So very well done Anoushka. Proud to know you.
The Quality First webpages https://www.bma.org.uk/advice/employment/gp-practices/quality-first are much more than templates for pushing back on unresourced work, but our vision on how GPs and practices can be empowered to take some control of their own workload.
They feature case studies on skill mix, delegation, working with others, new pieces of work like hub working and other things like LMC survey results, a list of enhanced services around the country, information on patient empowerment and so much more. Essentially lots of guidance for GPs to use as they see fit.
Really helpful comments Anita, thank you. Another billing software option is Penny Perfect. I am also aware of colleagues who have successfully designed their own excel sheets, accounting software for this purpose. The above is purely a guide and was written many months ago, please add to it as you see fit.
I found my accountant - Medic Accountants through locumorganiser. It gave me a shortlist of accountants based on my postcode.
I don't quite understand this. We recognise as a nation we need "more" not "less" GP's! We recognise that we are facing the biggest recruitment, retention crisis there has ever been. And yet there is even the suggestion that despite all this pay is likely to go down - if we increase GP numbers?
Even Kazakhstan, Argentina, Malta and Belgium amongst others have more physicians (generalist and specialist medical practitioners) on average per 1000 people than the UK.
The mind boggles!!!
Dr Farah Jameel, Sessional GP, London
Naomi, bravo - what an immensely powerful letter you have written.
My father just ran his 25th marathon this morning, on his 61st birthday. Running his own business and simultaneously fulfilling his duties as husband and father to 4 children, I've seen him somehow find the time for us all. This despite him also rowing and coaching the rowing team too. So it is all possible. I don't quite understand it myself, but it's his way of keeping going, coping with stress.
Hats off to this GP. Truly inspired by his dedication and his fitness levels.
The sign of a failed leader of the profession - to point a finger at his own profession. Instead of using his position of influence to nurture, support, rebuild and piece back together a falling apart, broken system. He condemns it, demoralising the very staff who are operating on their very last shreds of good will.
Forget partners, soon there won't even be locums to help prop the system up. Who wants to work in this negative, toxic environment that's being run down to the ground by thugs in the name of CQC.
This does not apply to Eastern European GP's I don't think, as they don't tend to face visa related hurdles, predominantly hailing from the EU.
This is to recruit Drs from South Asian countries and other such countries where visa restrictions has made it challenging to come over. It will be interesting to see if they choose to employ a MTI like approach, as has been done in the past for other shortage specialities. To provide a temporary workforce that helps plug a hole in the system.
Actually there was a motion in the agenda at conference. It was a motion I submitted, it was prioritised for debate but unfortunately the section timed out.
Motion nos 446;
Motion by EDGWARE & HENDON DIVISION: That this meeting notes the alarming findings of the recent Northern Ireland GP workload study, and calls upon the BMA to urgently carry out a UK wide GP workload analysis that can help inform and define the safe working limits for GPs.
It has to be said, I don't actually work till midnight! That is the caption the editor chose for the article, based on the working lives of many partners.
I do routinely work extended hour clinics till 8 and 9pm at some surgeries though.
I actually worked as a locum from time to time at this practice between August 2013 - January 2014. And have had interactions with both clinicians Dr Watts and Dr Osman and also one of the salaried GP's at the time. All very good clinicians.
I am certain CQC had found good reasons to shut the practice down. But without knowing more details it is hard to speculate or suggest what may have happened.
I am sorry to see a fellow colleague in this way and feel awful for how the profession has left you feeling.
Look after yourself, a big hug and lots of good wishes.
Get well soon.
Qualified in 2013, have only worked as a Locum. Have every intention to take on a partnership and will do so even if the tide hasn't turned and that will be at a time in my life when I am ready to commit to such a working pattern and that's a reflection of where I am in my life right now. Where my personal priorities take precedence and unfortunately the working pattern of a partner at present isn't conducive to me (in this moment in time).
This is a worryingly skewed view of the Locum world and is laced with an undertone of sarcasm. Richard has made an excellent argument, thank you Richard.
Excellent and not so excellent drs is a poor statement to make, based on what? Personal anecdotes!
Would my declining a sick note for the first week of illness and a partner signing it to avoid the hassle of a grumbling patient make us each excellent or not? You have your views and your way of doing things and so do I. We need to learn to live together and in harmony. If you have clinical worries, raise them. If you feel you can evidence your claim, go ahead and do that with facts and figures. Don't label a cohort of GP's based on anecdotes.
