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Independents' Day

Vinci Ho

Vinci Ho

  • GPs could deliver historic flu campaign from marquees and car parks

    Vinci Ho's comment 16 Jul 2020 12:47pm

    You still need a Standard Operating procedure (SOP) driven by common sense on one hand but also different models being allowed for different practices of different backgrounds to consider on the other hand .

  • PCN workload leading to ‘burnout’ and ‘high turnover’, says NHS body

    Vinci Ho's comment 15 Jul 2020 8:34am

    Speaking as a CD:
    (1) It is hard enough to get your colleagues in your practice to have an agreement on certain matters , how hard is it to expand that to multiple practices of different sizes and backgrounds , with only limited resources ?
    (2) Most CDs are still engaging in clinical care which is already time consuming and becoming more complex . Dealing with the ‘one size fits all’ bureaucracy and technocracy every day in PCN is often like going around circles and finding no answer . The current ‘command and control’ is totally unhelpful for CDs as CCGs inevitably have to surrender and succumb to the reign of NHS England ( and equivalents) . But I insist , GPs , by default , are not subordinates of the government.
    (3) While I could see the merits of some additional roles like clinical pharmacist and social prescriber serving important roles during the last 13 weeks of pandemic drama , the ongoing concern in the financial status in PCNs remains ,albeit 100% reimbursement of these extended workforce . The practicality , legality and complexity of continuing to employ more additional roles (physician associates, pharmacy technician , health and well-being coaches , first contact physiotherapist, care-coordinator, dietitian, podiatrist and occupational therapist ) , is questionable especially PCN is yet to be a legal entity.
    (4) Small and large practices in a PCN have completely different or even polarised views on certain matters . That is a fact as well as common sense . CD is often faced with the choice of either going for a civil war or ‘no solution’ scenario. They are treading the fine line between leadership and dictatorship, quite frankly .
    (5)I stick to the argument that the original motive and intention of the government in setting up PCNs , is to get rid of funding GP practices individually as it was deemed to be too expensive . Once again, one size fits all is the strategy serving for the grand plan to destroy GP partnership once and for all .
    It took me pain to finally sign the PCN DES a few weeks ago . The way I put it to my comrade practice colleagues was , ‘ the gun is on your head , I just tried to push the gun barrel slightly sideways so that the bullet will not hit the brain ‘
    And please do not challenge me why I had not resigned by now......and I know I deserve little pity from at least , some of you .

  • NHS England set to 'redesign' GP appraisals

    Vinci Ho's comment 10 Jul 2020 9:04pm

    (1)Hypocrisy number 1 : Where does the jurisdiction lie as far as appraisals are concerned? GMC? , RCGP?? NHSE??? I am afraid that the ‘outcomes’ are potentially predictable.
    (2) Hypocrisy number 2 :‘’It comes as NHS England has now launched its review into GP bureaucracy, which was promised as part of this year’s contract negotiations.‘’
    That reminds me of RCGP’s own investigated into the disputes concerning CSA . How independent could that be ?
    (3) Hypocrisy number 3:Looking at what NICE wanted to introduce into QOF for obesity and cancer care , it is dubious that the definition of bureaucracy is very different from what we understand .

    Nikki , I hope you know exactly what your ‘true colour’ is .....

  • Winter warning as '35,000' respiratory diagnoses 'delayed due to pandemic'

    Vinci Ho's comment 09 Jul 2020 11:07am

    (1)You see ,every specialist department are ‘screaming’ with similar warnings , A/E , cancer services etc and now respiratory medicine. What about cardiology , dermatology, rheumatology and more ?
    (2)Primarily , I would argue that this is predominantly a NHSE and secondary care issue . GPs had not closed their services last 3 months as opposed to the perception
    out there.We worked on Bank Holidays . But we were not given the ‘tools’ to operate namely , PPE , intact or contingent referral system to secondary care dogged by rejections , imaging requests being rebuked , restricted phlebotomy services etc .
    (3)The reality of dealing with the consequences of Covid 19 and the lockdown , has only just hit the ground . It is no good to say this is still a period of ‘command and control’ and we could recover but with no additional contingency in order to clear up these backlogs and hence , new referrals .
    Clearly , additional capacity and resources must be there especially considering the fact that every consultation( even phone consultation) requires longer time to cover more complexities due to delayed presentation of symptoms, for instance . And face-to-face is heavily time-constrained for PPE/cleansing issues . As I always say , time is one of the vital resources in medicine.
    (4)These figures created by ‘experts’ ( again !) in their closed-door computer room are telling as a reference , but without tangible , targeted coercion onto the stakeholders in the hierarchy to change their policies .
    Ultimately, we are ‘blaming’ each other at the frontline, widening the gap and dispute between primary and secondary care .
    (5) The government must be held accountable and act differently , urgently now .

