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CAMHS won't see you now

James Boorer

  • Plymouth: Where ‘no practice is more than a couple of episodes away from closing’

    James Boorer's comment 22 May 2018 2:40pm

    Plymouth is a fab place to work and the people down here are lovely. I have fantastic Partners who are really committed to their patients and the partnership model. I work with a superb clinical team comprising of salaried docs, nurse practitioners, paramedics, paediatric specialist nurse, mental health nurse, practice nurse, pharmacy techs, HCAs and an awesome admin team that keep the show on the road. I love working here!

    What I don't love is working in the current funding model – with a hugely under-resourced primary care sector and mental health sector culminating in late working and working on days off etc. I completely agree with the previous comments that can be summarised as “bail out, let the government sort out the mess they have created” – oh its so tempting, knowing I could walk away from Partnership and do less work as a locum whilst getting paid more! But I’m still in this job for the patients and the staff and for a love of the NHS. My good will is not unlimited though and there will be a time when I do bail out if things don’t improve and I suspect these sentiments are true for GPs across much of the UK.

    I am buoyed up by some help now coming from NHSE – this is very welcome – but NHSE struggle to deliver really meaningful help within the confines of the general practice contract. It’s the GP contract that needs to change to really save primary care.

    I don’t think things are too difficult to fix (although the longer the crisis continues the harder it will be to fix as doctors burn out and leave the country). The whole of primary care, across the country, just need a little more funding. For example if we received just £1 per patient per week extra we would not only save general practice it would revolutionise the breadth and depth of care we could deliver. £1 per week is not much - less than a cup of coffee per week to save and improve primary care and develop a service fit for the 21st century.

    I think it is also time to update the funding formula to better represent the health needs of deprived communities – it is not fair that our central Plymouth patients die about 10 years younger than those in the leafy villages around Plymouth! Delivering an adequately resourced, comprehensive primary care and mental health service would help to address the life expectancy inequality.

    When will the government wake up to the crisis? When will they realise that allowing primary care to fail will not only result in worse outcomes for patients but also massive escalation of healthcare costs: eg:

    We cannot leave this up to the government. Patients need to start demanding better care. Patients need to accept that a small tax increase is required to save the NHS. We’re not talking mega bucks - £1 per week to save primary care? And are there any other options on the table? Private companies? Private Healthcare? Now that really would be expensive!

    People of the UK – Contact your MP – March - Demand better health care – make your voice heard!

  • 34,000 patients left without a fixed GP as practices 'sucked into black hole'

    James Boorer's comment 17 Mar 2018 7:26pm

    The data provided by Access Health to Pulse is dis-ingenuous and entirely incorrect. Access Health have compared their PMS contract value (£191.67 per weighted patient) to the TOTAL payments coming to general practice for every other practice giving the total of £151.37. This data also includes practices outside of the city that are dispensing and far from average.

    Let’s review publically available data from here:

    Let’s remove the dispensing practices from the calculations and focus on city practices - the total cost of these practices is £126.70 per patient (to include GMS, QOF, LES, DES, rental costs etc). If we want to tally up the same data for Access Health we get a whopping cost of £315.65 per weighted patient – a whole 249% more than the average practice. But the Access Health practices in the data used for this analysis do make heavy use of PFI property so let’s be fair and compare just core contract value GMS versus PMS - £191.67 versus £78.71 – and we still get Access Health receiving funding per patient at 244% of the average city practice.

    This differential is not only massively costly for the tax payer (over double the cost) it is also incredibly destabilising for local practices – My practice has been severely affected by this when a locum, due to work for us, cancelled and went to work for Access Health who were paying considerably more.

    It is time for the politicians to wake up to the current primary care crisis and realise that ongoing financial constraint is causing practice failure that not only threatens patient safety but also massively increases the cost of the NHS. Primary care needs help now before it’s too late.