Have been testing BOTH Rheumatoid Factor and Anti-CCP last 7-8 years for suspected symmetrical synovitis , polyarthropathy etc . Thanks to the availability of our local laboratory. But not every region provides the test , I presume?
Rheumatology is like dermatology in terms of OPD waiting time. The commencement of disease modifying drugs is so restricted that a waiting of 3-6 months to see rheumatologists is a social norm in NHS. This recommendation to start treatment in ASAP in clear cut proven cases , is easy said than done.....
Ha ha ha
They will have to do CRP on video or on-line consultantions in Babylon . Well done . Let’s go along with that.
Just ‘love’ this story
Our new Secretary of State , Robocop, is a patient of GP at Hand
Ha ha ha
‘Alex J. Murphy/Robocop: Dead or alive, you're coming with me!‘’
Leave it to you whether you want to censor this name
Ha ha ha
A new name come on my head
(1)Not every choice we make are blessed with moral clarity .....
We are the no-man of the no-man's land
（2）Power is a lot like real estate
It is about location , location, location
The closer you are to the source, the higher your property value
House of Cards
(3)There are no morals in politics; there is only expedience. A scoundrel may be of use to us just because he is a scoundrel.
Based on these assumptions, job very well done ,Agent Hunt. IMF is looking forward to a prime minister Hunt in a not too long future .
This message will self destruct in five seconds
After all whether the ‘outcomes’ of a health system are good or bad depends on more than one factor ( of course , the way to measure and interpret these outcomes can be arbitrary or even intentional) . That is common sense.
Attributing ‘outcomes’ to ONE THING is a political strategy to win for your argument.(I sometimes use that as well especially against my wife and mother-in-law , ha ha ha).
.....concern the issues worried by the master.
(1) First of all , there is a Chinese saying , ‘swallow the reward from your master , concern the issues worried by the mater .’ （食君之祿，擔君之夏）. Whoever Mr Record or Miss Andrews is negligible . They will try to be as ‘hawkish’ as possible to defend the ones they work . Same applies to Babylon or GP at Hand spokesmen, especially under a chaotic political climate like now. Morality is not necessary as far as their job descriptions are concerned, let’s be honest . No law has been broken here , happy days .
(2) Private medical insurance is always allowed to exist , in contrast to Canada , for instance, where private practice is largely forbidden. The technicality only lies on the proportion of the split of proportion with respect to public money funded practices: 90/10% , 80/20%, 60/40% , 50/50% and so on . What comes around , what goes around. One way or the other , the money to pay for a health service comes from people , no two ways about this . Yes , the proper debate should lie on how to recruit resources (money in this case) . The debate should be honest and transparent. If the money is not collected directly from people (e.g. taxation) , a third party is involved and administration cost is always an issue if means testing is involved . Any argument deviating substantially from this is populism .
(3) As an elected MP and now Secretary of State in a system of ‘liberal democracy’ , the politician of concern has a duty of maintain a balance among three types of politics :responsible politics , ethical politics and realistic politics . The financial payments from any potentially influential organisation need to be treated extremely carefully and transparently , avoidable if possible ,in my opinion . Once again , it is political sensitivity as well as wisdom .
Presumed innocent until proven guilty , BUT a Secretary of State must know what he/she is representing and media like us will ALWAYS oversee the behaviour of a government and its health secretary.
(1)Not know much about this Hancock guy ; only 39 years old.
Found this on Wikipedia:
Hancock is the first MP to launch his own smartphone app in 2018. The head of privacy rights group Big Brother Watch called the app a "fascinating comedy of errors", after the app was found to collect its users' photographs, friend details, check-ins, and contact information.
Effectively, Simon Stevens is more like the health secretary in England anyway.
2）I wonder if the role of the Foreign Secretary in Brexit is going to be a bit ‘different’ in coming months.
One thing I wrote about Hunt was his Chinese wife who would love her husband standing next to President Xi one day. Hunt is a ‘converted’ Leaver , as he declared last year
3)Pound slides after Boris Johnson quits
The fear of a leadership challenge flattens the pound . If that is sustained , inflation can go up a bit more and give Bank of England and Mark Carney an ‘reason’ to raise interest rate .
:‘We are acutely aware that GPs and their teams are struggling to recruit across the UK,.........’
What does the word ‘acutely’ mean , forgive my poor English? How long has this crisis gone on now ?
Once again , Helen , disappointed of your poor political sensitivity, as of your predecessor......
...... more than we need it.
(1) If the government wants quality and standard maintained, there has to be no buts on the argument that more investment of resources must be here in general practice; the Expertise (of spirometry in this case)to be developed and maintained by these trainings NHSE is talking about , protected Time for GP practices to do spirometry in line with the requirements, Manpower and of course , Funding .
(2) Otherwise , the reality right now is we refer to secondary care for spirometry to assist the diagnosis of COPD , at least , in my local areas . The ongoing measurement of FEV1 will have to be referred to secondary care as well if the rules become totally inflexible. The ball is in the courtyard of the government and NHSE . General practice cannot take any more burden with this current level of resources. Full stop.
(3) Fine , they can consider providing resources through networks of practices , super/mega practices , federation, whatever . (We already know from NAO report last week even Simon Stevens’ baby vanguard sites , either MCP or PACS could not deliver what they set out to do for efficiency savings because most resources allocated to them ended up in filling the deficit holes in secondary care). It is no rocket science, if you want primary care to save your arse , cough up the resources . After all , it is increasingly evident that this weak government needs us (GPs) more than it needs us.
The message appears to be :
Apixiban or Dabigatran for AF
Rivaroxaban for DVT/PE
as long as renal function allows
From today until the Chancellor’s next budget statement, it is crucial to develop the narrative(s) about what we think must happen for NHS and general practice to stay . There will be some spinning from this weakened government and it is up to us how to anti-spin. NHS has been politicised far beyond necessarily. The future of the country will also needed be to determined in the next three to four months as far as Brexit is concerned. Whichever way it goes , we must not let politicians bundle NHS with agendas eroding the virtues and values we believe(well, one always has a choice not to believe anymore ).
My argument stays such that if even a primarily anti-taxation political party has to succumb to the political reality of raising more tax to sustain a socialist health system , NHS will stay for a long time.
It is a judgement call at this 70th birthday of whether we want our NHS with its gatekeeper to not just survive but shine again . We are at crossroad as a nation , not just for our health service but for our values , virtures and hence , a country for others to look up to in this most extraordinary time in history where protectionism, self interest and greed are dominating the world .
One can argue that it is something called ‘circle of life’ ; something has to die before another is born. But there are certain legacies that should never wither ......
‘’Is morality a matter of counting lives and weighting costs and benefits , or are certain moral and human rights are so fundamental that they rise above such calculations?’’
Michael J Sandel Justice
The difference is....
It might be only a fine line between people power and populism . The different is we are the people in the frontline reflecting the truth and reality .
NHS can only be saved by people , never populists......
’A reduction to the payment to practices for out-of-area patients. Currently, practices receive the same payment for both in-area and out-of-area patients, even though GPs do not have to deliver home visits or out-of-hours care to out-of-area patients.‘
This is the point I raised before about letting provider like GP at hand ‘peanut picking ‘ instead of cherry picking . It is interesting to know exactly what ‘A reduction to payment ‘ will actually translate.