This is part of the worrying trend of criminalisation medical staff that is being heavily promoted in the UK. No doubt it is very profitable but it adds very little to patient safety and is almost certainly harmful. As noted above, the CQC is very poor at preventing the outstandingly awful from happening, probably a byproduct of their 'tick the boxes and everything will be alright' culture.
Communication skills are only a small part of being a GP. For sure, some would argue these are important but for the profession to thrive we actually need a diverse workforce. That means recruiting people who have a head for business, people who want to do minor ops, people who have an eye for data crunching and audit and yes, people with high emotional intelligence. The current CSA is throwing a lot of decent doctors on the scrap heap at a time when UK GPs are on their knees drowning in a sea of demand. The CSA discriminates against anyone with any form of communication deficit, be that through cultural and language issues or autistic spectrum characteristics, this is terrible and needs to be called out besides which most doctors get better in the first 5 years of practice as they hone what was learned as a registrar and adapt it for the less forgiving real world of front line NHS care. Scrapping the CSA is not a demand for low standards, rather recognition of the wide ranging and rapidly changing needs of our profession.
The great and the good should have called this out several years ago. Sepsis is a complex catalytic inflammatory reaction, it's unpredictable but thankfully rare. What is now called sepsis is just an excuse to exploit the NHS for cash either by up-coding or dubious legal action. It's damaging patients and doctors alike. Something needs to be done about this immoral mess.
Researchers have tended to produce quite tight definitions of asthma that in IMHO don't reflect what we see in the real world, many studies have wide exclusion criteria. There are a substantial number of patients with chronic respiratory problems that flare up intermittently over the years. When they are well, they might not fit the research definitions of asthma. If you CT/bronchoscopy them all, and do fancy serology etc you would no doubt find some extra underlying respiratory conditions like bronchiectasis, alveolitis, fibrosis and so on. However this is not proportionate use of the resources in the primary care population for whom strict adherence to guidelines is often bad medicine and doesn't get people better.
This is terrible advice. Many insect bites present with inflamed round rashes and not all Lyme presents with a rash. This might be reasonable for Southampton and the New forest where Lyme is endemic but I'd have to question it elsewhere. NICE need to start asking what doesn't need antibiotics?
The RCGP needs to end its fetish with communication skills. Whist these are important, there is more to being an effective GP. If doctors are given the chance, they will develop these skills over time. The CSA should be scrapped.
They aren't handling this properly. If the NHS dabbles in Rachmanism then it is moving into the area of financial crime and the perpetrators need to be prosecuted wherever possible. Lets be honest here, there is no justification for hiking 'service charges' to levels way above the market, there is another agenda here. This has had significant adverse effects for patients around the country, it's not some sort of vaguely defined victim-less crime. The BMA should be demanding a criminal investigation.
All patient data has to go through the N3 line which in IT terms is so old it’s archeology. The solution is easy, just push data through the regular internet and use encryption that seems to be good enough for the entire banking industry. Unfortunately, there is too much protectionism preventing progress. The only upside is that our IT is now so flaky that the government can’t implement even more top down control, micromanagement and stupid data mining schemes because the internets are too slow to support so called ‘innovation ‘.
Current GP IT systems are actually quite dangerous in our high risk clinical environment. They are slow, prone to hanging, bug ridden, lack integration and sometimes you even have to reboot windows to get it to work again! This would never be allowed at air-traffic control or any other safety critical industry but hey-ho, it makes a profit for someone, somewhere. There is no excuse for this but lack of competition has lead us down the path of mediocrity.
We need to scrap performers lists. It's stupid having 2 parallel systems on an island the size of the UK. The GMC for all their faults should be enough - performers lists are just providing jobs for the old boys club whilst adding little of value to patients.
Why would anyone want to be trolled online? Feedback is the curse of the 21st century, holding individual workers personally accountable for corporate and political decisions. It has no place in medicine.
The CSA is a dogs dinner of an exam, with it's relentless focus on 'communication skills' (in practice trying to second guess exactly what people want and manipulate them into buying it). This will inevitably bias against anyone who is not from a UK culture, has darker skin or who has some degree of spectrum traits. Doctors need to be polite and nice to people, not perfect. How this has been allowed to carry on is anyone's guess but the cat's out the bag and we know the exam must be reformed.
NICE should have been shut down years ago, it consumes vast amounts of tax-payers cash that would be better spent on front-line healthcare provision. It's guidance is often of poor quality or simply difficult to apply to the real world NHS under strain. It creates a world of painful legal problems for doctors and does little to protect anyone from harm, driving the demand for investigation and treatment. NICE was designed for the pre-internet era when information was harder tom come by. Why on earth have we allowed this to continue?
The appraisal/revalidation system was introduced with deliberate malice, it's got nothing to do with quality or performance. Primarily it puts extra pressure on the NHS to ripen it for privatisation, as a happy byproduct it makes lots of money for an army of government bureaucrats. The ultimate losers are the patients and the profession.
This is why NICE has long passed it’s sell by date. These so-called guidelines have become an out of control monster that needs shutting down as a matter of urgency. They aren’t fit for purpose implying a level of simplicity in what are more often than not extremely complex human situations. We’d be far better off reinvesting their budget on routine NHS care and passing financial rationing back to parliament where it belongs.
It makes too much money to be successfully reformed. None of this would ever have happened if it wasn't churning so many doctors through it's meat grinder but it's impossible to wind the clock back because there are too many vested interests. The GMC is run by lawyers and accountants who have almost zero interest in a safer NHS because this would conflict with their interests.
All going nicely to plan then.
The present funding model is based on money following patients with a few adjustments which used to make sense when the complexity evened out over list sizes. This no longer works and practices are going under. The funding should instead follow workload, the number one concern amongst GPs. In practice this would mean more item of service claims becoming available from the GMS contract. Free markets tend to work poorly in healthcare as exemplified by the USA model but the European co-payment models do seem to strike a fairer and more sustainable balance when appropriate regulation is in place.
Can someone (BMA?) please challenge these people in court? They've done no end of damage to the profession which is 5000 GPs short. Feedback actually harms patients and we should force the GMC to stop it by law.
We can't think twice because the timetable doesn't allow it and anyone who says no will go under through loss of their enhanced service funding. It's pretty clear we're being glued together ready for privatisation and asset stripping. Does anybody care?