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Doc

  • NHS England tells GPs to prepare for 'significant increase in home visiting'

    Doc 's comment 21 Mar 2020 10:26am

    JAM GP. totally take your point and some of my colleagues had said the same- so an interesting debate and am open to others thoughts. . The difficulty was NHS11 would bot see the patient and told her to contact us and she was alone pregnant with 2 small children in tears on the phone.....prior to my assessment no one had or would see her? (NHS111 doesn't even acknowledge the vulnerability of pregnant women to Covid but this is a group I am seeing increasingly affected). I felt uncomfortable advising her over the phone and at least after examining her I knew she needed to be in....though getting her in was another matter- she took a cab in and has just messaged me to say she was there all night and on obs told she needed admission and waiting for a ward an then sudden turn around... as no beds-so sent home for GP review this morning....other thing visit added was reassurance for her- she was desperately scared and genuinely unwell- unlike 1/2 the cals I get which are " I have a bad cough I think I have corona can you test me"-no go away.....

  • As a GP who's overcome coronavirus, here's what I want you to know

    Doc 's comment 21 Mar 2020 10:15am

    I have a lot of respect for Dr Gerada and am glad she is recovered.....however not all experiences are like this and the reality is I am already seeing a lot of very sick people
    The plan from NHSE is for us to see more -home visits and hot/cold spots in practices - there is NO back up- a very unwell pregnant patient of mine I had visited 2 days in a row was deteriorating yesterday -I had done bloods- CRP 110 and temp 40.5 and dypsnoeic (normal white cell count- v typical of Covid). 90 minutes on phone on hold trying to get through to 999 ambulance !!! thats the call time NOT the wait for ambulance -she took a cab in the end....the system is clogged and dangerous- if that had been a stroke patient?? I couldn't get a 999 ambulance-its terrifying....

  • NHS England's 19 March update to GP practices on Covid-19

    Doc 's comment 21 Mar 2020 10:09am

    Problem with this is-???? " ring NHS 111? "-as per my experience yesterday(below) I was on hold for 1 hour 45 minutes calling to get a blue light ambulance for a patient and that was just the call to get through -not the ambulance wait time!!!
    They have no idea of the reality of practice.......
    it’s actually not safe!
    They want us GPs visiting the sick Covid cases-
    I have experienced this today-( LONDON GP)
    A pregnant patient, high fever and short of breath- couldn’t get a response from 111 yesterday and finally they told her to call her GP. I visited her this morning- assessed her: temp 39.5. sats 94 p 106-
    I Even did bloods- got them back a few hours later.....
    CRP 110 with normal white cell count- was sure it was Covid
    Discussed with med registrar in local big LONDON hospital - “ send her to A&E they’ll triage and call me if we’re needed”- I was gob snacked- pretty sure you’ll be needed mate! I called A&E- to confirm this was the right route....- it was! they have a red and a green zone and she could “go wait in the red zone”. The 999 ambulance call to send her to A&E had us on hold for 1 hour and 45 minutes. I then had to leave to see the next patient- she sent me a message that’s she’s still in A& E waiting to be seen having taken a taxi as couldn’t get through to blue light 999 ambulance! This is the reality! The service is not functioning- god help anyone having a stroke- never mind Covid death rates - what are cardiovascular death rates??? No one left to do normal stuff- all overwhelmed already! There will be hot and cold spots in practices for people to be assessed-just like in A&E already- its overwhelmed....

  • GMC asks 5,000 unlicensed GPs to return to work in coronavirus crisis

    Doc 's comment 21 Mar 2020 9:55am

    I’d say stay away- you’ve done your bit- it’s actually not safe!
    They want us GPs visiting the sick Covid cases-
    I have experienced this yesterday-( LONDON GP)
    A pregnant patient, high fever and short of breath- couldn’t get a response from 111 yesterday and finally they told her to call her GP. I visited her this morning- assessed her: temp 39.5. sats 94 p 106-
    I Even did bloods- got them back a few hours later.....
    CRP 110 with normal white cell count- was sure it was Covid
    Discussed with med registrar in local big LONDON hospital - “ send her to A&E they’ll triage and call me if we’re needed”- I was gob snacked- pretty sure you’ll be needed mate! I called A&E- to confirm this was the right route....- it was! they have a red and a green zone and she could “go wait in the red zone”. The 999 ambulance call to send her to A&E had us on hold for 1 hour and 45 minutes. I then had to leave to see the next patient- she sent me a message that’s she’s still in A& E waiting to be seen having taken a taxi as couldn’t get through to blue light 999 ambulance! This is the reality! The service is not functioning- god help anyone having a stroke- never mind Covid death rates - what are cardiovascular death rates??? No one left to do normal stuff- all overwhelmed already! There are plans for us to be visiting teams and have red and green hot spots in practices.....

  • Online consultation technology for GPs to be fast tracked due to Covid-19

    Doc 's comment 21 Mar 2020 0:14am

    5 weeks to this arriving- bit bloody late for us!

