As their remit does not include clinical quality what is the rule which they use to permit this kind of action?
The first two practices have been under the care of the PCT before the existence of CCGs. The CWP is a mental health and community NHS trust, so whilst it runs some inpatient facilities it is mostly about mental health care.
Having had a practice contract returned the commissioner is required to tender for a new provider before awarding such a contract. It would seem that this process has been quite brief and quiet?
Is it possible to prove that 'guidelines' improve patient survival?
Has the question been asked or answered?
Visiting a hospital in another corner of the world there was in the doctor's office a drawer filled with pills. All the colours of the rainbow, old new, certainly not stored in optimum conditions. These could be searched through to find one suitable for the current patient.
I don't know that the available pill informed the diagnosis, 'this week we will have epilepsy as we have antiepilleptics'; 'This week we are seeing a lot of hayfever as we have antihistamines'.
Important subject, might have been more GP focused in this publication.
In particular the point that we GPs don't get the information in time to act on it!
Also that many GPs around 50 may be subject to this even if not over the £110000 if the growth in the pension fund has been 'estimated' to be to high. This can happen if Capita fail to deposit a change in payments in the correct year!
Have NWIS identified the problems with their procurement which resulted in excluding the most qualified products?
Do they realise that these are problems, or are they framing them as opportunities?
opportunity 1 to stimulate the market
opportunity 2 to encourage innovation
opportunity 3 to break general practice by enforcing a massive unnecessary change on an industry with no financial flexibility
IT company 'optimistic' about its abilities, successful in winning contract, but struggling(unable) to deliver on time(at all).
Now where have we heard that story before...
The consultation is designed to produce the answers they want, with negatively phrased questions with yes no responses required!
The fact that they have no idea what primary care is doesn't seem to be preventing them from destroying it.
..of course now that the NHS owns the computers they all work perfectly...
Is your practice population really so small that 200 'early adopters' were making enough trouble that workload changed with an app?
The workload change identified in relation to these apps is real, but no-one is making any attempt to put any real understanding into the changes. What academic is going to waste their reputation when the commissioners of their research have already decided that 'Patients love it..' based on a skewed sample?
It is fun to play with toys. They only stop being toys and become tools once they are properly understood and applied in a rational manner. Call it science, or if that is out of fashion common sense.
...of course all the evidence could be wrong...
Is a cheerleading certificate a requirement for applicants for these posts?
How do the pom poms not interfere with wifi access?
It's true that a lot has been achieved, and we do need to remember that, but 'this plan is the only plan, and there is no other plan' suggests that 1984 wasn't high on the reading list.
Despite siphoning cash out of the NHS the babylon model does not seem to be making enough money to make a profit.
It is not sustainable, but that is not the point.
Massive paycut offered as solution to pension problem
..and no-one is keen. I wonder why not?
Headline should read;
"...flexible pensions are a paycut for doctors"
The DES puts pressure on practices to join, but also onto CCGs to 'encourage' them to join. Patients of practices who do not sign up have to be provided with services by the CCG.
It is vitally important to ensure that the CCGs are not allowed to abuse this power.
PCN formation has distracted many practices from the changes happening to CCGs which are trying to reduce clinical influence and to concentrate power with a managerial executive.
We know that the lines of accountability and governance become grey around managers, who have no registration, and move from trust to trust often without having witnessed the devastation they leave behind. They claim 'no conflict of interest' whilst representing a party line which is determined by the political whim of the day. They fail to recognise the legitimate interest of working for the patients individually, and directly.
To all practices;
Please look at the details of the DES and work out the costs and liabilities for your own practice. Don't sign up because 'its the only show in town', don't sign up because your mates have, and definitely don't sign up because the CCG says you should.
(COI employed GP in a practice which has signed up!!, and employed by a CCG )
It is nice, if a little counter intuitive, to increase accessibility to younger patients. It is important that these young people who objectively have less health issues to deal with are now being given a service that they can interact with.
All this with no extra investment, and falling numbers of staff.
Obviously, in no way does it address the failings already present such as inaccessibility for people with health problems, emergency department waiting times etc. Does this new service risk making these problems worse?
'running one isolated practice isn't enough for the model to work effectively'
The model doesn't work effectively at any level.
Though you can keep the delusion going for a long time though within a large organisation. If only there were more practices, or if we organised them like this, or if we do away with the GPs, or if we do computer consultations...
'Other practices have seen how well it works' and so want to join; is that with consistent with your other statement?
...'we have no evidence'... and we have no intention of looking in case we find some!
I would assert that NHS England is negligent in its administration of its contract with Capita.
'I have no evidence' apart from its own words and actions and those of Capita.
In fact, the 'investment' being made by the NHS in GPs has been falling, and the new investment is only for 'community and primary care services' not for GPs.
Investment is not being given to GPs to manage with the training and rationality that they have demonstrated over years of service to the NHS.
The figure of £4.5bn quoted in isolation makes a false impact.
The context is needed for the quote to be of use. What is the size of the budget? and over what timeframe?
Please decline to publish figures which are not in context.