his promises are barely worth reading. There needs to be an honest acknowledgement that one of our main problems now is the disappearance of full time vocational GPs. When practices want to replace a retiring partner all the applicants want part time or salaried work. You cannot run a practice without committed full time partners. End of.
having personal lists helps with this problem. Most of our patients are very cooperative and rarely ask for a home visit but then we are rather traditional with full time partners and no noctors. Our CCG has organised some visits by paramedics but I was rather shocked to learn that they average 6 visits in a 12 hour shift.
diconal, now there's a drug from the past. We used to call it the 'little pink darling' and patients with renal and biliary colic would have a few for emergencies. never had any addicts asking for it. It is one of those tablets where a drug company ramped up the price from a few pounds for 50 to many hundreds of pounds. Stopped using it then.
we front line clinicians need to fight back against the ever increasing paper workload. How about we start by all refusing to do the mandatory training? Even if only 10% of us do this they cannot possibly stop us working....
I see problems of spoilt children on a daily basis and have been involved in possible child safeguarding maybe once a decade.
All this mandatory training is manifestly NOT addressing the real need. It is a demoralising waste of time.
mid sized practices have evolved to be the most efficient and friendly. Why are we being forced into larger PCN groups which act as a time consuming distraction when all the effort and funding needs to go directly into the practices themselves?
The lack of new full timers is also a major adverse influence. you cannot run a practice easily with part timers. When will this truth be acknowledged ?
we have a new 2,700 house estate being built near our practice which is already bursting with 16,000 patients. this will add another 9000. How on earth are we supposed to cope with this and a tiny building designed to house 9000 patients originally. What other agencies are going to sort this out if we work with them.
What utter nonsense from the CQC...
our local private hospital (Gatwick Spire) has a 4 page proforma letter with the diagnosis or operation as a single line in the middle of page 3. repeated efforts to get them to make this safe have yielded no progress.
Where has common sense gone?
could pulse provide more details such as which system failed? This is poor journalism.
the OOH is becoming dangerously poor. It is not only the ambulances that are failing but the emergency doctors are too thin on the ground. And yet you can been seen by a doctor in 'the hub' for a sniffle.
we need to get rid of the hub so there is enough money and doctor numbers to provide a safe emergency service at weekends.
This is the politically correct approach to under representation. It is always the fault of white males.
Could the problem be that the under represented groups are not generating individuals who want these positions of added responsiblity?
Whenever I attend political meetings (to do with our contracts etc) there are at least 70% white males and women are a small minority. I always assumed they were busy with their own lives. I never realised we were somehow blocking them.......
dare I say it but I love being a GP and I work in a busy but happy practice where we give a good service and have happy patients. For us partners it is the best job in the world. Why can this not be replicated in other practices?
Scotland are going down the one GP covering a team of noctors route - more like a community geriatrician post than traditional GP as we know it.
Any young and aspiring GPs will run a mile from this type of set up.
please don't let PCNs take the funding and emphasis away from mid sized successful partnerships which have proven over the last 75 years to be the bed rock of the NHS.
While everything else changes in a bewildering carousel of 'new ideas' the local surgery continues to pick up the pieces and provide continuity for the poor patients; who are even more confused than we are at the new structures. 'Here today and gone tomorrow' is their core value. What a shambles!
It used to be a useful trick in my area to start the under 16s on an SSRi and then CAHMs would actually see them quickly to take them off it. It just shows how desperate the children's mental health provision is getting that the system had to be 'gamed' to get any sensible service.
can we refuse to be seen by non medics?
being mandated to take back responsibility for the ludicrous 12 hrly 7 day access is a poisoned chalice. We are fools to be bribed to take it on. We need leaders prepared to stand up to this nonsense. Where are they?
we were a pilot site for direct access physio and within a couple of weeks they had over a month waiting list so the patients chose to see GPs instead. we work quicker and cope better with the work load.
nocters don't provide a solution, we cannot manage GP work without GPs
EXCELLENT article. well said, and good to see lots of positive comments from traditionalists of which I count myself one. We need to defend this type of primary care which works well and wait for all the epiphenomena to evaporate when they are invariably found wanting.
I don't use emis but here in England it has a very good reputation in many practices. Why has it been pilloried in Wales. They should let practices stay on it and migrate at their own pace if they so desire. BEWARE managers forcing you to do something. It always ends in tears and they move those responsible to a new position and then deny any responsibility for the mess. Imagine if we behaved as badly as they do.....