This site is intended for health professionals only

At the heart of general practice since 1960

David Banner

David Banner

  • GPs told to avoid 'looping' Covid-19-symptomatic patients back to NHS 111

    David Banner's comment 07 Apr 2020 2:13pm

    We were TOLD to direct these patients to 111.
    111 now directs them back to GP.
    Just who is doing the looping here?

  • The faintest of silver linings

    David Banner's comment 07 Apr 2020 2:02pm

    Nice thought, but in GP world I suspect little will change.
    Despite being demonstrably proven obsolete, the twin scourges of CQC and appraisal will re-emerge from their lairs to torture us again and continue to bully many out of the profession prematurely.
    There are simply too many lackeys and collaborators in our ranks suckling at the devil’s teat, they won’t want to return to the trenches any time soon, so our Covid respite is, alas, merely temporary.

  • GPs should evaluate illness in children 'in the normal way', says NHS England

    David Banner's comment 07 Apr 2020 1:50pm

    This advice will kill GPs.
    Isn’t that obvious?
    Children with minor symptoms spraying CV all over older doctors during a totally unnecessary examination is playing Russian Roulette with our lives.

  • GPs asked to set up dedicated home-visiting team for 'shielded' patients

    David Banner's comment 07 Apr 2020 1:38pm

    THis is insane on many levels as indicated in the above comments....

    - most primary care teams are running at 50% staffing or less due to self isolating, illness, shielding etc.
    - those left on deck have been told to keep the doors open and run a full service via telephone triage
    - most still lack the full PPE needed for home visits
    - this group of millions of patients needs the most input, so would need multiple visits in 3 months.
    - when shielding was first announced it stated that vulnerable patients could be seen at home OR surgery. What changed??
    - surely the shielded are safer in a clean sterile surgery than a GP without proper PPE stomping his germs into the home?
    - patients are clamouring to be included on the shielding list for perceived social advantage (eg Morrison’s delivery slot), so the numbers will soon become unmanageable
    - who is manning the surgeries whilst we are driving around spreading virus to the vulnerable??
    - just who precisely on the GP front line has “not been in contact” with Covid patients? The only ones are the desk jockeys who have dreamt up this farcical nonsense. Turn off your computers, boys, pick up some Fancy Dress PPE and get cracking, you have a lot of visits to do that we have no time, no protection and no inclination to do.

  • Who has the right to decide who lives or dies?

    David Banner's comment 02 Apr 2020 11:00am

    Hindsight is 20:20, but the likes of S Korea and Singapore had shown us the way, rather than simply following our European neighbours into a lunatic lockdown that will crash the economy and lead to far more long term misery.

    1- Lockdown the vulnerable for 12 weeks
    2- “Test, test, test” anyone with symptoms and isolate them for a fortnight if positive
    3- roll out the antibody test asap for all key workers (then everyone else) and build up a true picture of community infection
    4- otherwise keep society ticking over with safe distancing safeguarding so the economic shock can be minimised.

    It appears the government are stumbling towards this, but the delay in rolling out both antigen and antibody testing has been more scandalous than the lack of PPE.

  • GPs should not examine children’s throats ‘unless absolutely necessary’

    David Banner's comment 31 Mar 2020 12:53pm

    If you don’t examine the throat and then don’t prescribe antibiotics, lots of luck in front of the GMC next year, even if the “fever/pain” score was 3.

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

    David Banner's comment 20 Mar 2020 9:29am

    Oh, 1 more thing.....
    - If I had been tested last week with my (presumably) Covid19 symptoms then I might be more confident with Visits. But I was refused. And large numbers of asymptomatic staff are self isolating for 2 weeks because family members not being tested. Then another 2 weeks when another family member goes down. Yet the few left standing are expected to maintain all current services, triage every call AND increase Visits??
    NHSE must be living in the place where people from Cloud Cuckoo Land go for their holidays.

