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A faulty production line


  • NHS England to collect GP appointment data through winter

    anonymois's comment 08 Sep 2017 11:10am

    How is this going to work?
    In TPP even the most basic of data does not seem to be easily extracable, and as for how practices configure it so differently that's another story; God help any analyst working on this project! Best of luck making sense of it all.

  • DH to launch crackdown on prescribing errors

    anonymois's comment 06 Sep 2017 11:10am

    Response to Conbblers:
    Repeat Dispensing has been available since 2003 and is available electronically now as well.
    The uptake has been very very poor.
    From where I sit this is one of the great lost opportunities of the last 20 years.
    Interestingly where CCG have strategy of investing in pharmacists in primary care, eRD progress across their CCG is looking very good indeed.
    Worth adding to the planning discussions at local level.

  • DH to launch crackdown on prescribing errors

    anonymois's comment 06 Sep 2017 11:02am

    The whole prescribing process is deeply flawed at system level - at worst it is an unmanaged production line of FP10 with only minimal
    oversight by a clinical system that is on its knees from transaction overload.
    I doubt that the findings by Arnold Zermansky in 1995 in Leeds published in JRCGP are much different today - only 50% had a clinical review in the previous 18 months in his study group of training practices. In a personal communication he thought in ordinary practice it was nearer 33%.
    The arrival of pharmacist as a key role inside GP surgeries is crucial as a manpower issue, but do is root and branch reform inside practice prescribing systems as a developmental strategy. More bodies added to a flawed system will not help in the long term.

  • NHS spends £21m on consultancy advice on how to cut costs

    anonymois's comment 01 Sep 2017 5:38am

    Sorry folks - but £21M ( and that is projected ), while by itself seems large, is a piffling small amount compared to total overall NHS spend - several billions. Kent and Medway £3.2M for a single local area however does seem rather a lot. My only question would be then, given this disparity, is the true spend underestimated? Need to know more about FOI responses profile to understand that.

  • GPs forced to get approval before referring patients to hospital

    anonymois's comment 11 Aug 2017 11:03am

    Anyone who looks at GP referrals will tell
    you the vast majority are OK.
    However there are some appallingly poor ones - mostly inability to frame the actual problem and lack of relevant information. The lack of a suitable local service also rapidly becomes apparent.
    Shining a light on a referral area produces imptovement in referral quality but numbers less sure about.
    None of the contributions seem
    to document changes in quality or identification in referral pathway gaps. This needs redressed.

  • Government 'in denial' about GP workforce crisis, warns former minister

    anonymois's comment 26 Jul 2017 11:02am

    Spot on about supply induced demand - what article does not say is contact rate went up by by 50% in Luton.
    Capital monies to set up but no revenue from DH.
    A decreasing GP workforce has to man 5 different access schemes - it will
    be interesting to see what gives and when.

  • Coroner writes to NHS after investigation ‘lost sight GP was a human being’

    anonymois's comment 29 Jun 2017 12:18pm

    Well done to the coroner for not allowing a whitewash here; It's very sad for the affected late GP and her partner - but does anybody give a damn - sadly I think not.

  • GP superpractice set to lobby ministers to rewrite GP contractual rules

    anonymois's comment 20 Jun 2017 8:19pm

    Not sure you have got your reporting right - the practice in question here is PMS not GMS,

  • Pressure put on Government to make GPs screen for atrial fibrillation

    anonymois's comment 10 May 2017 11:59am

    When I audited AF treatment - it was the old AF that a decision not to use Warfarin was the biggest issue by far - new cases were
    all being actively treated.
    This backlog effect is the issue that is not being addressed.
    We also noticed a number of strokes/TIA were in AF at presentation who we knew were in SR within the last year. From this latter observation, I wonder if there is a limit to how far we can go to prevent AF driven strokes as the events may happen quickly after the onset of new AF.