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Gold, incentives and meh

David Banner

  • GPs 'should stop using inflammatory markers as non-specific test'

    David Banner's comment 23 Jun 2019 3:20pm

    Here’s an idea. Why don’t experienced GPs assess, investigate and treat individual patients appropriately using the knowledge acquired from their expensive education. I know, I know.....totally crazy, it’ll never catch on.....sorry.

  • Thousands of terminally ill patients risk being denied benefits, says RCGP

    David Banner's comment 23 Jun 2019 10:58am

    Neil Bhatia is bang on.

    If the “6 month” rule is lifted there will be a rush of speculative DS1500 requests which (apart from a huge increase in our paperwork) will have a sudden massive financial impact on the already inadequate benefits system.

    People are told to request DS1500 precisely because they are terminal. They already know this. There is more of an issue with non-terminal patients making an inappropriate request, which I happily decline with a breezy “That’s for when you’re dying, and I’m glad to say you ain’t dying yet!”

    And if someone is palliative we should be happy to complete a DS1500 even if we think they may have more than 6 months left, because none of us have a crystal ball. These patients can pass within weeks if (for example) they develop pneumonia (especially for extremely unpredictable conditions like MND).

    The slightly trickier ones are cancer patients undergoing potentially curative treatment who may be struggling financially. If they request a DS1500 I explain that it is designed for patients with less than 6 months to go, reassure them it probably doesn’t apply to them, but fill it in any way on the grounds that cancer therapy is notoriously unpredictable, without stating definitively on the form that I expect them to die soon, and leave interpretation to the department dealing with DS1500........nobody has ever been turned down.

    We need a sensible compromise and the current system (whilst not perfect) gets it just about right. I know some people find the decisions uncomfortable, but GPs pride themselves on making these tough calls, it would be a disappointing dereliction of duty if we duck this one.

  • GMC says reflection should be 'less of a tick-box exercise'

    David Banner's comment 18 Jun 2019 9:05pm

    Anyone with sense will tick the box with pointless meaningless risk-free reflections, (such as that complaint when you refused to issue diazepam 2 weeks early, or learnt a valuable lesson when the fridge temperature dropped a degree) rather than mentioning ANYTHING of substance that could return to haunt you in future years.
    Treat it with the contempt it deserves.

  • NHS to investigate GP ‘fraud’ in retaining ghost patients

    David Banner's comment 14 Jun 2019 0:06am

    The picture accompanying this article is remarkably similar the the My Iron Lung EP cover.
    Spooky.

  • Major GP guidelines mostly ‘based on expert opinion and not evidence’

    David Banner's comment 13 Jun 2019 10:16am

    Nitwits Ignoring Clinical Evidence.

    These are the clowns who tried to impose FeNO testing and comically ignorant diabetes guidelines on us recently.
    But whilst we all laugh at and ignore their “cost effective” demented nonsense, the truth is that these deeply flawed dictats may be used as evidence against you by your local friendly GMC one day.
    Depressing and terrifying in equal measures.

  • How primary care networks can strengthen GP practices

    David Banner's comment 04 Jun 2019 12:56pm

    Look, we were effectively forced into networks (all the new money is attached to them), how many of us would have joined voluntarily?

    Our negotiators failed yet again to have money put straight into practices, so now we have to squeeze another hoop-jumping meaningless meeting into what used to be called our “lunch break” just to break even.

    These layers upon layers of expensive and useless bureaucracy eat into precious clinical time, and keep GPs away from their patients.

    Please don’t try to dress networks up as a brave new world, we’ve seen too many of these ruinously redundant reboots crash and burn over the last 20 years and we’re thoroughly sick of them. All of them. Just leave us alone....please.

