
Humbly, retired GP.
I can understand all the frustration that present GPs in England have over the services of Capita. Frustration, disaffection etc. Are all based on expectation. If GPs can control their expectations of others, they will feel better and stoically carry on. Long ago, when I was practising , 5 yrs. ago, I found this the only strategy for coping with the inefficiencies of management. Some writers have questioned why GPs are scrutinised so much whereas others aren't . The answer is very simple. Dr. Nagpal can do nothing. As stated many times by me, the problem is not NHS England nor Capita. It is the GP contract. If All should read this in detail, every word and sentence. There is no option to protest or complain against anyone or anything. The only two rights GPs have is to remove violent patients and not to register a patient living outside your practice area.However, both these come with conditions, which all GPs probably know. There is no option for negotiation other than the DDRB, which is usually ignored.This is only regarding pay.
The GPC, BMA, RCGP, the LMC CCGs, the Health Boards, no body can change the GP contract. In such a desperate situation, there are only two options. Resign, or Go on strike. These two options should be debated in every GPs heart. Dr. Nagpal can do nothing. Only you can do something. GP discontent has been simmering for the last 30 years. Nothing will happen now because GPs are not desperate enough. Only time will tell when GPs become desperate enough to take action.
I retired 5 years ago, but still feel the greatest kinship with present GPs. May God bless all. Humbly. Retired GP.
I do not agree with Anonymous Practice Manager, ( dated 21/07/16). All GPs run their practices efficiently, otherwise they would go bankrupt .Regarding prescribing generic against branded drugs, all CCGs, LHBs and other general practice authorities, all over the UK, have influenced and convinced at least 90% of GPs to change their habits to prescribe generically. So, Trust takeover will not reduce costs. The cost of administering general practice through a trust will be astronomical mainly due to inherent inefficiencies
that a large organisation has. Furthermore, most Trusts in the UK are in debt, Many reorganisations later, they are still in debt. This the reason hospitals wish to dump their work onto GPs. Now there will be no dumping ground left.
If the powers that be do not realise this,( penny wise and pound foolish),there is nothing GPs can do but wish them good luck. GP's incomes will drop but, better a live rat than a dead lion.
I agree with 1st. Post. This CCG advice is unbelievable. Lose your job by following their advice? NO WAY. The only charge that the CCG can bring against a GP regarding this matter is that of "overprescribing". To avoid this, prescribe in smaller quantities. If ever charged by anybody, remember the diagnosis and recommended treatment. If you are brave, the sly foxes will only bark at your feet.
Retired and experienced GP.
All very well to say we won't do this and we won't do that. They will all lead to breach of contract. The only solution is to try to have our contract changed. The present contract is like an albatross around GPs necks.
The BMA, hah hah hah! The GPC, hah hah hah. The RCGP, who?.
Unless a determined and resourceful leader emerges from our GP ranks, GPs will forever be shackled.
The present generation of GPs should not promote general practice at all. The terms of service are draconian. The salary is like rubbish. Time per patient is ridiculous.The advice given by CCGs is almost criminal, NICE guidelines are good but practically not implementable due to lack of resources, gross variations in all standards across the country, hospital dislike of all referrals, unacceptable orders to do work GPs are not trained for,more than quadruple legal jeopardy (including CQC inspections, poor working conditions, no contract health safeguards, poor eventual pensions after huge contributions, Need I say more? How can any practising GP promote general practice? Can all trainees join the few leisurely practices some where's in this country?
Retired GP from the Welsh valleys.
Why do we need to "sell" general practice to anyone. In spite of selling, trainees have antennas. They can sense that General Practice is toxic, for brain and body.. Work without resources? Can't leave, can't stay? Whipped regardless of reason? Sound familiar? If not, think of a word with 7 letters. Help! Slavery.
Retired, mentally and physically wrecked GP from Wales.
Who conceives these ideas? Not geniuses but Great geniuses. They all deserve Queen's medals.
15 year contract? WHY? What is the reason as compared to life long GMS? and, not salaried,
Any change in the wording of our terms of service? I wonder what is going on?
The last benefit is our life long GMS job. Even that will be lost.
Will there be a cap on list size in the new golden age? What if list sizes are increased unilaterally by the ACO.
.Dr Vell hasn't yet seen the contract Great.
I am a retired GP.
I am absolutely astonished, and am at a loss for words, as to the lack of intelligence of some GPs.HOW CAN YOU BE EMPLOYED IF YOU HAVE TO PROVIDE YOUR OWN PREMISES? This is one of the most important differences between being employed and salaried, for tax purposes.
Dr Vinci Ho is discussing the future, about future leaders. Does it even deserve mention?
None of the leave campaign are mentally retarded. At least not yet certified. They have made the UK POORER and FRAGMENTED, Why? To achieve their own great ambitions.
Retired 5 years
I think Dr Copperfield is absolutely correct. In a few years time, we WILL be required to do chemotherapy. We're we required to do T1DM management 10 years ago? So, look forward to chemo!
As I keep saying, the problem is the our contract wording. If the. GPMC and the BMA and the LMCs started fighting for our contract, on the basis of the ICD ( international classification of diseases list), all GPs would know what to learn. If they start now there may be a change within the next 100 years. The other option is, implement ICD or we will all resign. The wording " all GPs are expected to provide GM services, as provided by all other GPs, is like " an albatross around our necks".
Why do GPs want to be called specialists? Is this desire an ego trip? Why are GPs not happy to do a good job? Is it better to be a good GP or a bad specialist? Why is it necessary to receive a honour. I would like to think of GPs as hard working, honest professionals not seeking great rewards. A milkman was awarded a honour in thr queen's list. When asked what he thought, he replied "what did I do to receive an honour, I am only a milkman". I rest my case.
Retired singlehanded GP.
I know I am an idiot. But why should we refuse to issue a certificate to a person to hold a firearm? We will be pad for this certificate,Cwl know the patient, we have the medical history, we have our personal impressions about the applicant, we have a personal history, we can obtain a psychiatric report ( even on a normal person), so what are we frightened of?
If we let the BMA run our professional lives , we will find ourselves as disliked as the BMA is, by doctors. If anyone wants particulars of how the BMA is interested in only itself,contact me. I have experience ot the BMA, the LMC, the MDU or MPS, deserting you, when needed. Remember my adage, if you support your patient, legally, he or she, will always support you. Ultimately, you represent your patient. I f he or she is happy no one can touch you.
In many of my reviews and comments I have tried to explain that the patient is king.
This is in our contract. If the patient is happy , both you,and the patient is king.
Summary: try to help, not hinder, our patients.