North East GP
As a locum I get people who come and feels it is ok to be rude and/or late like a supply teacher but I am usually firm and fair I will tell them it is not acceptable. For too long I thought it is better to keep peace and bite my tongue but what I find it I would be driving home and be kicking myself for not saying anything and be annoyed so now I say it to them. Quite a few people are totally unrepentant but then someone needs to tell them they are rude and it looks like no one has so far. Unfortunately, there is no point turning to the useless GMC or DoH all they say it well it is "unacceptable" what a pointless and toothless comment.
Almost all the Darzi centres in the north east where I worked has closed. If Professor Lord Dr OMG too many titles Darzi wants to help why doesn't he become a GP first, I dont see anything about this is in conjunction with any GPs about this suggestions. Almost reminds me of the typical politician who has no experience in management or NHS running the health service. May be we could just get someone from Holby City to write a report as well.
As Prof Cumming says I am the 60%, finished training last year, there is so little incentive to work as a salary, why get tied up with a surgery work the same hours for 30% less. Agree with the comments so far, better working conditions and investment and people will stay in the UK and work. As for the 5000 FTE target the Tories shot themselves in the foot, on one hand, telling "immigrants" to go home post brixit and "hostile environment" created by the PM and another hand saying needs more people coming abroad, try not to have the cake and eat it like your Brexit negotiation.
The thing I question is what does it mean by "prostate cancer" when i was in medical school the urologist says by the time men gets to their 80s about 80% of them will have some form of "prostate cancer" most will die with it rather than off it. A fair number of prostate cancer seen in clinic will end up with watch and wait. Also my understanding is a normal PSA does not exclude prostate cancer as I have seen a few patient with normal PSA but an abnormal feeling prostate. So the idea of an examination is unnecessarily seems a little far fetch
I have finished my training last year, this is the reason why I work as a locum and I have received and turned down over half a dozen job offers. Why would I want to purposely work the same hours or perhaps more and get paid at least 30% less. Being nice unfortunately doesn't pay the bills. People who offer me the job keeps reminding me the downside but I am happy what I do at the moment. At £72k even a starting consultant would easily get that hardly worth the bother coming here to move house to do that is it.
I dont know how they can say have so many overseas GPs coming when there is a quota how many "foreigners" are allowed in. As the PM said herself she wants to create a hostile environment for illegal or from what we can see the Windrush scandal legal migrants.
I feel home visit is a waste of time and it is not an efficient use of time and resources.
In the winter just gone, my car skidded on ice because of home visit and it turns out the woman yes indeed have cancer but perfectly able to get to the surgery if she wants to but she just likes a home visit. Never mind the cost and time it takes me to get my car repaired and lost 2 years of no claim.
In 1 of the surgery I work in people just treat home visits as an entitlement they feel the GP should make their way in grace and go into their house and sort them out. I have now increasingly make it clear to a few of them that I will put in the notes to say visits should be screened and they need to come to the surgery for an appointment.
Completely agree with Harvey Steinwein only real patients that need a visit are terminally ill or genuine housebound patients. If a patient starts making a song and dance about it I often say well I don't see you asking the cardiologist you see from the hospital to do a home visit!!
Unfortunately, some patients are just too selfish and they don't care about their doctor, as long as they get what they want.
Especially for this group of patients I am very strict I will do my agenda set and make it clear we have 10 minutes and that is all and we won't cover everything. I always say to them if you wanted more things covered then either come back if you want and consider booking a double appointment. I have a few like this patient just don't like it, well tough, I am there to do a job and offer an equal service to all not a special extra 20 minutes for her alone.
I agree with Des Spence about productive of consultants. I have recently finished training and in 1 of my rotations it was GP half of the week and the other half was doing neurology OP in a hospital in North East (I won't actually name it!). My CS in the hospital and I decided to go to the different consultant secretaries to see which OP clinic I can attend on a regular basis. One of the full time 10 PA neurologists when we actually looked at his timetable was rather quite shocking to us both. Of the 10 PAs, he has 2 MDTs (1 within the hospital and 1 in the regional tertiary centre), 4 PAs for "admin" and 4 PAs for OP/ward patients. I wish in general practice I can have 4 paid sessions for just admin work!!! My CS is not a neurologist but works in rehab and he said his MDTs are always at lunchtime dashing between clinics and wards or on calls he cannot imagine having a PA in its own right. And you wonder why it takes about 4 months for an urgent neurology appointment.