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Independents' Day

David Banner

  • The career-ending Catch 22 decision

    David Banner's comment 29 Jan 2020 8:17pm

    Hmmm, what to choose, a naughty boy letter from the CCG for over prescribing, or struck off and potential prison for “missing” sepsis?

    This is an excellent article, but further issues need exploring...

    -mass use of antibiotics in farming
    - antibiotics freely available OTC in many other countries
    -the cost of diagnostic equipment is important, but don’t forget the hidden costs of staff, longer appointments, follow up responsibilities etc.
    - once a “test” for antibiotics is freely available, the viral hordes will descend on practices instead of sweating it out at home. Who sees them?
    - the tests are not 100% specific/sensitive. Who’s to blame when sepsis kills off a patient told 2 days earlier it was just a virus?

    As the article suggests, the best way out of this mess is a “no fault for missing sepsis” clause in our contracts. But we all know this will never happen in our damned if you do/ damned if you don’t society.

  • Coronavirus media reports will increase demand for GPs, warns RCGP

    David Banner's comment 29 Jan 2020 7:59pm

    Thank God we have lots of slack in the system, loads of free appointments, acres of spare time in the day, oceans of good will, effective treatments and a fired up reserve of GPs waiting to come off the bench to help mop up the extra work.
    Primary Care is more than ready to take on this challenge, no worries.

  • A third of GPs suffer from ‘compassion fatigue’

    David Banner's comment 28 Jan 2020 6:50pm

    I’ve stopped caring about the fact that I’ve stopped caring, because nobody cares any more.

  • Hancock wants ‘value for money’ from PCNs in GP contract negotiations

    David Banner's comment 28 Jan 2020 6:46pm

    Matt was just showboating in the House of Commons, playing the tedious game of oneupmanship over his Shadow.
    Deep down I think he knows that PCNs are in serious trouble. He surely can’t be THAT stupid......can he?
    If he is that stupid, then it’s up to our leaders to negotiate us out of this mess. Assuming they don’t (and hopes are not high here in the trenches) then mass desertion is our only weapon.

  • GPs shouldn't ignore the threat of coronavirus - but we're equipped to deal with it

    David Banner's comment 28 Jan 2020 2:13pm

    Cope? Hmmmmm
    We’ll be emailed dictats ordering us to run around to all and sundry prescribing massive quantities of expensive useless antiviral placebos (to fool the public something is being done), patients will be told to “call the doctor out” to avoid attending surgery, GPs will inevitably contract the virus themselves, and of course all the work currently drowning the few remaining GPs won’t just magically disappear.
    Having starved Primary Care down to skeletal proportions, don’t be surprised if it succumbs to this virus.

  • The gender divide is a result of an inflexible partnership model

    David Banner's comment 28 Jan 2020 12:55pm

    I’m baffled by this article. If a Young Doctor appeared in my patch wanting a Partnership, GPs would be trampled in the crush to offer the most favourable terms. You hold all the negotiating aces, whilst we are drowning.
    ”You want better hours, less administration, equitable pay? Sure, fine, whatever, we can come to an arrangement, just sign here, please, pretty please, oh come on please, please, no don’t leave, WE’RE DYING HERE!”
    Shop around and you can have it all.

  • Out-of-hours service suspended across city again due to GP shortages

    David Banner's comment 23 Jan 2020 8:37pm

    Be afraid. Be VERY afraid.
    Headlines like this will be exploited by HMG to dump OOH back on to GPs via the gigantic elephant trap of PCNs that nearly all of us were herded into last year.
    Winter is coming.

  • Media reports of sepsis deaths 'make parents pressure GPs for antibiotics'

    David Banner's comment 23 Jan 2020 8:28pm

    I deliberately put the “it’s just a virus, you don’t need antibiotics” poster right next to the “Sepsis - you need antibiotics NOW!” poster in our waiting room as the symptoms were remarkably similar!!
    The very definition of “damned if you do, damned if you don’t “.

  • GPs to share video consultations with hospitals under Babylon partnership

    David Banner's comment 23 Jan 2020 1:47pm

    “A patient would be able replay any consultation.....through the app”
    Eh?? What about confidentiality? No, not the patient’s, MINE! I DON’T consent to patients playing back my consultations to all and sundry thank you very much.
    Any doctor agreeing to this is either extremely naive or in need of an urgent psychiatric consultation.
    Now THAT’S a consultation I DO want to watch!

  • BMA and NHS in talks over funding for networks with multiple care homes

    David Banner's comment 21 Jan 2020 1:03pm

    To echo other contributors here, this is a staffing issue, NOT a financial one.
    If this DES is forced through, then many older GPs will simply leave the profession rather than burn out trying to achieve the unachievable.

