I agree 100%. Sad and frustrating state of affairs.
I suspect that giving almost everyone an unexpected break in their NHS workload for nearly 4 months (yes, us too) is not something anyone wants to rush back from. I reckon 50/50 split exists between clinicians on "won't" versus "genuinely can't" help.
An Xray receptionist told me 2w ago that although their scanner hadn't been used all week, "London" says no non urgent footfall until 1st July and no exceptions. Not negotiable apparently. If you are cynical (Moi?) this was another few weeks of reduced expenditure. Obviously the NHS would be able to recognise a second wave and this should be up to 2 weeks in arriving....plenty of time to do some "boring, normal work" in between.
.@.Honest from Yorkshire. Right on the money. Financial depression, biggest acute pressure on NHS since 1948, 10 million on waiting list by Xmas, (yes, we'll be patching up / ReSPECT forming these for poor old secondary care) trying to reboot structured chronic care at the surgery without any guidance or senior leadership from the profession. Sure, the DHSC is really interested in "carbon neutral General Practice" I agree that the death of General Practice would achieve this but then the methane from a rotting corpse is much worse for climate change anyway. Hmmm!
Well done. Learning to say “no “ is the first step in regaining some self respect for GPs. The illustrious CCG mandarins can always ask clinicians from that vast untapped pool of alternatives... we know there isn’t a plan B. Welcome to the downside of marketisation. Ha Ha Ha!
Merlin is right. The lockdown was to build up resources and then we will have some more, staged infections, hopefully with hand-wringing and long-faces but just what the FTSE100 needs.
When this is over, and we have all done our best, I hope the BMA will capitalise on our improved access to power. Don’t miss the chance. We could push through some good changes to the NHS
for the future.
Sorry to see column inches being used again by Drs who avoid patients more than the rest of us.
Ha, Ha Ha, Ha. Wouldn't make it as a screenplay.
"Jo Churchill said: 'I’m currently having those discussions to make sure that we can lift - within the bounds of making sure that patients stay safe - all appropriate bureaucracy"
So we need bueaucracy to stop us killing our patients, huh? Does "Vocation" mean anything?
"despite native" = as in "not travelled recently", in case the woke neoLibs choose to be offended.
So, it seems we are rationing the tests for now, because "you don't meet the criteria and it's just some othe rvirus" (desopite native to native transmisison now. Then, at an appointed time, according to the FTSE100 or price for Brent Crude: we will flip overnight to say "of course you have coronavirus, it's everywhere now,there's no point even testing you unless you are in resus".
What a load of b*llocks!
One of the few benefits of working for a heavily politicised NHS is that the politicians by definition are responsible. If we had say a 10 year charter and regular reporting but light touch interference from politicians this could all go away. At the moment it goes like this:
1. 6 sessions + associated admin IS full time. That's just maths. Suck it up.
2. NHS and the DoH refused to plan ahead. Just ask George Magnus.
3. Poor old, bleeding heart secondary care eats all the pies.
4. Filling surgeries with helpful but less able para-clinicians doesn't make it much easier after all.
5. PCNs like all the other DoH wetdreams is not looking at the core issue: sustainable demand, morale, helping GPs to feel valued and listening to our suggestions for simple,and relatively cheap service improvement.
Sdaly I agree with the contributors above. It's too late now. The 50-somethings who are at the top of their game are being forced out and that is a BIG mistake as it is gutting Primary care of its most efficient core.
Good luck Simon.
In my last partnership we consistently watched about 64% of our annual proft/income/drawings failing to arrive into our personal bank accounts. We have all left now. Working at KFC would be a betetr hourly rate: what a dreaful result after studying and slaving for so long in our teens, twenties, thirties, and even forties...! It is high time to just make it all stop. NOW. At aged 55y and working as a self employed sessional GP, my accountant says no point in ever taking another regular NHS post as the take home is so much less and my pension is maxed out (even if not as much as I had budgeted for...!) Ptahetic. If DoH wants the NHS to fail, just have the courage to admit it. Stop driving us out and doing the fake wringing of hands.
I know I have mentioned this before but if we all went to a chambers model, we could still see patients, secure our revalidation and work for the NHS and not within it, and leave the Rationing, Resources, and GMS Contracting to someone else. Never has been our job to be Health Economists: it has been a confict of interest all along and probably not consistent with GMS guidance about mixing personal finaces and clinical impartiality. For goodness sake why are we still working like this? Baa!
.. give notice on your lease and then threaten to close. That will get their attention. Bright future as a non-partner beckons. I did in my English practice. Marvellous uplift in pay and sanity. You might even end up in the same practice earning the same as a sessional.
… interesting situation. From Fundholding and LES heydays, I can recall hungrily signing up to things and then finding they cost 10-20% more to deliver than they brought in! The FHSA / PCT/ CCG always countered this by saying that if we joined in we would become the "A-listers" who would be first in line for discretionary stuff like IT upgrades, pilot funding (...which also never happened). You won't find anyone in the corporate world prepared to take on costs for no profit...apart from the idiots like Northern Rail, Crapita, Carillion (oh... they were government contracts too..) There is a pattern here!
So if a Gp accepts a Golden Handshake, expect shaming at the year end. Dumb*ss idea!
£150k is not a good return on the time invested in study, crap Jnr Dr working conditions, forgone income in 20s, being an absent parent from school plays etc. Recruiting more GPs...just not going to happen with this nasty 5y of looming brex-tatorship.
My brother left school at 16. Works as a skilled welder. We are both in late 50s. His lifetime earnings are still higher than mine. None of my kids became Drs... thank god!
Generally "worst diagnosis ruled out" has become the fsctory setting for a lot of secondary care encounters nowadays. Our consultants are smart and experienced clinicians with excellent communication skills. We see their full prowess when they have the opportunity to see patients properly in a private consultation. The NHS seems to settle for diagnosis avoidance: "medically fit for discharge" for example doesn't seem to be in any textbooks although this is often the only thing a patient can recall about the outcome of their admission. I do not have a CCST for their speciality so I usually send them back to clinic...
Sorry, but just a quick one : as OOH GPs we have our consultations audited regularly (my provider does monthly) and my compliance against PHEcurrent guidance is a part of this.
I hope you can justify your prescribing to this standard.
One million appointments a day not enough for the DoH?
..methinks it is time for them to rethink the model entirely. You just CAN'T HAVE ANY MORE, and that's it. The UK public purse can't afford it, you haven't planned for it and you don't respect what you are already getting. Stop bragging about your NHS at the hustings and to your sniggering international mates, and accept that it should be in the history books and not the newspaper.
... and if you're worried about your pension, you will be fine with a Private Pension regulated by the FSA and funded by twice your current income rather than a discretionary one bugger*d around with by a politician every time they are trying to show off to their neo-lib cronies.