  • This crisis offers the chance for a radical change of mindset

    Vinci Ho's comment 08 Jul 2020 9:01pm

    ‘’NHS England has said bureaucracy that was a ‘poor use of time’ should not be reinstated. Let’s hope its definition of ‘poor’ is similar to GPs’.’’

    Unfortunately, that is the bottom line held by NHSE that we could not breach . Perhaps , the political narrative had been shifted slightly as we demonstrated flexibility , agility , innovation and pragmatism in crisis management last 13 weeks . Our bottom line , though , was we did not trust NHSE at all . And it was the ‘perfect’ occasion for us to improvise with freedom while the regulatory bodies had to shut up inevitably.
    But you know , I know , sooner or later ( as both Ministries of Love have just resumed businesses) , the obsession and trepidation of ‘something would go wrong’ in a public service , namely NHS GP services , will be conjured up in the air once more .
    May be , just may be , our presumably influential ‘bigwig’ colleagues have just waken up to the reality of the true nature of our enemies in the system . Bureaucracy and technocracy are the two words they must relearn in their dictionaries.
    Early signs from the latest NICE recommendations on new obesity and cancer QOFs ( supported by some ‘top’ colleagues) are not promising at all .
    As I always say , the old die hard habits are hard to rid ........

  • GPs to do further follow-ups with cancer patients, under new QOF proposals

    Vinci Ho's comment 07 Jul 2020 6:09pm

    I think it is fair to differentiate meaningful QOFs from junk QOFs. (Some might argue they were all junk!’

  • New NICE indicators are interesting because they are likely to make it into QOF

    Vinci Ho's comment 07 Jul 2020 5:57pm

    While I can agree the part of immunisation is logical , obesity and cancer potential QOFs from these NICE recommendations are just ‘one size fits all ‘ once again .Politically correct but never touching the core problems.
    I would argue that unless you have an oncologist doing joint consultation with a GP in the community, these indicators are just another level of box-ticking bureaucracy. And remind me what had the college just said about bureaucracy in general practice , learning from Covid 19 ? Hypocrisy once again , old habit hard to rid .

  • GPs to do further follow-ups with cancer patients, under new QOF proposals

    Vinci Ho's comment 07 Jul 2020 5:56pm

    While I can agree the part of immunisation is logical , obesity and cancer potential QOFs from these NICE recommendations are just ‘one size fits all ‘ once again .Politically correct but never touching the core problems.
    I would argue that unless you have an oncologist doing joint consultation with a GP in the community, these indicators are just another level of box-ticking bureaucracy. And remind me what had the college just said about bureaucracy in general practice , learning from Covid 19 ? Hypocrisy once again , old habit hard to rid .

  • How GPs have used the independent model to adapt in the pandemic

    Vinci Ho's comment 07 Jul 2020 3:55pm

    Correction
    Things are NOT what they seem.....

  • How GPs have used the independent model to adapt in the pandemic

    Vinci Ho's comment 07 Jul 2020 3:54pm

    Things are what they seem, comrades .....
    And don’t wish for something one realistically can not afford . We are only in ‘transition period’ . Remember this terminology from Brexit ?

  • How GPs have used the independent model to adapt in the pandemic

    Vinci Ho's comment 07 Jul 2020 12:50pm

    I will take the view of pros and cons , advantages and disadvantages in any choice one would commit.
    But without examining the circumstances( political , medical , economic and social ) , we can fall into our own trap of ‘one size fits all ‘ .
    Undoubtedly, the pendulum was swung too far to one extreme BEFORE Covid 19 and for some(our ‘leaders’) who were engaging the government with wishful thinking had only just waken up , recognising the deception , untrustworthiness and incompetence of this hierarchy .
    Not a bad thing , but this has come with a hefty cost .
    What is the future ? I am still conscious of ‘old habit is hard to rid’.
    But what do I know ? I am only the sad ba****d who is constantly moaning 😈

  • GPs should refer a quarter of all patients for weight management, suggests NICE

    Vinci Ho's comment 06 Jul 2020 10:44pm

    And I am afraid I had to say the college and NICE are in the same ‘pact’ , especially when the former singled out Covid 19 as a lifestyle disease and hence , GPs are ‘well placed’ to change these bad lifestyles while the government could either do f**k all or even the opposite to breed more obesity .
    Boris , you should know by now why you were ‘at higher risk’ and nearly died of Covid 19 !

