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I guess this is the death knell of traditional general practice in St.Helens then. The CCG wants us all to be the same - so I expect we will all be forced down this route at some point in the near future.
Big mistake - can see the Daily Mail headlines now.
And, if they want patients to buy their paracetamol and cetirizine they need to remove it from the Drug Tariff. I cannot cope with arguing with the patients any longer.
Is it April 1st?
I have spent years at meetings where we 'split into groups' and took turns at discussing our referrals in different specialities. It was a bit 'my name is ... and in the last 3 months I have made ... dermatology referrals' - as if it was a crime/sin. My referral practice did not change as a result and I am sure nobody else's did either. It was a total waste of time.
We now use a referral management system - at least the triagers here are either specialists or GPSIs. I object to fellow GPs who may know less than me deciding what happens to my patients. I am perfectly happy to take advice from anyone who knows more than me.
I will walk away from general practice if this is pushed onto GP services. I am sick of becoming the dumping ground for everything 'due to the convenience of the patient'.
I would love not to do home visits but I do feel they are essential for the isolated elderly. I might be the only person such patients regularly see. The endless meetings and dross within general practice could do with cutting to free up time. As could the endless stream of appointments booked solely for the purpose of appealing the stopping of ESA and failure to obtain PIP.
If we stop all home visits, what happens to the dying? What about all the clues you lose by not seeing the patient in the home environment?
Stop the dross certainly. Retain home visits where clinically appropriate - and it drives me mad that patients who 'cannot be brought in' can then suddenly 'manage' to get transport to hospital.
Why just 'GPs' in the headline when specialists criticised also? Primary care refers to secondary and secondary to tertiary - but much to blame lack of tertiary referral on the GP.
Kids frequently have more than 12 reliever inhalers per year - one for Mum, one for school, one for Dad's house, one for each set of grandparents etc.
I did not know we should be doing spirometry in 9 year olds - how we are going to fit this in on top of everything else is beyond me.
Whilst this death is tragic and potentially avoidable (my deepest sympathies to his family) did he receive his three invitations a year for an asthma check? I find it very difficult to get kids in to attend if well. Was Mum bringing him and her concerns being ignored?
We have a limited number of same day appointments but most are pre-bookable 28 days in advance. In addition we see all patients who claim they are 'urgent' on the same day.
I have over 500 patients out of 3800 who are over 75. Appointments have to be based on clinical need and not be ageist.
I have recently taken on (under duress)provision on en ECG service as the CCG ran out of money to pay the hospital. I am also doing more ring pessary changes as the CCG moved the GPSI service to a community hospital 10 miles away and my elderly won't travel. I am already doing prostate cancer injections for no financial reward but because the hospital states it will be more convenient for the patient. I am currently fighting both the rheumatology department and Medicines Management Team who think I am being unreasonable in not accepting the transfer of denosumab injections and all the administration that goes with this as this is the cheaper option (no enhanced service being offered as has been offered elsewhere in the country).
I would love to spend time with my patients actually doing my job and not everyone else's. I would have far more time to see patients if it were not for the endless drivel of meetings that I am forced to attend. How to become a GP provider was the last one. I'm a GP for God's sake - just leave me alone to do the job I trained for.
Can we have a competition as to who can have the longest waiting time then? Prize being a week off at the destination of your choice as you are obviously so snowed under?
have missed you, welcome back, hope you are better. Excellent article - not just me then.
And the NHS could do more to help GP practices stay financially afloat. Sort out the ridiculous way they pay practices where nothing is itemised and practices managers have to constantly contact NHSE to see what various monies are for.
Surely the cost of treating patients from abroad in general practice is peanuts compared with secondary care costs?
There are so many patients now whose phones do not accept blocked numbers that mobile phones sometimes have to be used. I also give my mobile number out to palliative patients for out of hours as end of life approaches.
As a trainee in the Highlands many years ago I attended an ophthalmology lecture - the consultant having the same surname as me. His first slide was an example of a referral letter received from a GP who happened to be my uncle. The letter read 'MacRae, please see this lady who can't. MacRae'
Surely placing a patient on the pathway is only appropriate when said patient is no longer capable of taking oral medication and has clearly entered the last few days of life? I would be very unhappy about writing up the pathway forms until this time on a 'just in case' basis. If the relatives are kept informed at all times and the patient is reviewed regularly, there should not be any problems. I cannot be the only one to have taken patients off the pathway if they unexpectedly pick up.
Does the DH actually understand what 'holding a consultation process' means? We appear to be railroaded into doing everything the DH decides regardless of the opposition. It would be far more effective for the GP to pick the timing of any consultation on lifestyle - such as when the patient is likely to be most receptive to change. I suspect more and more patients will react like the lady who refused a BP check whilst attending for a smear if this goes ahead. Who are these 'medical' advisers to the DH? I suspect not medical in the slightest.