There are simply not enough OOH GP’s rostered on overnight to assess sick kids with fever who are too poorly or have amber/red flags to wait until morning. I believe there’s on average 2-3 GP’s per county overnight. Certainly in my area 1 GP solely covers 400,000-500,000 patients between midnight & 8am. There’s no way they can monitor a trial of fluids, response to a nebuliser or abnormal obs for multiple patients which the A&E team are staffed & equipped to do. This is completely unsafe & will result in inappropriate 999 calls & avoidable deaths.
This will create a lot of triage work for 111 & increase demand for OOH GP’s. There is not the recruitment, investment or man power to deliver this safely. During the Covid 19 peak patients were waiting up to 48hrs for a call back. Sadly with this approach I suspect patients will suffer avoidable deaths if they rely on such an under resourced & flawed system.
They should scrap them- end of. They have been a major factor driving early retirements & are a burden that cause resentment for every GP I know. When I qualified 20yrs ago GP’s were so much happier & less stressed.
If that’s the plan will need to dramatically increase OOH GP staffing levels. In my area just 3 GP’s cover a geographically large area which encompasses 4 acute hospitals & over 1 million people overnight. Without funding, staff & resources people will sadly have avoidable deaths in the community waiting for a call back. I don’t think they’ve thought this through or appreciate how the OOH GP service is run on a shoe string...
For me it is the lack of honesty & humility that really galls. The mixed messages give the perception that the government & PHE don’t actually have a clue what they’re doing so I have zero faith in their edicts. I’m very angry & frustrated that PHE downgraded the virus in March & has diverged from WHO recommended PPE standards since. 12 GP’s have died already- it is both a tragedy & an absolute disgrace. Why are we not following international guidelines? I hope there is accountability for this shameful chapter. I feel totally let down & I haven’t felt safe at work since March.
Johnson unfortunately is the worst possible person we could have as PM during this critical time. He strives to be the entertainer, wants to put a positive spin on everything & be popular. He singularly lacks the gravitas required to communicate the precautions that are needed. When he said in the commons people should go to the seaside my head was in my hands. The coastal towns are some of our least doctored areas in the country. Many have no hospitals & poor access to regional DGH’s. Places like Cornwall & Lincolnshire can not afford to have infection seeded in from areas with high prevalence. He wants us all to go out & spend money but it’s too fast & too early. I dread the coming months.
To quote Luke Skywalker “I have a very bad feeling about this”...
Binning appraisal would be the easiest win ever. Am sure I speak for the vast majority of my colleagues who qualified & worked as GP’s before their introduction that we regard them as onerous, excessive & a waste of time. Do not under estimate GP’s resentment of them. I’m sure a major factor in a lot of early retirements & lack of GP’s entering semi-retirement is a direct result of the work load involved in completing annual appraisals. Funny no other country has adopted them. GP’s in Australia, Canada, New Zealand & Ireland are all blissfully appraisal free.
I just can’t face another appraisal. Not after putting my life on the line with non WHO standard PPE for the last 3months. We have been failed so badly. At least let there be light at the end of the tunnel.... Abolishing appraisal would boost my morale immeasurably
I do wish as a profession we could stand together & reject the current onerous appraisal system. No other country internationally has adopted it. I totally resent the time I waste annually & it is a big factor that will push me to leave medicine as soon as I can afford to...
It’s liberating not having another yet time consuming & pointless appraisal hanging over me. If they are so great why haven’t they been embraced & adopted internationally? Time to consign them to history please...I think you’ll find a lot of doctors morale would jump overnight & it would be such an easy win to encourage doctors away from early retirement
The complete lack of acknowledgement from PHE that we’re not following WHO standards for PPE & quarantine times with no evidence to support why we’re not following international guidelines infuriates me. They appear to be corrupted by their political masters & I have no faith they are fighting to protect us. I do not feel safe assessing Covid 19 pneumonia patients in a plastic pinny period. They should tailor their guidelines to what is safe & adequate not what is available.
This all feels very chaotic & utterly shambolic. In the meantime sick patients are falling through the cracks. In my opinion 111 does not have the necessary number of clinicians to provide a safe timely service- either in or out of hours. There are no additional shifts being added to the OOH rota so the same number of doctors are on duty in a global pandemic as they were a Monday evening in June last year. Also massive rota gaps so in reality less staff than normal. This should have all been considered & planned for in February. Also no healthcare worker should be expected to assess a Covid pneumonia in a flimsy plastic apron. We need WHO standard PPE otherwise we are sitting ducks for serious illness & fatalities.
I am beyond angry at this mess. It’s a national disgrace which I believe meets the threshold for criminal negligence. I’m expected to visit Covid patients at home with a flimsy plastic apron I would be scared of making sandwiches in. The government/PHE/NHSE have totally let healthcare & key workers down. We needed WHO standard PPE yesterday. For crying out loud offer the bus drivers PPE too- they are literally dying!
Lack of PPE is a disgrace & a national scandal. The complacency & negligence is in my opinion criminal. The government should have attempted to procure or manufacture large quantities since early February. Also we should all have been fitted & trained weeks ago. We were warned but the advice was ignored & now we are going to pay a heavy price.
Grrr the way they have worded this infuriates me! Saying despite no appraisal it should not affect the doctor & they can practise as normal. Doh! Appraisals are a new phenomena- we were all doing ok before they were introduced. I trained, qualified & practised happily appraisal free. Hands down the most annoying aspect of my job. It is an unvalidated, time consuming, tick box exercise which should be scrapped. Can’t believe we’re mid pandemic & they are finally “recommending” stopping them. All the bureaucracy should have stopped a month ago end of!
The community teams should have been recruited, trained, fitted & equipped from early-mid Feb. Also know locally morphine shortage so if that can’t be sourced it will add to distress in palliative cases. Also who will administer? District nurse teams have been devastated by cuts- there is no army never mind cavalry of clinicians for non hospital patients. Where is the foresight? Community care has been completely overlooked or ignored by planners. Now we are in an emergency, things are about to escalate within days yet primary care is making it up on the hoof.
Local OOH can’t fully staff a normal service never mind these exceptional stresses & demands.
A) there is no staff
B) there is no PPE available unless you count gloves.
This is mission impossible & I suggest they go back to the drawing board...
Please engage with & support OOH GP services- they are going to collapse without urgent action. We need PPE & control over what 111 sends to us. Also imminent major staffing crisis- negligible permanent staff & not many GP’s are going to step up if it’s an unsafe work place.
I can’t believe how unprepared & unsupported we are. Friends & family are aghast as a frontline health worker I have essentially no protective equipment provided. There is only one PPE kit available for cases like suspected norovirus. If there is a significant outbreak in the UK there is no way we have the bed or staff capacity to cope with multiple respiratory patients. The death of the 34yo whistle blower doctor in China has really shaken me- I feel very anxious about the coming weeks.