GP principal - 25+ years
I feel better for this refreshing blast of honesty! It just illustrates how much of what we do is solely to meet expectation. It's not only the proctologists who spend their days 'going through the motions'. Hands up who reaches their diagnosis before the patient makes it to the chair?
Anyone who states that QOF has 'had it's day' should question critically whether the original QOF indicators were truly valid. Are we happy to continue this cycle in medicine where everything that is vital today can be worthless tomorrow? For instance, the provision of obesity and smoking services as public health measures?
There is a further issue here (and one that Agent Hunt will be loving). In order to maintain there list sizes, city GPs will find them having to compete with Babylon. They will have to offer instant Skype consultations to the entitled young professional worried well. At no extra cost to the NHS. A potentially endless increase in demand. Unfunded.
In your town is the medical referee a GP who works for nothing? And do all the other GPs fill in cremation certificates gratis?
The reforms are essentially aboutauthorisation of disposal of the deceased. The MCCD certification process will continue much as before, with a little oversight by the ME.
Why do an ECG? Why a GCS score? Why 999? Presumably the intent is to give the patient all the attention she so craves.
Attendance at A/E is of course appropriate, but what's the rush?
If as clinicians we can't use NHS resources appropriately, then what hope is there?
Excellent column Copperfield. Why is it that we feel we are fighting against NHS England constantly in order to provide a good service to our patients. Aren't we on the same side?
...better than using it without fully appraising it! Have you seen any evidence that a patient-held stethoscope is as good as one wielded by a GP?
Very well stated and illustrated. As doctors we really shouldn't feel every day that we are fighting against a tide of management, we should feel that we are gently riding the current in the opposite direction.
Top job Nigel. You always gave the impression that you empathised with the difficulties GPs face, and were prepared to champion our cause.
Now this is a proper use of CQC time and powers!
I'm all for evidenced-based medicine and trial evidence can be helpful. But let's face it, if you want to know the sensible correct duration of a repeat prescription just ask a jobbing GP. As the commets above demonstrate it really isn't rocket science and I would suggest that we should all be left to manage our own practices unencumbered by edicts from the ivory towers or researchers.
I have absolutely no problem with such a service, which should offload trivia by the truckload from general practice. But it is not a replacement for GMS services and should not be funded as such.
I'm interested to see how long it will be before a 'service user' is unable to access a GP core service from this provider. At that point the GMC need to be involved.
Newsflash: The Carr-Hill formula is not 'out-of-date' - it was always rubbish. Hence the MPIG farce.
The 'small business model' of GP partnerships is one of the few things in the NHS that continues to function efficiently and at ridiculously low cost. Chuck it out at your peril Jezza!
So when do you drink coffee now?
I love the BJGP. It is the only journal that I can drop in the bin without opening, safe in the knowledge that I won't have missed anything worth knowing. I just wish they would print it on softer paper, so that at least I could put it to a good use.
As a profession we must resist the knee-jerk move towards easier (electronic)access. It will not reduce waiting times, it will probably do the opposite by doubling the work.
I will retire before I Skype.
Dear CQC. Please advise us what the cost of inspecting 28,000 establishments was. Do you think this represents fair value for money as the purchase price for one knighthood?
GMC: "Indeed, appraisal rates have risen steeply in all four countries of the UK since its introduction."
It's funny that isn't it - you make something mandatory and suddenly we all start doing it. Does that mean that it is invaluable?