Anon GP Partner
Why are GPs constantly told that we need to be the solution to the problems that exist in other parts of the system (and over which we have no control)?
If there is not enough capacity in A&E or hospital beds, that is the problem that needs sorting out. It won't get sorted out until there is media attention and pressure on the politicians.
Dear Cambridge GPs - if you feel a patient needs an urgent hospital assessment, please discharge your professional duties and send them in. Do not risk their lives (or your careers).
If the hospital team then think they can be managed in a community setting, let them discharge them and take clinical responsibility for them at home for the period of their illness.
Prepare for the '5000 extra GPs' promise to be watered down to '5000 extra GP equivalents' or '5000 extra primary care clinicians'.
...and physicians assistants are riding unicorns in the sky outside Richmond House in Westminster, and all GPs are brought strawberry ice cream in golden goblets by pixies at 4pm each afternoon, and literally hundreds of GPs are boarding boats from Australia back to the UK, and all is well in the World According to Arvind. Hurrah for Arvind!
3 possible outcomes, 1 worse and 2 better than the status quo, all with major implications for England:
1. Not enough GP resignations are collected. GPC backs down. General practice even weaker as a result, eventually collapses piecemeal and is replaced by a much inferior but cheaper service.
2. NI Government recognises the level of threat and produces much improved terms and conditions. GPs accept gracefully, and back away from action. English government furious that threatened action has produced results. English GPC starts trying to remember where it left its backbone, and wondering whether to do the same. If it doesn't, individual LMCs start producing plans.
3. NI Government doesn't produce better terms and conditions. GPs walk. 6 months of chaos as the details and laws are sorted out. Some practices fold, most continue. Government pays for poorest and most vulnerable 40% (who continue to see GP 7 times per year), everyone else pays (and attend GP twice a year). Financial resources flowing into general practice increase 40%, workload drops 40% - improving working conditions enormously. GPs grapple with consequences (positive and negative)of providing a (partly) consumer-driven service.
The first sign of the NHS properly unravelling - why aren't the papers all over this?
£31 310 each over the two years = £31 million
Doesn't include placement costs, trainer costs etc. Equivalent to 50p per head of population.
Let's say 50% or 500 go into GP. That means 1 PA per 120K population or roughly 1 per 14 practices. This isn't go to do anything.
Job itself is quite attractive. 90% of a salaried Dr's pay (or more than most JDs) but no regulation and no responsibility, for just doing the easy bits? Brighter ones will become NHSE managers after 5 years in order to earn £100K a year for sitting in meetings thinking about lunch, shrugging their shoulders occasionally, and hiring consultants.
The DOH need to understand the crisis is NOW. 2020 will be too late. Silly token measures like this are just misdirection as the government wait for it to collapse and be replaced.
The core problem remains: the service is grossly underfunded.
None of the income streams promised in the GPFV correct this.
It is no longer sustainable: this is why the first tranche of practices handing back their contracts are mostly APMS (businesses with no real commitment to their populations).
STPs in their current form will not help us: they ask us to do even more at a time when we are already working beyond our safe capacity, in return for funding that itself is likely to be inadequate. Giving GPs an extra £3 per head and asking them to do another £6 of someone else's work is not going to rescue general practice, it will collapse it.
Until the core funding issue is sorted out our terms and conditions of work will remain poor, practices will continue to collapse and the profession will wither away. General practice will then be run by large private providers (like Hurley) to the huge financial benefit of the few at the top, or hospitals - the least efficient part of the existing system.