  • No details about how GPs’ winter pension tax charges will be paid, warns BMA

    David Banner's comment 21 Jan 2020 12:51pm

    Moving to Scheme Pays was always a trap.
    Yes, you don’t receive an AA Bill this year, but does anyone seriously believe that Crapita will be competent enough to deduct this amount when you finally retire?
    And since nothing was nailed down, expect HMG to backtrack on this verbal promise in years to come, with huge reductions in your pension on retirement.
    It was a short term con to keep doctors on the front line during an election December.
    Now they are free to renege on their promises.
    A verbal contract isn’t worth the paper it’s written on.

  • Hospital says GPs will manage patients it has told doctors to discharge early

    David Banner's comment 20 Jan 2020 10:05pm

    Boing!!!!

  • GPs should not prescribe melatonin on NHS for jet lag, independent review recommends

    David Banner's comment 20 Jan 2020 9:59pm

    Since you can purchase large quantities of high dose melatonin from health stores in the States (and cheaply online in the UK) this advice will be largely redundant.

  • One in four children 'rejected by mental health services, despite extra funding'

    David Banner's comment 14 Jan 2020 9:32pm

    Only 1 in 4 rejected???
    Surely that should read 1 in 4 accepted.
    And even that’s a tad generous.

  • Female GPs earn on average £40,000 less than male counterparts, finds report

    David Banner's comment 14 Jan 2020 2:41pm

    So.....

    Male GP works 5 day week for £100k

    Female GP works 3 day week for £60k

    Is the headline “Male GPs earn £40k more than female GPs”, or “Male and female GPs have equal pay”??

    You decide. I’ll lend you my calculator if it helps

  • LMC advises GP practices not to sign network contract

    David Banner's comment 09 Jan 2020 7:09pm

    We always wondered which straw would break the camel’s back. Admittedly this DES is more of a haystack than a straw, but still....
    If PCNs up & down the land REFUSE to sign up, then NHSE will discover that this filthy, ancient, clapped out, ill tempered, malnourished and malodorous camel still has teeth.....and a camel’s bite is the dirtiest and nastiest bite in the animal kingdom.

  • Children rejected by NHS mental health trusts as criteria for GP referrals tightens

    David Banner's comment 04 Jan 2020 10:28am

    Be warned. CAMHS have beaten the path for others to follow. Ruthlessly reject referrals, then claim you are meeting all of your targets. Adult Psychiatry is already following suit, and other specialties are realising the tantalising possibilities of dramatically reducing their workload and boosting efficiency statistics by using the same tactics.
    Wrong form, insufficient details, don’t fit criteria, refer somewhere else (that doesn’t exist).....Secondary Care is becoming skilled at sending patients in circles leading eventually back to your desk, and CAMHS can proudly claim that they showed the others the way. Yes, a few kids committed suicide, but look at our waiting time target achievements!! With only half the staff!! Result.

  • GPs to visit care home patients fortnightly under network requirements

    David Banner's comment 04 Jan 2020 10:13am

    There are approx 410,000 UK care home residents.
    So for every PCN of 50,000 patients this is roughly 350 residents.
    If there are 25 FTE GPs in this Network, that’s 14 patients per GP.
    Since they want “substantially more” than a standard 10 minute appt, let’s assume 20 minutes per patient every fortnight, plus travel time.
    That’s the equivalent of 2 surgeries per GP every fortnight.
    So across the Network every GP drops the equivalent of a surgery every week.
    This is utter madness. Massively inefficient, with a huge impact on non-care home patients, and minimum benefit for care home residents, who still need another visit when they become ill the day after their fortnightly check up.
    In some Parallel Universe where GPs are plentiful this might seem a good idea, but in the present climate it’s catastrophic lunacy dreamt up by Blue Sky Utopians with zero grasp on the grim reality of the chaos that is Primary Care in 2020.

  • Let’s start the new decade by telling patients the truth

    David Banner's comment 02 Jan 2020 12:24pm

    The problem is that there are light years between what is promised to British punters against what is actually available.
    Patients are constantly fed a diet of early presentation, screening, self diagnosis, “see your GP if...” etc, then are disappointed and angry when confronted by the reality check of the “no appointments” delapidation of Primary Care in 2020.
    We all need to adapt expectation management strategies this decade. Learning to say “no” to patients is a tough gig, but if our paymasters continue to peddle “Paradise for all” in a parallel universe that no GP recognises, we need to be the harbingers of hard truths and harsher realities.

  • Teen girls with anxiety at greater risk of developing eating disorders

    David Banner's comment 29 Dec 2019 10:18pm

    Re Premolars
    I’ve definitely noticed that more women than men are diagnosed with ovarian cancer, why oh why is there no research to back this up?