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GPs buried under trusts' workload dump

Hugo Minney

  • A patient won’t see a ‘non-white’ GP

    Hugo Minney's comment 21 Oct 2016 3:23pm

    this is certainly fraught with problems - some patients have limited socialisation and may be saying what their parents say, not what they hold strongly to. I remember inappropriate remarks in the pub excused by "present company excepted" as he was happily buying drinks for, and receiving from, a rainbow of mates.
    It's entirely appropriate that someone should ask to be seen by a doctor who understands their cultural (or even gender) background. The rub here is that probably every doctor who works in UK does understand the white working class or middle class background, so the time when you can ask is when your background is culturally a minority.
    I suspect the right answer for a first offender is to decide how urgent the requirement is, and either book them in to see a GP as requested (if it's urgent), or advise them that the Practice Manager will call them back (if it isn't). Then the GP or practice manager can take a bit longer to make a proper assessment, and decide if their expressed attitude can be changed or if they don't fit with the practice. If the latter, then I would consider reporting racist attitudes to the police (with the patient's knowledge, of course).
    Remember, a doctor should not withhold care from anyone who needs it (where "need" may depend on urgency).

  • Junior doctors lose High Court legal challenge against health secretary

    Hugo Minney's comment 29 Sep 2016 12:29pm

    I love this judgement. What does it say? That SoS #unt doesn't have any legal right to impose anything (he said so himself). Employers and Employees can go ahead and design an NHS that works, and completely ignore SoS. Leave him ranting and frothing at the mouth in a corner!

  • Jump in private referrals after GPs are told to ask patients about insurance

    Hugo Minney's comment 05 Sep 2016 10:15pm

    Spend on health is money not available for investment in enterprise, or simply in spend on other things that will generate a tax revenue (eg sales tax, income tax on the people providing the service).
    Many countries see that UK National Health Service is of enormous economic benefit to UK, they just can't get their heads around trying to introduce their own NHS as a "big bang" approach.
    Squeezing people to use private insurance will drive the prosperity of UK down. But Britain has become a laughing stock anyway so I suppose it's no different.

  • BMA suspends this month's industrial action over safety fears

    Hugo Minney's comment 05 Sep 2016 10:09pm

    It was certainly a challenge and a difficult judgement call. IMHO i think BMA has really messed up this time. They need to pay for some advertising and buddy up to some journalists to get the doctor side of the story out - J Hunt is getting away with murder.

  • The independent contractor model is being left to die

    Hugo Minney's comment 03 Jul 2016 8:01pm

    Salaried model is simply too expensive - the employer has to pay too much for contingency whereas partners can take a chance that they won't need sick cover etc, so I really hope that the independent model (whether as at present or through super-practices) is still there in 5 or 10 years

  • Hunt orders 'pause' of all new contracts with GP IT supplier following QRISK errors

    Hugo Minney's comment 26 May 2016 0:30am

    How did they know? The QRisk2 is only 43% accurate in women and 38% accurate in men (the algorithm predicts this % of the variation) (certainly better than nothing) and doesn't appear to be overly complicated, so how could the computer programmers get it wrong?
    Just wondering?

  • Filling practices with non-doctors will not solve workforce crisis, say GPs

    Hugo Minney's comment 22 Mar 2016 10:56pm

    There are many things that only a GP can do - that difficult diagnosis, making a decision to change care for a complex patient. But we all of us use our practice nurses for patients whose management is well defined, and none of us enjoy processing discharge letters and ensuring the meds are the right ones and don't conflict.
    There's a place for these "non-doctors". I'm not saying I like it, but when you can't get doctors then we need these others to make a GP's work-life a little closer to being balanced.

  • Government has listened to GPs on seven-day opening, says NHS leader

    Hugo Minney's comment 22 Mar 2016 10:49pm

    Dr Robert Varnham, Head of General Practice for NHS England is a politician. He might want to deny it but that's the simple fact.
    And to put £110million in context, it's roughly 1% of the total GP Practice budget so it probably won't go very far

  • GP practices forced to tell NHS England if they pay over 'maximum rate' for locums

    Hugo Minney's comment 22 Feb 2016 4:34pm

    we had this from our (private sector) Out of Hours provider. Nobody else was to pay too much for GP locums, because it forced up their costs.
    This will drive doctors out of the service or the country.
    RESULT? Poorer healthcare for patients, but bigger profits to some companies

  • GP leaders reject call to explore salaried only status

    Hugo Minney's comment 01 Feb 2016 4:33pm

    I applaud GPs for considering and debating this, and as it happens i agree with the result.
    For the sake of patients, the health of the population, and cost-effectiveness, GP partners are much better. Salaried GPs move from job to job (when you are young you want to be in the city; young children - move to the country etc) and patients don't have time to build up a relationship of trust. Less trust = less likely to unload little worries = develop medical illnesses with corresponding costs.
    GPs and primary care provide the vast majority of care and patient contacts. What we really need is better funding in primary care and services aligned around GP practices. More money means that GPs can afford to employ that extended primary care team that frees up GPs to do the things that noone else can do.
    So there's an easy solution. Pity it is one that #unt won't countenance.

