Locums are likely to deliver safe care, but it is likely to cost the NHS more. If locums do not know the patient well, they are more likely to do more tests and make more referrals. Continuity of care is the most cost effective way to deliver health care.
What a good article. I prefer my day to be full of minor illness and chronic disease, so that I can cope with the occasional patient who has the life threatening presentation, that I have to sort from the triva. No one can cope with full on high drama, all of the day. That is the way to burn out.
Capacity is assessed at the time of any procedure and is specific to that time and procedure. So no I will not be doing them on another's behest.
Watch the dominoes fall, all the singlehanders destablised. Then when digruntled patients try and return to their old practices, they will not be there.
Annualisation means I stick to my regular GP sessions and refuse any extra work, no matter how stretched my practice is.
Unintended consequences. Let the Government reap what it has sown.
It is often better to eyeball the patient, telephone triage can miss desperately ill patients while a sight of then gets them blue lighted to safety.
Good and safe medicine cannot be done on the cheap.
The only comfort is that the accrual rates in the 2015 scheme are 1/54 compared to 1/80 so that offsets the reduction if you go at 63. This is if you ignore the lost lump sum.
None of us are honest when we give feedback on our appraisal. We don't want to rock the boat, and we do not want to disparage our appraiser, who is probably a nice enough chap.
I think this might be the last straw for many. Just when you thought it could not get any worse.
" We can't provide continuity - which is the only unique feature of general practice and the tool of our trade. "
To that I would add, that we have less and less places to refer patients who need more than the ten minutes of care that we can give.
When that happens, our job satisfaction breaks down. We know that we are failing that patient, but we have no other choice.
30 patients a day would be luxury for most of us.
Does this not discourage established salaried GPs from taking on any extra adhoc GP work. Surely the Government would want GPs to be flexible and do extra work.
The way this is set out will discourage any salaried GP from taking on any extra sessions. Bizarre !
Money needs to follow the patient with a fee per service. That way if demand increases, so can capacity be created.
The fee needs to be adequate for it to work.
If I complete this survey it may give a skewed idea as I have already been driven out of General Practice by the very workload that Lucy Marchand describes.
I now do one session a week and I feel so much better.
If the notes have to be redacted to make past notes fit for patients to see, aren't we in danger of losing their purpose for medical decision making ?
Also we are losing the historic record in its unadulterated form.
What about the patient with undetected Von Leiden deficiency ? The patient whose BP rises with oestrogen ? The patient who develops focal migraines ?
For the majority this will be fine , but not for all patients.
Food for the week would have been about £25, so the cost is not as high as it first seems.
We will be doing ' The Cambridge Diet ' out of business. They are set up to provide psychological and motivational support.
In the past I have directed patients to them, in fact I have successfully used them myself. It took a good few years for the weight to come back, but I had learnt a lot about the ability of my body to experience hunger and not succumb.
I now successfully maintain weight loss with a low carb diet and exercise. These are approaches I prefer for patients but many are so wedded to their cereal for breakfast and sandwiches, that it does not work. It is a rare few that succeed. I tend to be less evangelical now, as I know it is futile, and I do not have time to waste.
I agree a calorie deficit is needed, but a low carb diet makes it easier to achieve because of the lowered insulin levels and thus lowered appetite.
Christopher Ho ,
Are you seriously advocating an American Style Health System ?
I cannot think of any model that is worse.