It would be useful to publicize the impact assessment describing how you ensure that disadvantaged groups are not further discriminated against by this new service.
There are many who feel that this analysis demonstrates that introducing this service is unethical. If your analysis has a different answer please share it so that we can all learn.
The results of your pilot study should really be published to ensure that there is no unconscious bias in your interpretation of the results. For example How did the patients unable to use econsult fare? Did they feel that access was improved by this service? Was it easier for a homeless person to use than traditional General Practice?
What were the satisfaction scores of patients who never contacted the practice? What was the awareness of patients regularly using services like?
If you could let us see the analysis it would allay the fears of many specialist primary care consultants with many years experience who are a little skeptical at times about this particular 'new' technology.
of course with all the extra diagnostic tests they already do in hospital that must mean they treat less people with antibiotics empirically? Is this what is found when it has been measured?..... oh you didn't measure that yet, .....and actually after all the tests they still treat too many
Is it asking too much that you think for a few seconds before trumpeting your master's latest distraction?
The history of UK General Practice has been one of innovation and development especially in IT. It has worked much more effectively in the UK because it has been championed by small independent businesses. These have had an incentive to make and then evolve systems which actually work.
At the time in the 90s, development has seemed slow, but the electronic records in general practice are patient centred in a way the the fortune spent on the NHS IT project never could. Even now 20-30 years later hospital IT is a long way behind.
This announcement is nothing of the sort. The ability to access appointments on line is already in place. The aim of this announcement is therefore not to inform the public about its existence.
What is the reason? Could it be to have a 'good news' story to help celebrate 70 years of the NHS. 70+ years of opposition to publicly funded accessible equity driven health care delivery from the conservative party and from money/profit driven individuals.
Government ministers are responsible to the crown and to the people. They are not supposed to be responsible to a small group of wealthy companies, and individuals. Those elected representatives may claim accountability, but the upper chamber is supposed to champion experience, and wisdom.
Unscepted, these were the APMS practices, they still couldn't make it work.
2-3 % of Livepool population so may not cause too much of a domino effect yet.
If econsultation is so great just give the money to practices and because e consultation is so great they will buy it.
What, you don't think they will?
You think they might have several hundred more pressing, and effective things to do before econsultation comes anywhere near to being the answer, yes that right that's what everyone else thinks too!
ACO is a lie boldly stated.
Accountability requires transparency and openness.
Caring is expensive and we have and efficient system which has been driven to destruction.
Taking funds out for increased 'administration' and 'share holders' reduces cost efficiency.
This arrangement in rail has been shown to be a poor deal for the people, and for taxpayers. The disorganization of rail franchises clearly demonstrates the failure of this model. Strangely they involve the same companies too!
The investment may have flowed out of NHS Engand, but it has not gone to General Practice. It may have gone to the companies whose lobbying secured the funding. Those handy management consultants who set up the schemes outlined in the 5yfv.
Still as long as their shareholders are happy we are all happy as our pensions are invested with them... what... they aren't?
it is an interesting list of achievements, but demonstrates what little respect they have for General Practice or for statistics.
Whilst there may be 3900 FTE other practitioners how many less Nurses and Doctors are there?
Whilst there are 2100 staff who have done the 1 hour 'care navigator' course to do what they were already doing is that course of benefit to anyone?
And these same staff now look at letters? well who was it opening the post before?
2100 practices 'benefitted' from resilience funding. £100 for a group of 4-5 practices to hold a meeting is very beneficial, but unlikely to turn the tide of the 'hostile environment' flowing daily from DoH to NHS E to CCG to practices.
mixed feedback = trying to think of something positive to say about this.
They are all nice ideas, and there may be something that a practice can get from the whole package, if it has enough funding to 'play' with how the ideas work in practice.
That is the problem, the funding is dependent on using these ideas, and often goes to the management consultant advising NHS England and not to the practice doing the work.
Perhaps if federations want to do something to bring this money back to general practice they could set up as management consultants so that NHS England can give them the 'money for primary care' and it can be put in to practices!
The business modelling around this needs aspects from Babylon, but also demands a review of business planning from other affected practices, from affected commissioners of 1ry care, providers and commissioners of community services, and from the NHS as a whole.
Whilst this organisation may be loss-funding this program for 'data gathering' or 'market busting', contingencies need to be built to prevent an evermore predatory approach to the UK treasury. At present it seems that the break point is the Health dept as even 'NHS' funding seems unable to use its structures to regulate funding to organisations set up with a predatory manner. The structures seem to be effective only for 'traditional' organisations, or 'gentlemanly conduct'.
the promise of resources in return for more work based on a gimic
this is how the world is being run at present
does this mean that previous reviews were 'not very serious'?
Why has the GMC though it not 'very serious' until now?
There are quite a few differences between the industries given above and healthcare. Many of those differences are relevant to the discussion. I agree we will see much more of this.
Not least from those who do not understand how ill health affects people who never have their photograph taken, do not use barrels, and even manage without socks.
'bid' for 'grants' so no money actually being delivered then
Perhaps the school based educational psychology service would be ideally placed to manage this. If they did the screening tests on all children, instead of waiting until parents reported 'issues' then the pick up rate would increase dramatically.
Of course you would need a lot more psychologists, and a lot more LD 2ry care, and a lot more drugs, and 'austerity' is far more important than lives. So it's not going to happen.
CJ: I didn't get where I am today by not being able to say one thing and do another convincingly
It would be expected to have more strokes in the at risk group, but studies in patients with a wide variety of conditions need to be done to balance the unthinking protocol driven increase in anticoagulation.
'i've not met anyone who wants it closed'
She should perhaps talk to the CCG, NHS England, the DoH, and Mr Hunt.
oh for the diagnostic certainty of hindsight; it turned out to have been bronchiolitis, so that prescription for possible sepsis or pneumonia was obviously wrong. Why did you follow that wheezy baby pathway and not this ill baby pathway, both have tachypnoea as key symptoms, but in retrospect and guideline club there is never any overlap.
When the evidence reflects the actual situation and not some imaginary ideal world than it might influence practice.
of course if investment in staff and other resources was 'following the patient'.. ie 'more work, more pay' then it would be less of a problem (although there is still the issue of nobody left to do the work due to loss of staff following years of persecution, lack of trust and abuse)