  • Patients ‘not at risk of serious harm from doctors' strikes’

    Hugo Minney's comment 26 Nov 2015 2:28pm

    Jeremy #unt wants to paint the doctors as the irresponsible ones. That's like Putin saying it's the rebel moderate's fault that he fired on them because they were objecting to Assad.
    Patients won't come to harm. A bit of inconvenience, maybe. But patients would come to harm if doctors were forced to work silly hours, and once they came to harm, they would start to go to private companies like say the ones Mr #unt has shares in

  • Physician associate indemnity ‘costs practices upwards of £2,400’

    Hugo Minney's comment 30 Sep 2015 3:14pm

    2:29pm says GPs see too many worried well. Makes you wonder what a GP's job is? It's to listen to all of those people who desperately need someone to listen to them, sort out the real problems from the perceived, and to stop anxiety turning into serious mental illness or serious physical illness. Someone has to do it (and they have to be pretty expert) or our hospitals would become overwhelmed. Don't underestimate the value of listening!

  • Physician associate indemnity ‘costs practices upwards of £2,400’

    Hugo Minney's comment 30 Sep 2015 3:10pm

    We tried all of the medical defence organisations and felt that we were being over-charged, so we've gone to a boutique insurance specialist (actually they mainly insure oil rigs and other unique structures) and they are providing ANP and CPN insurance averaging £800-£1500 per prescriber. Wonder if they can cover Medical? Message me if you want to know more (GP federation, 15 ANPs and 4 CPNs so far and growing)

  • Hunt: Doctors will realise seven-day access is 'the right thing to do'

    Hugo Minney's comment 16 Sep 2015 12:00pm

    Will the Hon *unt be proved right? that depends on the proof.
    How about - almost no fresh graduates choose General Practice as their specialism
    - GPs retiring early or leaving the country
    Current thinking in the business community is "I look after my staff, they look after my customer". Which means *unt is still in 1980s thinking, thinking he can talk about the "customer" without even considering the workforce.
    NHS 7 day opening is already there - plenty of NHS is available at weekends. It doesn't have to be every part. And I'd like 7 day access to my MP (or a neighbouring MP) - actually, better than 25% response rate to constituents' letters would be nice?

  • GPs are the key to the survival of the NHS

    Hugo Minney's comment 31 Jul 2015 6:36pm

    Nigel, you underestimate by a long way. Yes, those are the easily measurable bits. But GPs start much earlier, stopping problems getting worse before they even start to clog up the hospital system, before they can be measured. The maths goes as follows: GPs see around 90% of all patient contacts. Therefore a 5% change in referrals in a GP practice changes hospital planned attendance by 50%. That's huge.
    We can't afford a US-type big business big profit healthcare system. US can't afford it, which is why Obama brought in Obamacare - 16% of GDP was crippling the country. UK Economy needs universal healthcare, to keep adults working, to keep them from worrying about their elderly parents, their own sickness, their children's health. It's simple economics.
    BUT, and it's a big BUT here's the tragedy of the commons:- our NHS, our GP practices don't pay lobbying funds to get decisions made in the public interest. We have the numbers from USA - government costs the taxpayer $2bn, but commercial interests spend $2.6bn on lobbying, no wonder they tend to get laws made in their favour. I wonder what the figures are for UK?
    There are other figures. The richest countries have the biggest tax take - developing countries approx 12% of GDP in tax, developed countries 30-40% of GDP in tax. So by trying to reduce the size of government, by reducing total tax take, this government is trying to make us a backwater developing nation. Simple numbers like that don't lie.

  • Stevens: We must consider alternatives to list-based general practice

    Hugo Minney's comment 10 Jul 2015 0:26am

    We could have a system like they have in Canada and Australia. It serves what proportion of the population? And it costs how much?
    Oh sorry, I thought Simon Stevens' plan was supposed to save money!

  • Government's GP recruitment data found to be 'seriously flawed' as GPC calls for withdrawal

    Hugo Minney's comment 24 Jun 2015 1:39pm

    It also depends on the definition of "Under Doctored". We have around 1300 patients per GP, yet our GPs are working far more hours than full time. That's because the population in areas of high deprivation require up to 3x as many GP consultations/1000 patients as population in affluent areas. We're under-doctored. GP practices in more affluent areas such as Kent may be comfortable with 2500 patients/ GP. Let's understand this better

  • Our rapid mental health service saves lives

    Hugo Minney's comment 01 May 2015 9:59pm

    Dr McKinty has managed to put aside funds for a further 12 months of the project, so it might just survive the change of government. But the funding is "brittle".
    Is this a throwback to Fundholding? perhaps. But perhaps it should be, since in most cases fundholding worked so well.

  • Our rapid mental health service saves lives

    Hugo Minney's comment 01 May 2015 9:59pm

    Dr McKinty has managed to put aside funds for a further 12 months of the project, so it might just survive the change of government. But the funding is "brittle".
    Is this a throwback to Fundholding? perhaps. But perhaps it should be, since in most cases fundholding worked so well.

  • NHS England to publish details of each GP practice's income this year

    Hugo Minney's comment 01 May 2015 4:35pm

    This is an excellent idea! We will be able to see salaries of Directors of NHS CCGs and hospitals, which ones are taking their money through consultancy companies and being "efficient" on tax, and so on.
    Oh, silly me, the proposal is only about GP income.