  • Practices will not be reimbursed for locum cover from day one if GPs self-isolate

    Doc 's comment 21 Mar 2020 0:13am

    They haven’t forgotten about PPEs- read the latest NHSE document- we are supposed to be the home visiting service for Covid patients as hospitals and nhs 111 can’t cope!

    They want us visiting the sick Covid cases-
    I have experienced this today-( LONDON GP)
    A pregnant patient, high fever and short of breath- couldn’t get a response from 111 yesterday and finally they told her to call her GP. I visited her this morning- assessed her: temp 39.5. sats 94 p 106-
    I Even did bloods- got them back a few hours later.....
    CRP 110 with normal white cell count- was sure it was Covid
    Discussed with med registrar in local big LONDON hospital - “ send her to A&E they’ll triage and call me if we’re needed”- I was gob snacked- pretty sure you’ll be needed mate! I called A&E- to confirm this was the right route....- it was! they have a red and a green zone and she could “go wait in the red zone”. The 999 ambulance call to send her to A&E had us on hold for 1 hour and 45 minutes. I then had to leave to see the next patient- she sent me a message that’s she’s still in A& E waiting to be seen having taken a taxi as couldn’t get through to blue light 999 ambulance! This is the reality! The service is not functioning- god help anyone having a stroke- never mind Covid death rates - what are cardiovascular death rates??? No one left to do normal stuff- all overwhelmed already!

  • Government formally launches 'NHS needs you' campaign for retired GPs

    Doc 's comment 21 Mar 2020 0:10am


    I’d say stay away- you’ve done your bit- it’s actually not safe!
    They want us GPs visiting the sick Covid cases-
    I have experienced this today-( LONDON GP)
    A pregnant patient, high fever and short of breath- couldn’t get a response from 111 yesterday and finally they told her to call her GP. I visited her this morning- assessed her: temp 39.5. sats 94 p 106-
    I Even did bloods- got them back a few hours later.....
    CRP 110 with normal white cell count- was sure it was Covid
    Discussed with med registrar in local big LONDON hospital - “ send her to A&E they’ll triage and call me if we’re needed”- I was gob snacked- pretty sure you’ll be needed mate! I called A&E- to confirm this was the right route....- it was! they have a red and a green zone and she could “go wait in the red zone”. The 999 ambulance call to send her to A&E had us on hold for 1 hour and 45 minutes. I then had to leave to see the next patient- she sent me a message that’s she’s still in A& E waiting to be seen having taken a taxi as couldn’t get through to blue light 999 ambulance! This is the reality! The service is not functioning- god help anyone having a stroke- never mind Covid death rates - what are cardiovascular death rates??? No one left to do normal stuff- all overwhelmed already!

  • PPE problems 'completely resolved' for hospitals 'and other care workers'

    Doc 's comment 21 Mar 2020 0:08am


    They want us visiting the sick Covid cases-
    I have experienced this today-( LONDON GP)
    A pregnant patient, high fever and short of breath- couldn’t get a response from 111 yesterday and finally they told her to call her GP. I visited her this morning- assessed her: temp 39.5. sats 94 p 106-
    I Even did bloods- got them back a few hours later.....
    CRP 110 with normal white cell count- was sure it was Covid
    Discussed with med registrar in local big LONDON hospital - “ send her to A&E they’ll triage and call me if we’re needed”- I was gob snacked- pretty sure you’ll be needed mate! I called A&E- to confirm this was the right route....- it was! they have a red and a green zone and she could “go wait in the red zone”. The 999 ambulance call to send her to A&E had us on hold for 1 hour and 45 minutes. I then had to leave to see the next patient- she sent me a message that’s she’s still in A& E waiting to be seen having taken a taxi as couldn’t get through to blue light 999 ambulance! This is the reality! The service is not functioning- god help anyone having a stroke- never mind Covid death rates - what are cardiovascular death rates??? No one left to do normal stuff- all overwhelmed already!

  • NHS England tells GPs to prepare for 'significant increase in home visiting'

    Doc 's comment 21 Mar 2020 0:04am

    They want us visiting the sick Covid cases-
    I have experienced this today-( LONDON GP)
    A pregnant patient, high fever and short of breath- couldn’t get a response from 111 yesterday and finally they told her to call her GP. I visited her this morning- assessed her: temp 39.5. sats 94 p 106-
    I Even did bloods- got them back a few hours later.....
    CRP 110 with normal white cell count- was sure it was Covid
    Discussed with med registrar in local big LONDON hospital - “ send her to A&E they’ll triage and call me if we’re needed”- I was gob snacked- pretty sure you’ll be needed mate! I called A&E- to confirm this was the right route....- it was! they have a red and a green zone and she could “go wait in the red zone”. The 999 ambulance call to send her to A&E had us on hold for 1 hour and 45 minutes. I then had to leave to see the next patient- she sent me a message that’s she’s still in A& E waiting to be seen having taken a taxi as couldn’t get through to blue light 999 ambulance! This is the reality! The service is not functioning- god help anyone having a stroke- never mind Covid death rates - what are cardiovascular death rates??? No one left to do normal stuff- all overwhelmed already!

