Some hospital specialties had an 18m backlog to start with. If all are cleared, we will be in a better position than we started. Great news!
What about all the extra covid induced beaurocracy? SALT forms, physio forms, bladder and bowel forms. Every piece of meaningless paperwork that is put before a GP to complete. If I am referring a patient to SLT, it’s not helpful to have to spend half an hour quizzing the patient. I have established they need to see SLT team - should be passed over to them to do their job next. Every form which is ‘required’ for referral must be vetted and critiqued to establish whether it is an efficient or necessary use of a GP’s time. Enough dumping more rubbish on us.
Thank you Jaimie, I agree, representing All groups fairly is essential to get the best talent and ideas, for how to improve our crumbling health service. Not all natural ‘leaders’ will have the best ideas, or the greatest insight. And from where I’m sitting, the CCG and local leaders appear pretty uniform and increasingly unrepresentative. If they don’t understand the workforce coming through, or the wider population at large, how can they possibly hope to lead effectively? Bring on the diversity - of race, age, sex, and (IMO most crucially) opinion!
Will someone clean my house? Our cleaner has been very reluctant to come back. I think it’s the ‘NHS worker’ stigma at play. Anyone else feel like a pariah?
Why will primary care be kinder if we are dealing with patients remotely or via e or video consultations? The relationships will almost certainly be weakened, and the dross of excessive demand from the ‘well’ will continue. My conclusion is that we need to reduce demand - bring in some charge or deterrent. I expect the author would fight against this to high heaven, yet he cannot face working in the present system. Like the GP leaders we have. They need to build a system that they would be happy working in full time. Maybe they should lead NHSE on secondments, dependent that afterward they work 9 sessions GP for 5 years. They’d quickly sort it out!
It’s quite apparently nonsense. The PCN model is fatally flawed and will bring about the destruction of the independent contractor model, welcoming an era of salaried doctors presiding over a range of professionals (some of whom will create more work than they save). NHSE trying to sneak it in while we are all preoccupied. Do they want to destroy general practice? Looks very much like it.
Stoking demand. Will this help those who need it most? And will it improve general practice? Or another money-spinning exercise at our expense?
The question I have is: are the GPs paid for their services, and why shouldn’t the staffing be on a voluntary basis? I believed our work was not that of indentured servitude?
Please stop the micromanagement. The PCN model is nonsense. Stop dropping targets into our laps with days to enact. We don’t believe NHSE acts for GPs and we don’t think you, or they, have a clue what they are doing. If you could do one thing, take a moment to look yourself in the mirror. Is the ‘vision’ for the future of GP fundamentally flawed? And if it is, will you develop a backbone, and go to your masters to denounce their plans? GPs are being sold down the river for a pipe dream which will turn out to be a nightmare (for patients and clinicians).
Thanks for the positivity. Who knows what the consequences will be? Hopefully not decades more austerity.
I think there is a lot of truth in what you say. We are casting aside normal work in favour of the ‘cause’. And, is there sometimes a little bit of relief that we can advise the patient to leave us alone for a few months? Only me? I think we are so worn down and NHS feels so weakened, it’s hard to do anything but batten down the hatches and hope for the best. But maybe it wouldn’t have been this way if we’d fought harder for better funding, more resources, better preparedness. Something was obviously going to overwhelm us sooner or later. Here it is. What will we do with it?
I note with interest point 12. Does this mean that if someone has severe covid for palliation at home, we should abandon self-isolation / shielding and allow them time with their families? Seems the kinder option and their families could then self-isolate afterwards. Also, I fear of these may be difficult to achieve in the time pressured situation we face. Finally, point 7, giving contact details of teams who might help. Who I wonder will be happy for us to give their contact details for urgent care services to call? Palliative care teams who will not have met the patients in question? The only person whose details will be relevant are surely the GPs. Again, it all comes back to the GP. A crucial problem when there are not nearly enough of us. Now, when we need our GPs, we will find they are not there.
Are they being paid for this? Nursing students are. Another abuse of the medical profession? Start as you mean to go on...
Many congratulations and hope the NHS looks after you on this final (perhaps) foray! Good luck.
I don’t know if this is insensitive. But GPs are about to come under huge strain. Their workforce is being depleted by self isolators, many staff are having to work from home or be shielded. There is about to be an explosion of ill health in the community. Some CCGs are asking GP surgeries to stay open unpaid for the Easter bank holidays (partners footing the practice running costs). Partners may need to reduce drawings to cover extra staff costs. And GPs are asked to volunteer their spare time (as if they are not stressed enough and working enough?). This crisis cannot be a time to ask more of GPs for less. Carrying on down that road will only worsen the recruitment crisis. Support practices, pay GPs for their time, and show them they are valued. Registrars are looking on and deciding whether to stay in the profession, whether to sign up as partners. We need to see that GPs are valued and looked after through this. Please don’t take the piss.
Can admit I’m not weeping over my coffee. Any fool could see the organisation’s expenditure is excessive. Headquarters in Euston Square. Endless glossy monthly bulletins. Not fit for purpose. Needs a cull (sorry).
Good to see, many staff in managerial / leadership roles could contribute more. Now, and going forward... but those retired, it is definitely worth our appreciation.
Obviously as a profession we must pull together. But also, we have a duty to highlight the errors of the past and the changes that need to be made going forward. Life coaches in GP surgeries? Honestly, what were they thinking? We must not let this opportunity for transformation pass, or there will be similar crises repeated over and over and many more will suffer. But, yes, now we must fix this mess and be vocal in what needs to be done. GPs will have a huge influence in how this all turns out (and Jaimie - we will be seeing the Covid patients - it is inevitable).
It’s going to happen. We are sitting ducks, and our contracts are held by the hospitals (not sure why). So we will be dragged kicking and screaming into a war zone. Agree that we have sleepwalked into this and NHS sadly not prepared.
Thanks for the piece Clare and hope you are fully well. I think I’ve had it, and similarly laid a bit low feeling feverish. Woke in the mornings with sweats (and I’m a spring chicken in my thirties so no menopause here I hope!). The tickle cough has lasted four weeks but the alarming thing was how many of my friends and relatives have come down with flu symptoms (approx 10). It is really incredibly virulent. The self isolation advice is not misplaced.