These figures , 5000, 6000 whatever , has become new political terminology for these guys to play with .
I leave you with your crystal clear mentality to make a judgement.
God bless general practice......
....reasonable and logical ....
One has to be sensible in looking at the meaning of this guidance. It is all about what to do AFTER the diagnosis of CAP is made . And I think that is then quite reasonable abs logical.
The problem still lies BEFORE the diagnosis was reached in primary care which could be very tricky in general practice( like many other serious , life-threatening conditions in their early clinical stage) . CURB is not completely CURB because GPs cannot get urea( and also white cell count and serum CRP) right away , for instance. That is the part of any guidance( written by academics) which seems to be disappointing in appreciating how difficult our job is in the frontline .
On BBC Health news as well
Obviously we have not had all the details of this tragedy. But reality is this kind of following the protocols, triaging , category of urgency and eventually conclusion by algorithms, is an overcompensation for a system being neglected too long by successive government(s) . The end result is painted by loss of lives . One can say we are crybabies, scaremongers etc but the reality has become too apparent to be denied by this bunch of politicians . I always believe that we , doctors, always have a duty to oversee these despicable politicians and bureaucrats from harming our patients but the truth is we have only limited power to prevent disasters from happening.....,.......
Aren’t you guys bored of this kind of Brexit-like polarised debates , especially on primary prevention with statin ? As I wrote before , I am more fascinated by this nocebo effect and the less one told the patient about statin side effects , the less likely they would have them . Let the pharmacists do the ‘shit job’ of hard selling high dose statins to them . The government is pushing it anyway .
Ultimately, again , it is not about deserve , it is about what one believes.
In 2013/2014, the median number of pregabalin prescriptions was 66 per 1,000 population. In 2017/2018, it was 119 per 1000 population.
The number was almost doubled in only four years . Is there a trend going further up ?
If the fundamental argument is that GPs are not well equipped to manage these patients on these drugs , am I right to infer that the currently available specialist services where GPs are supposed to seek help , are failing us, GPs , then ?
Would like to similar study on Tramadol prescribing.
One interesting point I want to raise here is ever since the passing of the Health and Social Care Bill , there was a surge in number of APMS practice contracts won by private companies. In fact , there was no new GMS contract approved , if I am right ??
Now , we also know how obsessed the current health secretary is for IT-smartphone-AI driven general practice . I am not insinuating anything (in case somebody sues me for defamation , ha ha ha ).
But folks , think deeper.......
Nine lids to cover ten cups , to start with .
What is common sense of making this even worse by merging all into one ?
Do the arithmetic: 9x6= 54 lids to cover 60 cups then , ha ha ha
Thanks , Jaimie
Ok . It is probably logical to say every tree has some bad apples as far as the outsiders are concerned. But , always a but , how would one verify the evidence and classify the ‘severity’ of the problem realistically , are the bottom line questions here .
I dare you NHSE to ‘promote’ these figures to the media (especially you know who and which) and let them spin and see what happens??
The crisis of retention and recruitment started from the top of the hierarchy and I stand by my argument, the government and the country need GPs more than GPs need them .
So please go ahead , spin with these figures 😑
Read this if you want
Ha ha ha
This government, quintessentially , is fraught with utilitarianism . Keep topping up the number of GPs will solve this crisis ?
My gentle reminder to you , Robocop and MojoBojo (and all the subordinates) : discern the fact of the matter before applying the principles and virtues . Why are you haemorrhaging GPs way faster than you could employ ? Stop putting the cart in front of the horse , you stupid f***🥴
This history of Brexit will become a must-read teaching material in future university courses of history and politics . So toxic with so many ‘casualties’ , ha ha ha.
Cannot resist the temptation to buy Lord Vader’s new book , For the Record , when it is published next week . It is obviously about pointing fingers in a game of ‘blaming each other’ . While I never forgive the passing of Health and Social Care Bill contributing to our(GP) current crisis , the only credit I would give him for this book is donating some of the book’s profits to a charity on behalf of his son who died of epilepsy and cerebral palsy .
And for those die-hard fans of the two ‘big’ parties, politics was simply a medium which had exposed unreservedly the weakness and dark side of human beings in your ‘beloved’ party .
There are some ideological dilemma and hence , arguments here :
(1) Are patients actually customers in 21st century technology driven world ?
(2) The ‘fascinating’ story about statin , especially in primary prevention, is the way side effects can happen . Remember the evidence that there is actually a nocebo effect ?
June 27, 2017
Nocebo Effect May Account for Statin Adverse Events
Anita Slomski, MA
JAMA. 2017;317(24):2476. doi:10.1001/jama.2017.7582
(3) Hence , the patient was more likely to develop side effects if more information about adverse effects was given to them ??
Then one found oneself in a ‘damned you do ; damned you don’t’ situation. As you guys alluded , the pharmacists would be tempted to run a different philosophy by simply treating a customer to ensure the pack of high dose statin would appear in the checkout basket . Full stop , ‘happy days’ for everyone(less likely to have side effects ??). GPs , please shut up , say less is better , ha ha ha .
This feels like the chief executive officer of Hong Kong government finally withdrew , in totality, the infamous extradition law causing the mayhem in last 3 months .
Problem is : too little , too late , Robocop .
As I wrote before , we had been sleepwalking into this scorched earth politics which is nobody wanted to see . The inevitable damages to NHS could not be undone in short space of time .
Age 16-18 with mental illnesses is the group of ‘lost child’ as far as our local CAMHs is concerned.
Suspected ASD and teenager-to-adult ADHD in this group is virtually no man’s land. Something is not right in the ‘system’
Thank you for the insight on OST to clarify my usual ignorant rantings . 😄😇
(1) The reality of these patients who are heavily dependent on opiates(Co-codamol, Dihydrocodeine , Tramadol ( I called it CDT and etc ) and lately , gabapentinoids, are no different from those on methadone blue prescriptions . Even reducing the latter from 50 mls to 45 mls a day was confronted by strong objection from patients , for instance. And GPs have 10 minutes to complete this debate with a patient! Seriously?
(2) The recommendations from PHE are sound but was quintessentially written in a bookworm fashion , ideological and intangible. Somebody needs to get real and mobilise resources to help the frontline.
(3) Pain clinics need to take more responsibilities in monitoring the patient being initiated and maintained on all kinds of complex pain medications, rather than throwing them back to GPs to ‘continue’ .