  • Antibiotic prescribing in primary care in Scotland falls to lowest level on record

    Doc 's comment 14 Nov 2019 10:29pm

    Hah hah- love it! Fab comment above. Don’t even read the articles; just the comments! Sane people are out there in this broken system- thank you!

  • Labour pledges £2.5bn for 'overhaul to primary care estate'

    Doc 's comment 14 Nov 2019 10:19pm

    Bollocks to that red flag-I’ve worked my arse off giving every ounce in me to the nhs for 25 years and am drained and depleted. Never mind the thousands I lose in tax, pensions as above. I’ve worked about an extra years in free overtime and more than paid my dues.
    No I won’t pay a “small amount extra” in tax to benefit the current calamity that the nhs is.
    It’s a total free for all, poorly run and managed and should be free at the point of need. not free at the point of WANT as it currently is.
    I’m done. You can’t bite the hand that feeds you this long without it biting back. Speaking of inequity; labour is so Anti aspiration and all about dumbing down to the lowest common denominator. Does not encourage striving, success or betterment at all.

  • How GPs are being buried under secondary care work

    Doc 's comment 30 Oct 2019 8:28am

    It’s the subtle unrecognised or acknowledged clinical dumping where out patient appts aren’t available and Cmht or A&E junior psychologist or CPN assesses and discharges “back to GP” after no active input......that’s what’s killing me.... drowning in it- feel my head is exploding- we have nowhere to send people too..... social prescribing-wot a joke! some community supports are great don’t get me wrong but it has no place in clinical practice for the patients we see ( social support CAB yes but they access this already)- these workers create more work for me........ and look to me for advice and support- they can’t cope with clinically unwell patients.... Am looking for my exit route ASAP

  • The consequences of an underfunded mental health system

    Doc 's comment 23 Oct 2019 9:21pm

    Huge assumptions from comment at 9.03
    Not all GPs need more training- but we do need more support - we are carrying and managing huge volumes of mental health Rita because the secondary care systems are so stretched.
    We simply don’t have the time ( 10 minute appts?) or appointment availability to offer this service- but we are carrying the can so we have to- care for the patient and their families / others involved when they are unwell.

  • No-deal Brexit could close down practices, says RCGP chair

    Doc 's comment 23 Sep 2019 6:23pm

    Echo Vinci Ho and NI GP
    Fed up of left with g RCGP agenda - claiming to speak for all doctors- they don’t and can’t - and do should shut up on such political matters! Not like they don’t have enough to do sorting out stupid PCNs and contract and CQC rubbish. Taking the biscuit.

  • NHS England appoints Dr Nikita Kanani as primary care medical director

    Doc 's comment 11 Sep 2019 9:48pm

    Joke of an appointment- same old small minded bunch of “meeting attenders” avoiding anything other than bare bones of clinical work.... congratulating each other.....
    Contract was a joke- networks are a pointless nightmare and general practice is devastated! Why not get someone with real backbone who knows what they’re doing?! This is a tokenistic appt- she’ll do nothing but try and make a name for herself- doing nothing!

  • NHS Health Checks to be reviewed under government prevention plans

    Doc 's comment 24 Jul 2019 8:36pm

    Ivan Bennett- though what u add is correct- “ health” doesn’t address this.... see Black report etc...... social changes do!!!!
    Hence public health and health prevention- critical as it is..... should be separate from health care.....
    Increased health input doesn’t reverse obesity, smoking, drinking etc etc - social changes do
    Exercise in school etc etc.....
    It’s a key point ; health care influences about 10% of population health
    We have enough to do caring for sick people- public health and social changes should be preventing them getting to us....... that’s whats overloading GP currently- confusing all singing all dancing roles- emergency care, routine care, health promotion, It confusing for patients and impossible for doctors......

  • NHS to investigate GP ‘fraud’ in retaining ghost patients

    Doc 's comment 12 Jun 2019 7:23pm

    How about they pay us for the 3000 of our 17,000 patients that are not even counted or remunerated - we cover them for free- thanks to Carr Hill formula impact?!

  • RCGP withdraws invitation for Julia Hartley-Brewer to speak at conference

    Doc 's comment 31 May 2019 2:50pm

    Agree with above ..... pathetic response from college and very sorry state of affairs ......
    Intolerant “ liberal left” reign!

  • 'Vicious cycle' of workload pressures facing GPs in deprived areas

    Doc 's comment 09 May 2019 7:03pm

    Is shit regardless of deprives or not deprived..... we’re a very mixed population across 2 sites and consultation rates generally are sky rocketing regardless of patient numbers. Forgetting deprivation; Carr Hill means we are not paid AT ALL for more than 3000 of our not so deprived patients -( true vs weighted list size is shocking!) but they damn well present enough with complex medical problems and have to be cared for -so both ends of the situation are grim!

  • A tribute to the 9ers

    Doc 's comment 08 May 2019 9:41pm

    Beautifully written- days it all! Should be in national press!!