What codswollop - how can you talk about fairness or balance in the system ? It’s not capitalism that stokes the demand on the system- but socialism
and it’s not a cash limited system- it eats huge amounts of cash- it’s just used stupidly ;as per other examples above- chris grayling etc- politicians cant run jack shit!
It has run on doctors goodwill for years and when that was thrown in our faces, we voted with our feet and mass exodus follows.
Black report clearly showed increasing health input in deprived areas did not change outcomes. wider system changes needed and individual responsibility / accountability
- where’s Dr V Ho when u need him?
People abuse the system and expect everything from it with no respect. it can’t be all things to all people- urgent care, as needed access for anything and health promotion/ prevention.doing job of failing / overloaded secondary care clinics. It has run on good Will for too long.
there needs to be a clear acknowledgment we cannot go on funding things people WANT but don’t NEED - it was supposed to be free at the point of NEED! There is just no way of saying NO enough is enough.
3 partners leaving in July as they are literally paying to work thanks to pension tax and falling profits etc..... and the tax penalty is already crazy.
increase access and you increase demand.... it’s endless and corresponds to a total loss of personal control
and I clearly remember Labour started the decline.... PFIs and the like, appointment meddling- .they’re no better than current crap.
there should be no political meddling for short term gain in the nhs!
After 26 years I’m out as soon as I can plan an exit strategy
am drained and have nothing left to give.
Or inappropriate bookings- eg appt with doctor for stitch removal or 10 minute appt booked expecting coil fitting?!
N Grundy- we fund 30% of the additional staff- “to start” - will prob increase!
NHSE funding streams that used to go direct to practices will go to networks!
And have u seen the 7 statutory requirements for networks- ?? That’s just for starters- it’s the same old hoop jumping for money that used to be ours!
there is no free money!
CCGs openly admit this money is coming from our own other pots! We lose out of hours money - which is put into networks- instead of practices. it’s not free money- the additional access funds will go in there too- to work towards us covering it all! admission avoidance schemes, care home schemes etc..... all piling on us/. and it will grow!
2 of our partners have resigned after getting advice on the implications of this contract - this is not positive - but their spin has clearly worked!
Plus the worry is the more they pull in “cheaper than doctor” alternatives- the more heavy stuff piles on us!
There is nothing addressing the workload, stress and pressure - and the more I read- the more worried I am - whatever they give us with one hand is taken away in another guise!
I’ll have her e mail please!
Where’s this bit about “ Banning GPs from doing private work on their premises” come from ?!
Who is that helping?
“ you have to choose”- ok I’ve chosen- bye! Bot sticking with falling nhs funds and spiralling work
Was doing 5% private work but helped fund nhs..... worked well for small no. Of out of area patients wanting to be
seen ....... how dare they say we can’t do this?! All consultants do! It’s in our own time and a separate patient set?! She’s clearly not a jobbing GP so peddling this rubbish...... hastening the exodus.
I agree with Dr Ho!
Such desperate dilution and dumbing down of all nhs services- there are several hospitals I fo t bother refers g to as clinics consist of physio or nurse assessment..... then telephone follow up?!! No disrespect to these practitioners but you’re not eg an orthopaedic surgeon and it’s their opinion I referred for?!
why does the nhs just admit it can’t provide every service in preference to putting out shit ones and pretending it’s all ok?!
Then maybe people get the wake up call.....there’s no limitless supply?!
This contract is a kick in the teeth- nothing positive in it snd let concerns addressed. Undervaluing our work and getting cheap replacements.......fed up of being psychiatrist, gynaecologist and social worker in one as more and more dumped on us.
14 hour days, relentless demand and no gratitude- just constantly vulnerable to complaints send dissatisfaction...,,
Oh my god I have said exactly this in an essay for old style TTT- we are told to reflect and be resilient- all Rick biz rubbish as long as the onslaught of 10 minute appointment with concurrent overflow of all hospital cut backs ( most of my clinics are psychiatric level mental health but in 10 minutes to manage an securely disturbed teen and their family- no psych would tolerate that-) and council cut backs ( drug, alcohol, sexual health) fall on us!!
It’s like warfare!!!! PTSD
We also sift through 1000 results endless calls and 1 item not followed through speedily enough and the complaints follow- ignoring the hundreds of people who’s lives you’ve changed for the better that day....
Risk averse nhs scan says fibroids but mri to exclude malignancy ? Nurse ordered scan - but didn’t follow it through and unrelated issue now blamed on GP who never saw patient just filed the scan. Really in what universe mr radiographer is that a standard clause you’ve left us to deal with?! And now endless practice e mails.....our screens are overflowing with patients and calls when do we do the e mails and what happens if something gets missed - GP gets it though the system is at fault!
Totally agree- we give our all as GPs and are left drained and unappreciated. Packing in desperate patients- adolescent acute severe mental health ( patient and family ) in 10 mins as can’t get CAMHS appt, alcohol, drugs, sexual health, everything falls on the GP and in hospital they’d have more time and resources- etc etc-
Thankless soul destroying job.... drained the life out of me- am on the brink-
I feel for you too
Plus they snuck in banning private patients. Many practices have responded to falling nhs income by running a small private practice ( not for their eligible nhs patients- but others and fully separately run -in doctors own time).
With less than 6 weeks to go before this is implemented “further details to follow”-
This doesn’t apply to hospital doctors or Babylon ...
how can they dictate what GPs do in their own time? “You have to choose either nhs or private not both”
What do we dissolve our business now? Plus shoot your selves in the foot NHSE as my nhs runs at a loss that is covered by the private work... so I know which I’ll choose..... maybe that was their intention- drive more doctors out?!