  • There isn't a one size fits all approach to weight management

    Vinci Ho's comment 06 Jul 2020 10:14pm

    And I am afraid I had to say the college and NICE are in the same ‘pact’ , especially when the former singled out Covid 19 as a lifestyle disease and hence , GPs are ‘well placed’ to change these bad lifestyles while the government could either do f**k all or even the opposite to breed more obesity .
    Boris , you should know by now why you were ‘at higher risk’ and nearly died of Covid 19 !

  • There isn't a one size fits all approach to weight management

    Vinci Ho's comment 06 Jul 2020 9:59pm

    Weight management services are Cinderella services . NICE needs to get real and practical. What was the track record of percentage of obese patients realistically and religiously referred to bariatric surgery as according to previous NICE guidances ?
    The fact that these ‘experts’ could not find a way out of this well known national crisis of obesity , does not warrant passing the buck to GP under , once again , an ‘one size fits all’ tick-box exercise for the sake of presenting a ‘solution’ to the public .
    We saw how badly this old model failed during last 13 weeks of Covid 19 nightmare . But I always said ‘old habit is hard to rid .’
    Superficial and simply out of touch.....

  • GPs should refer a quarter of all patients for weight management, suggests NICE

    Vinci Ho's comment 06 Jul 2020 9:52pm

    Weight management services are Cinderella services . NICE needs to get real and practical. What was the track record of percentage of obese patients realistically and religiously referred to bariatric surgery as according to previous NICE guidances ?
    The fact that these ‘experts’ could not find a way out of this well known national crisis of obesity , does not warrant passing the buck to GP under , once again , an ‘one size fits all’ tick-box exercise for the sake of presenting a ‘solution’ to the public .
    We saw how badly this old model failed during last 13 weeks of Covid 19 nightmare . But I always said ‘old habit is hard to rid .’
    Superficial and simply out of touch.....

  • NICE publishes draft proposals for new £40m vaccinations QOF domain

    Vinci Ho's comment 06 Jul 2020 9:27pm

    Interesting
    Childhood immunisation is of the few matters where ‘one size fits (almost ) all ‘ except those who are still strongly campaigning against MMR

  • The coronavirus diaries: A GP's perspective

    Vinci Ho's comment 02 Jul 2020 10:21pm

    Thanks for sharing your stories
    Fascinating
    Perhaps Covid 19 is a nature call to make us , survivors, even more mature in a very short space of time .
    Introspection , rumination and awakening .....
    One ( and his/her) can only get stronger .

  • Two areas set to pilot call-before-you-walk A&E model

    Vinci Ho's comment 02 Jul 2020 8:15pm

    Well, this is well cooked politically . The fact is , we had an A/E consultant asking the question during daily update session about when GPs would return to ‘normal‘ seeing patients face to face . NHSE was absorbing the pressure and prepared this ‘solution’ . Patients will be shuffled around .

  • GPs in Covid-19 lockdown area told to stop routine services

    Vinci Ho's comment 02 Jul 2020 10:41am

    (1) ‘Stories’ in Leicester(and the areas with higher incidence in Covid 19)will provide important references to rest of the country . Cannot trust the government to have the totality of the big picture locally . Colleagues in Leicester are welcome to share your stories on this platform
    (2) 135 per 100,000 in incidence is really bad( 50-100 per 100,000 usually in a bad flu endemic )
    (3) PPE supply , arrangement(s) to deal with red(hot) patients and efficiency of testing etc are vital . Jaimie , Pulse can report with updated and accurate information.
    I am concerned of a second spike in Liverpool because of the inexcusable behaviour of some LFC fans , against the backdrop of celebration ,winning the premier league title .

  • RCGP criticised for 'all-white' board in open GP letter

    Vinci Ho's comment 02 Jul 2020 8:08am

    And for the college , I am afraid that it has fallen into the same category of GMC as far as unconscious bias is concerned . In many other aspects , it also lost credibility in representing your members ( not me) with ambiguous telos. Otherwise , as an ‘examination authority’ to pass or fail and certify GP qualification to work , it is yet to re-establish reputation since the dispute over CSA ( involving a judicial review) a few years ago .
    Furthermore , I would , again, like to quote Michael J Sandel for his definition of justice :
    ‘'Arguments about justice and rights are often arguments about the purpose, or telos, of a social institution, which in turn reflect competing notions of the virtues the institution should reward and honour .''