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.
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.
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.
The picture accompanying this article is remarkably similar the the My Iron Lung EP cover.
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.
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.
“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”
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,
No vaccines = no school
This must be why CAMHS is such a fabulous service that is easy for GPs to access. Job well done.
I can’t take this any more. Pass the pregabalin......mmmm, that’s better
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.
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.
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.
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.
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.
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......blacklist them or shut up.
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.
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