Its our own fault guys we know these drugs do more harm than good so why are we prescribing them?
I am a 63 year old gp locum and i work partly in the uk and partly abroad. In the uk i have to cope with myriads of forms, IFR rules which vary from area to area, QOF, irritating interference in my prescribing, appraisal, and really stupid mandatory training in FGM etc etc. Outside UK there is none of this . No wonder we are putting off potential gps.
The government is actually not trying to reduce drug costs as that would harm their friends in big pharma.
If we really wanted to reduce costs we would follow the Kiwi example and negotiate prices in a sort of auction -who wants the Acei inhibitor contract and what is the lowest price you will accept - etc etc. it works and the patient gets the branded drug they now, but really cheap for the country buying the drugs.
We get generic prescribing and timewasting dangerous rubbish like Optimize. And gps are retireing in droves- go figure.
We should send a big hug to dr bawa garba and salute her persistence.
We should send a big raspberry to the coroner the police, the daily mail and the gmc and tell them how much harm this has done to medical care in the uk. Many good docs have gone and the rest are practising defensively and badly.
“Nice has links to big pharma”
Surely not .....
Let’s hope these GMC people are losing at least some sleep when they consider those dates.
Last out turn off the lights.
All these patients are going to need to be seen so it will mean GPs doing more work, with no reduction in the work of the specialists. Obviously all BCC's need to be seen and assessed as 2WW as some of them are SCCs.
Waiting lists do not reduce work - they increase it ! as this stupidity demonstrates.
So crp and strep testing are effective as has by the way been proved around the world but we aren’t giving GPs these tools, we are just telling doctors to record blood pressures ! and hand out leaflets, and if it goes wrong don’t look to us for any help we will be in a meeting.
And do short courses really reduce resistance?
The most logical approach is always to prescribe 2 antibiotics together. Fleming recommended it and it is a strategy that needs testing.
And crp etc testing works to cut prescribing in Europe no question about it.
How ‘professionally’ were Roy Meadow and David Southall treated by the Gmc ?
The Appeal court said ‘not at all ‘
They have quite a cheek I must say to lecture anyone.
Clever MDU the Evil monsters.
So they reduced the premium for 1year then whacked it back up to nearly the same as full cover, and now they have us trapped so we either pay the run off fee which will be huge I bet or stay with them.
Come on bma do something for a change.
not for the first time Pulse magazine has missed the point completely
The main problem with the governments proposals is that the new scheme does not cover claims made before april 1. So that means that many gps will need to keep paying the bloodsucking MDOs if they want to carry on working.
So what will the effect of this be?
That GPs like me will say s** it and stop work and stop paying and what will the effect be on the workforce.
And did the government think of this ? maybe they did and maybe they do want to destroy general practice - but more likely it is just the usual explanation - Cockup - not conspiracy.
Where do I start! QOF was introduced with no evidence base, and has had no effect on outcomes according to the experts.
It has increased workload massively and led to massive increases in expensive and dangerous polypharmacy mostly advised by Noctors who are not trained in pharmacology or EBM.
It has led to a breakdown in trust between doctors and patients due to the conflicts of interest involved, and along with the CQC it has pushed many good GPs into early retirement.
According to the latest European comparisons see the recent BMJ, we are now no 16 out of 35 in health care quality with one of the worst records on access, below Macedonia!
If we are happy with that , then retain QOF.
Old news. First of all it’s 4 year old data. Then the price differences are tiny, under 2percent for ACEIs, and less for PPIs. The Sartan data is skewed by the poor availability of Valsartan.
And of course there are a small number of dispensing doctors who do let their financial interest bias their prescribing, but to smear 1in 8 GPs on the basis of aggregated data is unfair just as it is unfair to accuse pharmacists in general of being biased in advising patients to buy useless and expensive remedies for coughs etc because some of them do that.
Could Dr Goldacre and colleagues also do a comparison of patient satisfaction scores, continuity of care, and unnecessary admission rates between dispensing and non dispensing doctors. No prizes for guessing the results.
My dad would turn in his grave. What a stupid idea. Practices should only take on the number of patients they can cope with and then accept the duty to deal with them.
Top tip. Open access turn up and wait surgeries provide a good service, make patients happy, and discourage time wasters.
Second top tip. Continuity
It seems that the guys in charge are determined to implement new ideas that are demonstrably inefficient.
Are other countries doing this? No they are not. I wonder why?
We all have a choice. We can close lists employ locums, reduce practice areas, etc. We don’t do it because we are greedy. The result is bad quality care by rushed doctors, and incompetent Noctors.
And the exceptional practices that have good doctor patient ratios and don’t overprescribe or over refer get no appreciation from on high. After all they expose the uncomfortable truth that it’s the practice that counts, not federations networks CCGs area teams etc etc
It is crazy that we are allowed to prescribe these drugs when you see the abuse and harm we are causing.
Make them all specialist only. End of problem.
Didn’t the recent study and the Cochrane review agree that treating high bp under 160/100 does not reduce mortality but does cause falls AKI etc etc.
Public health is not our job
We have plenty of sick patients.
There is a very obvious answer which is in widespread use. Open access just turn up and wait surgeries for acute problems. Watch your patient satisfaction results shoot up, save lots of money spent on paying re eptionists to say no. Know that your patients acute problems can be treated promptly and sleep well at night.
We used to do this in my former practice but had to stop it on the orders of the NHS area team!
Dear Mr Hancock,
You are right about the problem, that we need better IT, but you are so wrong about the solution.
The main issue GPs face is pathetic bandwidth due mainly to the crap and expensive deal offered by BT which is simply not fast enough to run IT systems with remote servers. Apart from that GP IT is ok though personally I find that very few systemone practices have adequate summaries.
GP IT was world leading when it started in the late 1980’s due to a few bright guys and GPs making informed choices which made EMIS the most popular system. In contrast centrally mandated systems like GPASS were a failure.
You do not need to make all doctors use one system, what you need is interoperability and choice, and a massive effort on broadband.
And by the way, it’s hosptals where IT really is a disaster.