  • Patients feeling supported by GP as important as medication for diabetes control

    David Banner's comment 02 Jun 2019 10:33am

    “Your HbA1c is 100. Just to let you know, I’m here for you”
    “Oh. Aren’t you going to prescribe me anything?”
    “Nope, no need, I’ve checked the research, just know that I’m behind you all the way. I believe in you!”
    “Errr, cheers Doc, but I think I’ll see the Locum next time”

  • The full story on how practices are closing in record numbers

    David Banner's comment 02 Jun 2019 10:24am

    Whilst this is FINALLY getting some band width on national media, I doubt there will be any action.
    Listened to a radio phone in where call after call consisted of people slagging off overpaid lazy GPs.
    15 years of brainwashing with this stereotype has closed the minds of the public to our plight. The partnership purge will continue as planned,

  • We need to change how we tackle the anti-vax movement

    David Banner's comment 01 Jun 2019 8:56am

    No vaccines = no school

    Problem solved

  • May heralds 'proper funding for mental health' in resignation speech

    David Banner's comment 24 May 2019 7:24pm

    This must be why CAMHS is such a fabulous service that is easy for GPs to access. Job well done.

  • Jeremy Hunt to run as candidate to replace PM Theresa May

    David Banner's comment 24 May 2019 7:21pm

    I can’t take this any more. Pass the pregabalin......mmmm, that’s better

  • Chancellor downplays hopes for pension tax reform

    David Banner's comment 24 May 2019 10:18am

    Doctors in secondary care are already cutting sessions and refusing extra work.
    Some are even considering setting up limited companies for these extra sessions to avoid the AA trap.
    Either way, it is insane. As soon as these senior doctors saw their first massive AA bill they either cut work or starting dreaming up ways around it.
    Did HMG think they would happily do extra work (effectively) for free?
    If HMG don’t change the rules they will either face (another) workforce crisis or financial meltdown shelling out to limited companies charging whatever they feel like.
    Utter madness.

  • GMC to spend ‘bulk of resources’ on supporting doctors

    David Banner's comment 23 May 2019 5:01pm

    The last paragraph says it all. ANNUAL patient questionnaires?? This utterly useless, futile, infuriating, time consuming chore is a pointless pain every 5 years, but ANNUALLY??
    Clearly anyone hoping GMC might bin the evidence free appraisal ain’t seen nothing yet.
    They don’t care, never have, never will.

  • Sorry, I won’t go south at this time of day

    David Banner's comment 22 May 2019 8:36pm

    I used to set my phone’s stopwatch to 10 minutes, ending in the sound of a duck, then state “the quack says it’s time to go”. It worked well, but the mound of complaint letters on the P Manager’s desk convinced me to reluctantly cease and desist.

  • Chancellor downplays hopes for pension tax reform

    David Banner's comment 22 May 2019 8:27pm

    Clearly Hammond will not change the thresholds for annual allowance, but second prize would be to allow GPs to voluntarily reduce the amount of income they wish to be superannuable , rather than the all or nothing system we currently have.
    But this statement suggests nothing will change, and experienced doctors will leave in droves when their AA tax bills start piling up.

  • Capita wrongly archived 160,000 patient records due to processing error

    David Banner's comment 20 May 2019 1:40pm

    Another week, another Crapita cock up story.
    They have been beyond parody for years. The real disgrace lies with those who have repeatedly failed to kick Capita out of the NHS. Shame on you.

  • Thyroid medicines are being overprescribed, says research

    David Banner's comment 16 May 2019 7:06pm

    Glad they have abolished the “borderline hypothyroid” TATT with a marginally raised TSH and normal T4.
    But we need clearer guidelines on the huge number of these patients already on low dose thyroxine rather than the usual “discuss with your GP”.

  • OTC medication rationing only made a quarter of its targeted savings

    David Banner's comment 18 Apr 2019 9:42am

    OTC......blacklist them or shut up.

  • Half of patients on statins have ‘sub-optimal’ response to treatment

    David Banner's comment 16 Apr 2019 1:09pm

    It’s fairly easy to spot the non compliant patients......if they turn up for a blood test.
    A cholesterol of 7 which dropped to 4 on a statin and is now mysteriously back to 7 doesn’t need Sherlock Holmes to figure out the reason why.
    Compliance is in the patients’ court, not ours. If they choose not to take their tablets contrary to medical advice then it is their right....and responsibility....to do so.

  • Homeopathy prescribing set to be blacklisted under NHS England plans

    David Banner's comment 09 Apr 2019 1:00pm

    Finally NHSE have the courage to blacklist sterile water on prescription.
    So if you want us to cut out all the OTC drugs, front up and blacklist them too, and stop passing the blame (sorry, “issuing guidance “) to GPs