Hastily formed PCN’s have created extra layers of bureaucracy increased our workload without providing any practical help to ease the current GP recruitment crisis. Attending pointless MDT meetings is taking us away from our patients. Appointing of pharmacists, social prescribers etc. will not make any difference to our increasing workload.
I am opposed to PCN’s taking on the responsibility of employing pharmacists / social prescribers etc. for two reasons:1) some practices may not be able to afford 30 % contributions 2) there is no assurance that long-term funding will continue for these jobs.
You may be aware that those pharmacists who have not already jumped on a PCN bandwagon will be more than happy to embrace their new contract - Community Pharmacist Consultation Service which involves pharmacists taking referrals from 111 to provide same day appointments for minor illness at £14 a time; but I can bet you the patients will still want to see their GP the next day.
It seems the pharmacists have done better when negotiating their new community contracts in comparison to our hopeless self-serving leaders and BMA who have endorsed PCN contract without putting it to vote. I feel the PCN's have been created to demolish GP partnership model driving a final nail in the coffin of General Practice.
Given an already stretched GP workforce and recruitment crisis how on the earth are we ever going to manage PCN contracts? In my opinion PCN contract is another gimmick invented by senior NHS managers and lawyers to force us back into 24/7 cover.
As a single handed GP with list size of 2800 patients my daily work starts at 6 AM from home having full remote access to clinical system using emisweb with integrated “babblevoice” telephone system.
Today 11/2/2019 I have dealt with:
27: Test results
15: IC24/111 reports
12: Email electronic discharge letters
18: Telephone consultations
25: Patient consultations
02: Emergency appointments
25: Hospital Clinic letters
110: Repeat prescriptions
01: Home visit
Back home at 8 PM
GO to your GP syndrome must stop; why does everyone from milkman to a consultant has to say to a patient go and see your own GP! I think they all pass on the buck to protect their own asses.
GP has to submit a claim for every item of service is just a symptom of underlying carcinomatous growth that has invaded the NHS. Everything we do is controlled and micromanaged but as a profession we and our leaders have to accept the responsibility for this situation.
Areas of discussion (My appraisal 1/3/2017)
General practice is becoming a nightmare - overwhelming bureaucracy and micro-management combined with huge unfunded workload shifted from secondary to primary care, increasing patient demand and lack of resources ....
Another load of rubbish if a patient can afford a holiday abroad why can’t they afford to pay for their travel vaccinations? The reality is that lot of our patients do not bother to take preventative measures against travel related illnesses when going abroad? Is it because they expect to be treated free on the NHS if they do happen to develop any travel related illness on their return to the UK.
We GP’s don’t have any voice even if we do make some noise now and then no one is listening - so why waste our time and energy. BMA, GPC etc. are all toothless tigers they are only protecting their own interests “barking dogs seldom bite”.
Proliferation of locum agencies shows how our own colleagues are exploiting the profession- high locum costs are driving the already moribund general practice to its terminal stages…given the current scenario of unaffordable locum costs resulting into recruitment crisis and practices closures the locum force will soon be out of demand.
If the tariff system / payment by results would not have been introduced we would not be faced with this mess today.
Having really enjoyed working in the NHS, 12 years as a hospital doctor and 32 years as a GP I have decided to quit as soon as possible. I feel general practice in particular has become a very risky business: - fragmentation of the services, overwhelming bureaucracy, micromanagement, over regulation, lack of support, dumping of work from secondary to primary care, ever increasing demand from our patients, fear of litigation, free for all complaints process, demoralized work force, huge increase in practice running costs….I ask myself why on the earth do you want to be a GP!
These old fashioned ideas are unworkable in the present climate- where we are dealing with an increasing demand created through huge demographic changes, perception of needs and expectations determined by our clients (based on political rhetoric) , woefully inadequate resources, lack of medical manpower and demoralized NHS staff.
Seven day access is politically driven Mr Hunt’s stunt, it can only deal with trivia and address the never ending needs of our worried well. In my view this will result into further fragmentation of care, generate a huge amount of workload for GP’s – as almost every consultation will be bounced back to patients GP – “see your GP next day” - we all know the reasons why!
A high QOF score does not necessarily indicate high quality care, any quality indicator that is financially driven and data open to manipulation is unreliable. In my opinion financial incentives to improve population outcomes do not work, despite spending 5.86 billion on QOF incentives it has led to no significant improvement in mortality rates (Lancet).
Like all other imposed gimmicks upon GP’s - online access, patient surveys, NHS Choices, PPG’s, unplanned admissions, yearly ritual of appraisals; NHS health checks are a share waste of time & resources. But don’t forget there are lots of people employed to see that these rituals are carried out they have to justify and protect their armchair email pushing jobs.