Panem et Circenses
11:20am. Agreed. 14h day now and I can't get the basics done like clearing tasks and results.
In a further announcement today the Department of Health committed to investing in improving patient access using mind reading and teleporting. Using yet to be discovered technology, the NHS Programme for Pandering to Whims and Securing More Votes will enable round the clock detection of those lying struggling to sleep after looking up their blood results on the NHS app and Googling all the causes of a slightly dodgy monocyte count. Their named doctor will be immediately alerted and teleported directly to the client's bedside to provide reassurance, and to opportunistically check the smoke alarms. The BMA broadly welcomed the plan, highlighting an unmet need to improve 7 day access for the worried well, but asked how this could be achieved given that teleportation might not actually be discovered, and that a sufficient number of GPs to safely manage a normal Monday to Friday week is frankly the stuff of fiction. It was clarified that it might not be an actual doctor that teleports in, but an appropriate professional such as a firefighter's assistant who could not only check the smoke alarm but also measure blood pressures and advise 5-a-day.
I am sure that there are parts of the UK where increasing the notice period means that people will get to see a GP for one year and not just six months before the towel is thrown in.
6 sessions over 3 days now routinely hitting 40 hours at the surgery plus work from home to clear the stuff I am just too knackered to do after 13h+ without stopping. If I was a partner i'd have 2 or 3 evening meetings plus running the business (which is why I am no longer a partner). Perhaps time to stop thinking in terms of sessions and look at hours actually worked?
Finally someone is actually doing something - well done NI, I hope you encourage more examples of deeds and not words.
For those who think that this is playing into the hands of Hunt, just look back over the last year or two - do you really think anyone is ever coming to the rescue of general practice? We can stand together on this or we can quietly carry on giving up one by one.
Dear Fed Up @12.24
42 years old, 20 years in medicine and a GP partner until November last year. Now work three days a week as a salaried GP. For the first time in a few years I sleep well, I look forward to coming in to work, and I enjoy being a family doctor again. In the months before I quit I was seriously considering leaving the medical profession entirely - glad I didn't, it turns out that fixing broken people is just as rewarding as it ever was, but I have to say that all the money in the world would not persuade me to return to the crushing pressures of partnership.
IIRC the patient record is the property of the secretary of state for health. Historically paper notes and electronic records stored on a server physically located at the surgery have meant that we have sole control over who sees the information.
Now that more and more patient data is held on remote servers we simply don't hold the keys any more. Our local walk in centre, MIU, and hospitals trust all have access to our patients record, and if NHS England decide to share that info further there is B all we can do about it. It also won't be our problem when patient confidential data is leaked or sold to a third party.
We all know that if NHS E decide to share the record there is nothing that we can do about it so in a way this story is a bit of a non-event. My biggest worry is that the more people share the notes the harder they are to make sense of - our chiropodist and district nurses have templates that seem to clog the screen with three pages of cobblers whenever they just say hello to a patient.
So, we tell NHS England we are fighting fires - they send a fire engine.
Is this not taking right time, right place, right person a bit too literally?
Yep. Our practice swapped imdemnity providers 2 years ago and I was astonished to find I had 6 "open cases". 4 were related to some medicolegal advice and two were to check the wording of letters to patients who had made complaints about other members of staff, but just happened to be on my personal list. The worst is that the indemnity providers actually encourage us to discuss with them so that the early response is solid and a potentially expensive complaint is defused.
Watch this space. As a profession we might be useless at standing up for ourselves, but on an individual basis if the costs do keep rising I don't think may of us will be altruistic enough to work for peanuts.
Any system that tries to force change using threats will be met with resentment and undermine the credibility of those responsible for it.
Why don't you explain the problem, suggest a solution and ask us nicely?
With every day that passes I feel more and more like the victim of an abusive relationship.
It will be interesting to see if this works, and I wish them luck.
If this level of input fails to reduce unscheduled care/admissions/A&E attendance then surely it is time to look hard at some of the resource intensive admissions avoidance activity we are already doing.
I'm not convinced we get a good return on this investment at the moment, but perhaps if secondary care was integrated so closely into our practice MDT this would change?