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

    David Banner's comment 20 Mar 2020 9:10am

    To summarise...
    - we don’t have any/proper PPE, so Visiting is a reckless risk to both patient and physician
    - huge swathes of our workforce are already self isolating. Just who is to carry out these visits?
    - the statement makes it crystal clear that we must keep our doors open, whilst stepping up telephone triage. So just where is the time to do Visits coming from?
    - I can see 6 patients an hour in surgery, but only 1 or 2 Visits in the same time. In a crisis we need more efficiency, not less.
    - if NHSE are serious about visiting, they should organise Acute Visiting Services (with paramedics and doctors) taking visit requests triaged by the GP surgery.

  • GMC defers revalidation for GPs to 'free up vital time' for coronavirus

    David Banner's comment 18 Mar 2020 9:33pm

    So all those GPs who took early retirement (when they were at their peak) because they didn’t want the hassle of annual appraisal can now return (having been out of practice for years) with no revalidation.

    Will the penny finally drop at the RCGP? Appraisal is now proved to be the useless colossal waste of precious time we’ve been been telling you for years. Let something positive emerge from the Corona Crisis, scrap appraisal forever!

  • Healthcare workers with early symptoms set to be tested for Covid-19

    David Banner's comment 16 Mar 2020 10:54pm

    Why not IMMEDIATELY!!
    We have staff in lockdown for 2 weeks with NO idea if they are infected or not.
    So they’re off 2 weeks, return none the wiser, then catch another virus, then off ANOTHER 2 weeks!
    And when family members show symptoms, that’s the whole house on lockdown.
    If they test health care workers with symptoms we can either get back to work, or self isolate 2 weeks then return with confidence.
    The BMA , RCGP etc must demand testing for us IMMEDIATELY, or within a month Primary Care will be shut.

  • Retired doctors won't have to revalidate to help with coronavirus

    David Banner's comment 15 Mar 2020 9:40am


    If I a working full time GP with a spotless 20 year record, but who hasn’t jumped through all of the the appraisal hoops, then I cannot be revalidated and will be banned from practice as a danger to the public.

    But if I am a 5 years retired GP who hasn’t done any appraisal/revalidation and not read a single guideline nor had any update education then I am perfectly safe to practice.

    Glad we’ve got that straight then.

  • GP practices advised to triage all online bookings remotely due to coronavirus

    David Banner's comment 10 Mar 2020 0:39am

    Switched ours off today. Suggest anyone with a scintilla of sense does the same.
    NHSE have shown their true colours in this crisis........CQC inspections, QOF box ticking, meaningless appraisal and now online booking, all to continue as before. Unbelievable. Yet totally predictable.
    Dogma before doctors.

  • Government may call in retired doctors to help deal with coronavirus outbreak

    David Banner's comment 02 Mar 2020 1:05pm

    The scorn in these replies has been well earned by an uncaring government that has spent a decade undermining primary care.

    But ultimately there has to be a Plan B if the virus spreads rapidly and huge numbers of frontline staff are either ill or self-isolating.

    Yes, the majority of younger patients can be dealt with off site, but there will be a huge surge of seriously ill older patients who, like it or not, will be swamping primary and secondary care.

    It’s sensible to alert the recently retired that they may be required, though the actual details really should be published ASAP so prospective staff can make an informed choice. But they really should be limited keeping the show on the road with prescriptions, checking results etc rather than being exposed to the viral hordes.

    And as others have stated, Plan A ought to be encouraging part timers to step up, and freeze all PCN, CCG and similar non-clinical work and return those GPs back to the frontline.

  • We need to tell the time wasters to bugger off

    David Banner's comment 27 Feb 2020 11:24am

    Re Amba

    Many of us already use triage, albeit by accident not design. The GP recruitment crisis forced most of us to employ ANPs rather than GPs, who screen the daily “acute” calls and divert them to the appropriate service. This has been a Godsend, especially for visit requests. Naturally it hangs on employing an experienced and confident ANP, but if you find one they are worth their weight in gold.