Before anyone judges.... I go over and above in my nhs work- 15 hour days trying to do everything for everyone....because I care for our patients... but not at this cost! And 25% of appts blocked for nhs111? Accessis shite as it is.... I can’t deal with more patient complaints about not being able to book routine appts?!
This is saying- oh they haven’t made u pay for this, that and the other that they were gonna to claw from you so be happy..... yeah feat - they haven’t stolen our dinner money?!
The extra funding goes to federations and GPs- not us- we don’t see it! We like many in London had s small private practice with our nhs one ( separately run and only for patients out of area) - as our nhs finances dropped- this supported the practice... we never took a wage from it?!
We can’t run the nhs without it? How can they give us 2 months to close it? Hospital doctors work privately- why target us?
I can’t afford to continue my nhs work as a partner without that additional income stream - so am looking for employment elsewhere and suspect our nhs surgery will fail....so yaaaaay new contract- decimate general practice further!
Agree- most funding going to CCGs not direct to practices and to “alternative ( cheaper imitation GPs ) staff” army and CCGs for “creating” networks....??
No longer able to see private patients as NHS GPs( hospital consultants can????)- some may be against the idea but a small flow of private patients was the only thing that kept our NHS practice viable- it’s not worth my whole working 15 hour solid days for the nhs money alone.....
Looks like the end for us
Had enough to get appts for our patients already- now so many are “ blocked” for 111, A&E, “ 8-8”
It’ll be even harder? Bizarre disjointed thinking.......worsening accessing.....
Agree fully with yellow..... how do they calculate this “ cost”?
We see an average of “5-8 extras” in most clinics- so by the same logic we are owed 100 million extra to cover this?
To care of GP not toxare ?!
Definitely needs a change to reflect activity!
Plus we get NO funding whatsoever for 3,000 of our 15000 patients in London as they’re “ too young”- don’t meet deprivation criteria.....
lots of media attention to “ghost patients “- none to totally Unfunded ones?! Never mind that these young patients present at LEAST 6 x a year MINIMUM and we cover their mental health needs ( all CMHT referrals- discharged back toxare of GP- having offered no input?!!) gynae, neurology- lots of pathology MS, etc etc - but if it doesn’t tick a box for NHSE it doesn’t count?!!
All patients have a “need” and are entitled to good basic care-
Many deprived areas have huge social problems that are the drivers for many of the medical issues that result- as the Black report showed- increasing medical input
Isnt the answer!
What about the healthy individual with a first severe debilitating episode of depression - blights their lives- and takes a lot of GP time....management, support, review- liaison with work, DDA etc
Adolescent mental health.....postnatal depression,
Multiple sclerosis, ovarian Cancer in a young patient with Lynch syndrome - pulmonary embolus, congenital cardiac problems in a sporty young man- (lost his uni scholarship).
Epilepsy , endometriosis, acute psychosis, premature ovarian failure.....lymphoma, ankylosing spondylitis, Angelmans syndrome in a 3 y old, renal failure in a neonate, ectopic pregnancy, drug and alcohol ( occurs everywhere not just in areas of deprivation-)
None of the above are related to deprivation- but none
“ count” under QOF....saw all the above and so much more last week..... make my complex multimorbidity 80+ year olds look positively easy. Why should their care not be funded? East end GPs are v vocal about their deprivation workload - it’s a devicive approach- we’re all snowed under and overworked... 14-16 hours days are the new “norm “!
Unrecognised work load is everywhere -
stupid simplistic funding formulas like Carr Hill aren’t the answer!
Unscepted- don’t insult Sceptic! I fully agree...... all political parties have wrecked the NHS with their short term vote appealing policies..... labour and the PFI outrage, tick box culture etc started the rot which the tories continue....
It is insulting for a publication which we read for MEDICAL need to assume we all think alike just because we work in the NHS! Respect our differing opinions and engage in debate..... not hurling childish insults!
I don’t want to see political posturing in Pulse- for the same reason I no longer read the guardian....
I don’t expect it in Pulse - it’s not the place for it and the arrogance and assumption of it really incenses me.... I’m not allowed to rant at my patients with my views- nor would I dream of inflicting them in people........equally Pulse spare me yours- I don’t share them!
So happy to read these comments and agree entirely...... how bloody dare the RCGP do this?
Arrogant misguided political posturing- no mandate from me either? They don’t speak for us..... we are a disparate group not aligned with one political Opinion - what an arrogant assumption..... none of their bloody business to be even voting on this?! I want it withdrawn!!!!
Mental health issues affect all of society not just the poorer- it is not class specific! A review into postnatal suicides showed it was mainly white middle class women at risk.....a group who can be conveniently overlooked by health visitors etc as “not needing input”.
My plea..... leave politics out of medicine!
Treat what needs treating, however it needs treating for that individual ....... every individual has equal health needs for GPS- maybe different needs but equal needs! GP is NOT the realm for health inequalities or societal problems- that’s a wider public health issue and it is dangerous to fall into that path as GPs.
Eating disorders in teens, self harm, psychosis, alcohol, depression, bipolar........... that’s not bloody austerity related- the push back to GP is enormous- as the reader above commented the most shocking, serious referrals are “ discharged back to care of GP”- no input?! All lies at our door- who do we discharge to?
Public health can do targeted work in communities etc- for sample......but everyone has an equal right to care and treatment too
GPs are uniquely placed to provide individual care to ALL....irrespective of social class/ economic background!
I hate this political posturing.... that’s for public health or MPs!
Add on gastro oesophageal reflux ( ent presentations) and glandular fever and so on.......as well said above...... we don’t just dish out antibiotics or not...... we look at each case and actually diagnose the issue.............take a lot of risk and a lot of flack for doing a damn tricky job?! Damn cheek trying to foist cheap replacements ?!