Hello it’s me
A brilliant and well articulated reflection. Many are taking the opportunity that Covid offers to down tools, and claim they are doing it 'for the good of the patient'. We need to insist that our secondary care colleagues do not hand back their work to us. It is not safe, not fair, and patients will suffer. There is no justifiable reason for the refusal of much of the work that is now being seen. A stretched and fractured system, is taking the opportunity for a much needed rest, but at what cost?
I'm not entirely sure what the main point is of your blog. If it is, 'don't drag the GP into this', then I'm inclined to agree. Far better to invest in education, public health screening, and early intervention... I would welcome simple self referral systems with better access to gyms, pools, and more PE classes for children.
Lambs to the slaughter?
I agree. seemed like the sensible approach at first, but as numbers have not been as extreme as we were led to expect, the need is not there. just as safe to use a dedicated room in a surgery, and better for practice stability and cohesion. this was not possible to know 2 months ago however, we thought we were dealing with a very different beast. we were expecting our colleagues to turn people away from hospital, and that they would be overwhelmed by demand.
i'm pleased to hear that we are being given discretion to decide how and when we undertake routine work. this cannot be a one size fits all model. GPs have to (as they always should) be able to decide what is appropriate for them, their patients, and their staff - in their local area facing their local challenges. Some areas will have high rates of covid with a vulnerable population, others will have lower rates, and their population may be less at risk. so we need to be given the freedom to decide how we manage our work. less top down control, more autonomy, support structures from NHSE/ CCG when we ask for it. its not that hard. Frankly, nothing can ever be completely safe, and we'd be in total abdication of our responsibilities if we refused to see patients (even routine issues) until it was totally safe. I've not met many GPs who would advocate that. We are very capable of risk assessing our own staff, and working together for the good of patients.
i'm not even going to begin to discuss group consultations via zoom. is that put in to goad us?!?
i don't believe i have ever received applause without distinct awkwardness. I don't intend to learn to do so now. and i'm not doing this job for applause. i signed up because i thought i might make a difference, by the time i realised i couldn't, it was too late!
The claiming of 'progressive' always makes me smile. Is it progress to euthanase a depressed older lady in a miserable nursing home because as a country we cannot provide decent living standards for our elderly? Is it progress to euthanase a teenager following a spinal spinal injury? Some would say yes. Your idea of progress is different to mine. But yes, it's just because cardigans are voting, they know nothing. Bring on the progress!!
This is where it is all going. This pattern will continue round the country...
Agree wholeheartedly with: 'If networks are able to stabilise general practice – and I am dubious about whether they can – this will take years.'
There is little to suggest that PCNs offer any meaningful solutions to the GP crisis. Many of us suspect that NHSE is trying to subvert GP into a new model, larger scale, salaried, private provider - with the pretence that they are trying to 'shore up the partnership model'. This might be a last ditch token attempt to say 'we tried to sustain partnerships, but...'. Pretending to be trying to help secure partnerships, all the while paving the way for large-scale mergers, and a sell out. Would be genius if it wasn't so painfully obvious. And our representatives in the BMA haven't the balls, or the will, to do anything about it.
This will end up being worse for doctors, worse for patients, cost a fortune, increase health inequalities, and almost certainly diminish the health of the population.
A brilliant commentary. GPs need to be united and firm in their response. Workforce needs to be the priority, and stabilisation. You make many excellent points. Once the profession has seen the benefits of extra staff (or any of the 6000 extra GPs have materialised), these specs can be considered. Until then it's a massive no.
I'm with soren. While we have an underfunded, inadequate NHS, our suffering, disabled patients will be faced with a terrible choice - take the poison, or suffer the indignity of death in an underresourced health service. I have seen too many neglected older folk to assume that all family members would act with decency towards their older relatives (whose houses and assets are likely to pass onto the younger generation, that is IF they don't live long enough to need expensive care in a nursing home). There would be a terrible upsurge of elder abuse, mark my words, if physician assisted suicide were an option. The disabled and dying would be viewed as a drain on personal and NHS resources, and would be (consciously or unconsciously) encouraged towards ending their lives. That is not compassion. Invest in palliative care. Offer hospices to all dying patients. This is the harder, but better, and more humane option. Our older members of society are not dogs.
The ship is sinking. We have been trying to warn policy makers of this for years. I suspect GPs working part time are still doing the workload done by full time GPs of old (in terms of the numbers of patients seen, and number of problems, and medications dealt with). We will never keep up with the burgeoning demand. FATPOA is no longer sustainable, if we battle on trying to save it, we will destroy the whole service. Whats the point of 'free but no access at all'...?
Sincere condolences. Your plain speaking and honest reflections on Pulse, do you and your family credit. It sounds as if your wife was a remarkable woman. I hope that there is comfort in looking back on a life well lived. And I hope you will carry on contributing.
I don't get it. They voted in favour of a motion saying they had no faith that PCNs will reduce workload, and they want GPC England to reject this model, but they didn't vote in favour of BMA GPC to negotiate for networks to be removed from the contract? Where is our professions backbone? It is madness. They are selling GP surgeries out, leaving GPs holding the can after years of underinvestment, and workload dumping. And we can't even call them out on this? PCNs will increase workload, decrease continuity, and leave GPs ultimately responsible for ever more patients, with fewer and fewer doctors. It is a shambles, and we are sleepwalking into it...