  • We need to tell the time wasters to bugger off

    David Banner's comment 26 Feb 2020 1:14pm

    Dear PALS,

    I wish to complain about my rude and uncaring GP.
    I went to see my GP today, because I have a sore throat. I waited 2 days before calling the surgery because I’m not like all those time wasters who run to the doctor on day 1 of a sniffle. I had to fight the receptionist on the phone that, yes, it IS an emergency.
    Well, I wish I hadn’t bothered. The GP glanced at my throat, checked my temperature, then told me (and I quote) to “bugger off”.
    I left after 2 minutes with no antibiotics, no sick note, no ibuprofen.....nothing!
    Is this what I pay my hard earned taxes for? Just so some uncaring alleged “doctor” can tell me to “bugger off”? Has she never heard of sepsis? Or Coronavirus? Is she even a qualified GP?
    I returned home, my throat hurt like hell, and I developed a sniffle. Luckily I snapped up an out of hours appointment where a proper doctor diagnosed “URTI” and prescribed me penicillin.
    Why on earth couldn’t my own GP treat me properly like this?
    I would like you to investigate my GP and hopefully tell HER to “bugger off”....out of the NHS for good!

    Yours sincerely,

    Ivor Wright

  • PCNs can start recruiting new roles early using unspent funding, says NHS England

    David Banner's comment 23 Feb 2020 12:11pm

    Let’s see if I’ve understood this..,...

    Around the country, 1300 PCNs staffed by expensively trained GPs will sit around in committees (instead of, y’know, seeing patients) desperately trying hose away many millions of desperately needed pounds on staff they don’t need and can’t find to do totally unnecessary tasks (that the staff are not trained to do) that make no impact on GP workload that is rising exponentially because the last few remaining GPs are sat in committees rather than, y’know, seeing patients in their underinvested practices as they were (expensively) trained to do.


  • RCGP remains opposed to change the law on assisted dying

    David Banner's comment 22 Feb 2020 11:50am

    The RCGP putting their fingers in their ears won’t stop the increasing demands of Boomers to be allowed the dignity to determine the destiny of their own deaths.

    We (rightly) allow choice on abortion yet continue to deny terminally ill patients the right to a dignified death.

  • Almost half of over-60s with CKD are undiagnosed, research suggests

    David Banner's comment 19 Feb 2020 0:07am

    The eGFR formula supplied from the lab is useless after age 75.
    An 85 year old with a creatinine of 80 has an eGFR less than 60 and is told they have CKD3.
    Yet the ACR and Cockcroft -Gault will often be normal.
    But hard pressed clinicians haven’t the time to do these extra checks, so will either ignore the eGFR or stick them on the CKD register, then do nothing, because there is nothing to do. Medicalisation of normal ageing is not progress.

  • What to do if you suspect coronavirus

    David Banner's comment 07 Feb 2020 12:21pm

    I think it’s right to be over cautious....

    1- most models show this virus spreads far more rapidly than seasonal flu
    2- most vulnerable patients have been vaccinated against seasonal flu. No vaccine for this virus yet.
    3- the case of Dr Li shows that the Chinese government tried to cover this up, so their figures may be unreliable
    4- Dr Li was only in his 30s, and presumably fit, so it clearly can kill non-vulnerable people too.
    5- international travel has expanded rapidly in East Asia.
    6- initial studies suggest 10% death rates, far higher than seasonal flu
    7- pictures of Chinese stadiums stuffed with makeshift beds and new hospitals springing up in weeks suggests they know something we don’t .
    8- the virus will continue to mutate, hopefully to a less deadly strain, but possibly more so.
    9- better we over-react than get caught with our pants down
    10- this was an excellent article, thank you for the important info.

  • Health minister claims PCN service specification ‘will reduce GP workload’

    David Banner's comment 06 Feb 2020 10:24am

    They’re not listening.
    Anyone surprised?
    Now do GPs have the nerve to resign from PCNs en masse?