This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

David Banner

  • GPs asked to support weight loss in obese women before pregnancy

    David Banner's comment 03 Dec 2018 7:29pm

    If they want help, they will ask for it.
    If they don’t, they won’t.
    It’s called freedom of choice.
    We’re not the obese police.

  • Our GP safeguarding peer support network is helping vulnerable families

    David Banner's comment 01 Dec 2018 10:14am

    The balance between under and over reporting to safeguarding is being destroyed by zealous non GPs who will seize on a single line in a referral letter and report the offending GP to a disciplinary body for failure to refer.
    GPs are used to making balanced line decisions in borderline cases, but non doctors who have done their Safeguarding training only see black and white, and refer each and every one of these cases.
    The result is a culture of fear, so that now GPs are referring each and every borderline case, causing potentially dangerous serious mistrust between doctor and patient, and the flooding of the safeguarding team with inappropriate referrals.
    When their department can’t cope, they will be forced to act like CAMHS, and simply reject most GP referrals, making a nonsense of the whole safeguarding system.
    We still suffer from the delusion that all appalling cases of child cruelty could have been prevented, yet still demand the freedom to raise our children without interference from authorities.
    But unless we want to live in a Police State, with children snatched away on the tip off of a vengeful neighbour, then we have to reluctantly accept that a few will slip through the net. It is the high price for living in a free country, but now the piggies in the middle (GPs, health visitors, social workers) are the easy ones to blame & shame when inevitable tragedies occur.

  • GPs should urgently refer all suspected TIA patients, says new draft NICE guidance

    David Banner's comment 30 Nov 2018 12:54pm

    Is this really new?? Suspect we all do this any way.

  • Diabetes patients to be put on 800-calorie-a-day diet, says NHS England

    David Banner's comment 30 Nov 2018 12:46pm

    If dieticians supervise and patients purchase the products (they’re not buying food, so it’s cost neutral) then fine by me. If they are truly motivated they will happily cough up for the products and stick to the programme.

    BUT, if these products are put on (free) NHS prescription it will cost a fortune and eat up huge swathes of non existent GP time with barely any impact on the diabetic population.

    The real world is very different from the trial world. As others have pithily stated above, the vast majority will fail to comply with their liquid diet, but the massive demand for these “free” products will decimate NHS budgets.

  • Revealed: the effect of the Government's NHS long-term plan on general practice

    David Banner's comment 29 Nov 2018 4:03pm

    Why is this article accompanied by a picture of Harry Potter’s weird uncle? Do you have to be a wizard to figure all this gobbledygook out?

  • CCGs tackle winter pressures with extra GP appointments and remote monitoring

    David Banner's comment 29 Nov 2018 3:52pm

    GP Winter preparation checklist
    - invitation from Satan - check
    - train ticket to Hell (1 way) - check
    - 1 rickety handcart - check
    - all hope abandoned - check
    Right, I’m good to go, hope the rest of you are ready.

  • Winter is coming

    David Banner's comment 29 Nov 2018 1:52pm

    “The night is dark and full of terrors”

  • GP workload warning as primary care diagnostic testing increases threefold

    David Banner's comment 29 Nov 2018 1:33pm

    Re Paul Cundy ,
    Bang on. The runaway train of utterly useless Vit D testing has been a total farce and a scandalous squandering of scarce resources. This pointless test should be banned in Primary Care, vit D should be blacklisted from prescription except in specific patient groups , and Secondary Care need to stop randomly testing then dumping responsibility back on GPs.

  • CCGs tackle winter pressures with extra GP appointments and remote monitoring

    David Banner's comment 29 Nov 2018 1:17pm

    No additional funding to practices
    No GPs
    Flu jab fiasco
    Winter chaos (yet again)

  • Choosing our battles wisely

    David Banner's comment 28 Nov 2018 2:24pm

    I’m with Copperfield on this one. If an OPD discharge letter suggests annual PSA with “refer if rising” instructions, then this is a perfectly reasonable request of any semi competent GP. The alternative is armies of elderly men queuing outside chaotic Urology clinics who are then unable to offer reliable urgent/2WW appointments. The numbers per practice are low, we are probably bleeding them annually for cholesterol, diabetes etc any way, this is simply good co-operation between primary and secondary care. The public would be totally unsympathetic if we decided to make our stand on a cancer issue.
    Copperfield has regularly seethed over the trivial crap dumped dumped on us by secondary care, this (as he says) is different.

