This epitomises the classical dispute between academics sitting in their computer rooms looking at statistics and grass-root GPs bleeding at frontline fighting to clear the block of patients ten minutes each everyday . You can assess the CVD risk of a patient so meticulously that 20-30 minutes would have gone on the clock . Pressing a button and going for a threshold of 10% takes two seconds . But aren’t we falling into the same trap of prescribing antidepressants too liberally because we ran out of time .
Yes , without a calculation tool like QRISK( whatever version) , relevant cases could be lost . Primary prevention of CVD with statin remains a contentious issue , whether protagonists like it or not. More innovative ideology is welcome.
I deliberately wait to read your comments before writing anything. The problem is indeed pervasive and omnipresent in NHS and this case represents only a tip of the iceberg . I certainly have a collection of cases where my referrals were rejected because either information was so called not enough but more frequently, an ‘inappropriate’ referral . Ultimately, the child and family are shuffled to different service providers and there is a lack of coordination and organisation, in my opinion . Time was consumed unnecessarily which appeared to be paramount in this case . It is an issue of rationing but also a matter of safety of these children and their family . I am sure we are not the only country under whatever health system , which has to face this potentially dangerous health issue . The world is unsafe , at present time , and is certainly not a happy one . We have to protect my children and youngsters. This government, once again as I wrote before , have a big decision to make .....
PS please send in more comments. We have not had an article with more than 100 comments for a while.
Obviously, there are many pre-existing factors contributing to the closure of a GP practice , as ice deep frozen three feet down is never due to one day cold . But the reality is that practices are currently demanded to spend so much effort and time (which itself is a resource) involving in PCNs , overseen by CCGs . Yes , there might be ‘resources’ there for PCNs to utilise but it also begs the question of whether the ‘leaders’ in PCNs and CCGs actually know how to use these resources to effectively benefit the frontline grass-root GPs which still include many small-sized practices. The ideology of investing through GP networks is always contentious as a ‘step forward’ from the traditional model of funding individual practices directly.
The government is very clever in turning some of us into ‘cardigans’ to govern the rest of us ( Sorry to sound like the frontline protesters in Hong Kong right now ). ............
This is from Wikipedia:
Call for mandatory by-elections for MPs switching parties
In March 2019, it emerged that Wollaston had supported a 2011 bill that required MPs who switch parties to face an automatic by-election. Wollaston herself switched parties on 20 February 2019, but did not call a by-election. Chair of the Labour Party in Totnes and South Devon, Lynn Alderson, said Dr Wollaston "made her views clear". Wollaston acknowledged the likely calls for her to face a by-election but refused such a proposal, stating "neither this nor a general election would answer the fundamental question that is dividing us".
As far as political ethics is concerned, there is indeed an argument whether you should resign from parliament if you switch your membership of a political party . When I advocated her to resign from Conservative Party a few years ago on this platform, it was to be followed immediately by renouncing her MP position and triggering a by-election . The chance for her to be re-elected as an independent MP , in fact , was substantial. But it was then , this is now .
Mr Hancock said: ‘Personalised, preventative healthcare is a mission critical to the future-fit healthcare service we want to build. We must harness the latest technology and techniques to move away from the one-size-fits-all approach of the past.......’
I am so ecstatic that a health secretary actually knows the meaning of ‘one-size-fits-all’ (OSFA, well, you can interpret that FA(all) differently😆😂🤪). Well done , Robocop!
Then again , there is a punch line , though , called ‘technology’
Welcome Babylonians and AI, 😆
We are where we are , austerity carries on
From day one , we probably foresaw this ideology of CCG would end up like this i.e. subordinates and puppets of the NHSE and its hierarchy. Thanks to our most ‘beloved’ PM ever and the current Facebook’s head of its global affairs and communications team(well , at least the latter said ,’live by the sword , die by the sword’).
How many of you have to ‘twist the truth’ everyday to justify the severity to deem a referral necessary everyday ? I always advise my patients to consider a private referral as an alternative if affordable these days .
As I wrote before , the government has to make a serous decision about how this is to go forward . Boris , you can fool some people sometimes, but you cannot fool all the people all the time.
I think the original version (if there was one) NHS111 was totally ‘following the algorithm and please go to A/E for covering my arse.’ . After all these morning and arrows we fired towards NHSE , the reality is probably somewhere in between the extremes .
Problem is this is outdated directive , decree from a past , ‘well beloved’ prime minister and his bloody government. The logical solution is always provided by adequately funded GP led services (whether is in or out of hours) with direct contact with a clinician .
Of course , it is f**king dearer , common sense , Boris .
Apology of the typing error of the first two words
and backlashes The truth can only become more apparent , the more the matter being subjected to debates
After so long , if stakeholders still insist on this kind of the cheapest model of triaging( considering even the older model of NHS Direct was contentious) as the legacy of austerity from this Tory government, they can only expect more criticism and backlashes from all directions.
Report from :BBC news /health
Quite specially mentioned the issue of protecting patient data . The fiasco of Facebook-Cambridge Analytica-Vote Leave is always to be reminded . The Babylonians can say so much about how secure their system is . My scepticism stays.
And this is in contrast to Familial Adenomatous Polyposis (FAP) which is autosomal dominant . One subset of this is called Familial Colorectal Polyposis , Gardner Syndrome.
Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), is a type of inherited cancer syndrome associated with a genetic predisposition to different cancer types. This means people with Lynch syndrome have a higher risk of certain types of cancer.
Ok , benefit of the doubt.
Let’s see what are you made of , Boris?
The funny , ironic thing is no matter how much one debates on left versus right wing ideologies on issues of tax , the actual phenomenon is many of us(GPs) are leaving because of this pension fiasco and the whole thing is under a presumably ‘to the right’ Conservative party . LOL 😂
And you still have to reduce your practice income earned if you are a partner.
When you look at this 50:50 again :
‘’Tapering of this annual allowance began on 6 April 2016 and reduces the standard £40,000 annual allowance for pension contributions by £1 for every £2 earned over £150,000, down to a minimum of £10,000 allowance (at £210,000 income).’’
Because this is one size fits all (again !) , this is not just punitive but like wiping out a ‘tribe’ . As long as your total income that year goes beyond a certain threshold , you are f***ed UNLESS you play the loophole of forming a private company to exploit the advantage of corporation tax rate at around 18-19% but there is certainly ‘restrictions’ to set up a limited company.
History cannot be re-written . The truth is Mr Massey would not behave like what he is behaving right now , trying to be the ‘good guy’ again ‘bridging’ the differences between the profession and GMC . The problem is one word : Trust .
One cannot sustain on his feet if trust is already lost .(民無信不立） Analects.
Mr Massey , with decency and conscience, should you consider stepping down now ?😑
The ideology of PCN is always at risk of becoming a slippery slope fallacy with the same kind of traditional mentality in NHSE . Two-tier system , biases, one size fits all ; how many times have we been criticising NHSE and its hierarchy on flawed principles. Bottom line is : loss of touch with the frontline and implementation of some politically correct directives in short space of time .
Some people might be allurred and enticed by your charm , Boris . Sorry , we are not ......
I kind of expected this from MojoBojo . He is so predictable and ‘charming’ , isn’t he? In parallel universe , he is actually Winston Churchill 2.0. But this is our reality here instead .
He needs the approvals from as many sectors for leaving with no deal on 31.10.2019 as possible.
Whether this money is new or old , I don’t think his new cabinet cares too much about that , as long as optimism about 31:10.2019 remains .