  • ‘Insufficient evidence’ that diverting patients from A&E curbs overcrowding

    David Banner's comment 28 Nov 2018 1:54pm

    it’s multifactorial
    - rising population
    - rising elderly population
    - increased patient expectations
    - decreased acceptance of personal responsibility for health
    - noctors attending acute visit requests in primary care
    - the slow death of general practice, thus...
    - dearth of GP appointments
    - A&E doctors bogged down in red tape (I rattled through 50 patients per shift on a wing & a prayer in the 90s, now they rarely hit double figures)
    - fear of litigation (safety first, pass the buck)
    - too few hospital beds
    - spending not kept up with NHS inflation (real term cuts)
    - decimated OOH services
    -trigger happy NHS111
    Etc etc etc wonder a single fix failed to work.

  • GPs face restrictions on glucose testing strip and bath emollient prescribing

    David Banner's comment 28 Nov 2018 1:34pm

    If the DOH want to ban these items from NHS prescriptions, then fine. Complaining patients can be pointed to their local MP.

    BUT, if the DOH cop out yet again by “strongly advising” GPs to avoid issuing these items (whilst leaving them technically available on prescription), then drawing up League Tables of “bad practices” so they can name & shame then bully & persecute us whilst taking zero responsibility themselves , then they can go to Hell.

  • GPs could face quinolone antibiotics prescribing restrictions from next year

    David Banner's comment 28 Nov 2018 1:07pm

    Hmmm, posters and leaflets discouraging patients from asking for antibiotics, there’s a novel idea.
    If you have a lab result stating cipro is the only oral option, then you can prescribe (and be damned), not prescribe (and be damned), or admit for far more precious IVs (and be damned).
    GP as whipping boy....yet again.

  • Ambulance trust cuts out-of-hours GP winter shifts due to summer overspend

    David Banner's comment 28 Nov 2018 1:00pm

    With the over 65 flu farce, there is a high chance that this Winter could be the worst in decades. Glad to see the NHS is geared up for this inevitable and preventable disaster.....

  • Urgent care company collapse leaves GPs just 10 days to find out-of-hours cover

    David Banner's comment 26 Nov 2018 11:22pm

    Re Jam GP

    As far as I know, only this part of Birminghan and St Helens remained “opted in” after the 2004 contract (bar the odd remote country practice), because they had a strong effective co-op in place. 14 years later he he recruitment crisis has hollowed out OOH, so the opted in practices face doing the work themselves or (more realistically) opting out.

  • We need to tackle societal problems to stem the tide of mental illness

    David Banner's comment 26 Nov 2018 2:05pm

    So much effort has gone into raising awareness, reducing stigma, early diagnosis and “defeat depression” campaigns, but nobody seemed to realise that doubling or trebling the patient population needed a corresponding rise in psychiatric services.

    So now the Adult team have learnt from CAMHS that all you do is reject vast swathes GP referrals, or discharge everybody after one appointment with a letter to GP asking for multiple medications to be titrated up.

    The result? Huge numbers of dissatisfied patients labelled with dubious mental health diagnoses swamping GP surgeries moaning about the lack of care available.

  • Revealed: the effect of the Government's NHS long-term plan on general practice

    David Banner's comment 26 Nov 2018 1:49pm

    There is nothing here that would encourage younger doctors to become GPs, nor persuade older GPs to not retire early.
    More guff about “Primary Care investment” (with not a penny to small partnerships), waffle about “social prescribing” (didn’t that used to be somebody else’s job?), and Futurama style fantasies regarding hi-tech consultations that most GPs and patients over 40 simply don’t want or need.
    Reads more like the Last Rites than another Forward View.

  • RCGP backs second EU referendum amid fears Brexit will 'damage' the NHS

    David Banner's comment 26 Nov 2018 1:35pm

    These RCGP clowns foisted the annual nightmare of appraisal on us, have been as effective as an ashtray on a motorcycle in defending us from the government onslaught against GPs, but they are so trumped up with their own inflated sense of importance that they think anyone cares about their views on Brexit.
    Anyone who still pays their subs to this deluded rabble should hang their heads in shame.

  • Capita-run GP back office services are an ‘unmitigated disaster’, says GPC chair

    David Banner's comment 23 Nov 2018 1:01pm

    Who would have thought that palming this on to a private company running a shoestring service to maximise profits would be such a disaster.

  • GPs vote to end clause that allows practices to recruit patients outside their boundaries

    David Banner's comment 23 Nov 2018 12:58pm

    Hancock is wedded to Babylon so this will be quietly ignored, but at least this LMC has the sphericals to speak out, let’s hope this shames the BMA into action. (Not holding my breath).