I choose to be a Locum because I refuse to find myself in a situation being bossed around by partners in a salaried job. I choose to be a Locum because it allows me a flexible lifestyle, one that keeps me switched on at 100%, it helps me practice safely. I choose to be a Locum because I find that at 32 I have other wants in life than to be sat working 12-14 hours everyday doing endless administerial work that is mind-numbing, poorly remunerated and thankless. This is not the worklife nor career I signed up to and I chose to make a choice, to have control over my working life. I enjoy seeing patients but not all the time, not everyday and not when I don't want to. This way I am in-charge, not the system. Just like you appear to be by choosing to spread your time between A&E and GP.
Why don't you set up a chambers in your region or get in touch with your local sessionals group, you could train your locums to work to your satisfaction. Feedback cases, set up a two way flow of information. I've certainly made suggestions to practices which have been well received and always welcome feedback on my practice, learning is constant. Do something constructive and positive with the obvious frustration you have about locums and agencies, writing articles like this helps no one and does the profession a disservice or atleast that's my opinion.
@3:42, survival is a basic instinct, you've just got to do what's right for you in that moment in time. I Locum anything between 8-10sessions / week. By definition this would be full time, but not by the current standards of working hours salaried and GP partners are having to put in.
I take offence to the candid use of "proper" full time job.
What is full time? And what is proper?
We've somehow accepted to work unsafe hours and when more and more drs move away from wanting to work like this, it gets deemed a female problem. I am not certain working longer hours equals a proper job. It's about quality not quantity.
As Manjiri has pointed out, this is less a problem of the sexes and more a workload problem. And to each where they find their resilience. I am only sharing what's worked for me.
Well done Shaba, as always saying it how it is.
Dear Dr Coales,
In response to your very last comment. Some of us actually believe in the founding principles of the NHS and wish to stand by it.
These principles can be found here:
Now I specifically say "some of us" as I recognise that there may be a growing cohort that feels otherwise. UK General Practice is currently in a state of flux and ultimately future General Practice will be the resultant product of changes that are likely to take place.
I for one would like to continue seeing a free healthcare system that does not rely on the ability of a patient to have to pay for their healthcare. What a shame when a developed nation cannot sustain and fund its nations healthcare.
So in my opinion we should be doing more to preserve and build further on the excellent services we already have. Not shouting willy nilly welcoming privatisation. But that's simply my opinion, one based on personal experience having been brought up in a completely private system of healthcare. There are no winners with such models.
Being the proposer of this motion which originated following a years worth of discussion at the South East Coast Regional Council, I am still not certain this is a good enough reason for such a motion not to have passed or atleast be considered as a question?
Why is it there an arbitrary number of 4 sittings with respect to the MRCGP exams (AKT, CSA) whereas other colleges get 6 prior to further attempts pending trainer support?
I welcome meetings, think tanks attempting to find a way forward. The question needs addressing; why are trainees failing? But in the meanwhile, why can't the RCGP be persuaded to follow the example of all the other royal college exams.
The General Medical Council, in partnership with the Academy of Medical Royal Colleges, considered the question of how many exam attempts is reasonable. Most colleges have taken on their recommendation that 6 attempts should be permitted before the trainee should be more closely scrutinised.
There needs to be a strong push to consider all options. 2010 this matter came to light, we are now in 2014 and none the wiser. How about some simple solutions whilst we continue to further evaluate the situation?
Dr Farah Jameel
I qualified in August 2013 and have been working since as a Locum. Part of the reason I chose this was due to the unsteady state of General Practice at the time.
I have since qualifying worked in 53 different practices and seen first hand just how General Practice is now on its knees. As much as I want to consider taking on a partnership, I am very concerned about what the future may hold. I want to be part of the solution but also don't want to jeopardise my own future by locking myself into such unhealthy working patterns. I welcome Pulse taking a stand and fully back GPC and RCGP in their respective campaigns "YourGPCares", "PutPatientsfirst".
The judge asked many questions, analysed many facts and eventually came to a decision after much thought. We are for what it's worth in a fairer country than we have come from and I want to believe a system of justice prevails. So I put my hope in this system and hoped it would draw an inference that is fair and keeping. As much as one wishes to chastise a group acting in good faith to bring fairness, it is important to remember that it’s taken a court case for this to happen, to get here. For the college to even acknowledge that something needs to be done?!
Key messages I take away are these:
“However, the court did say that ‘the time has come’ for the RCGP to address the differentials in the pass rates.”
“He said the reviews showed ‘unavoidable unconscious bias’ due to the nature of the assessment, and that some of the significant differences in pass rates between racial groups could be put down to education and cultural differences.”
Unconscious Bias: Is this something that the college is going to now work on? This is something that has been brought up in the past by a college council member however never been acted on.
I find it worrying to put things down to education and cultural differences, saying education and cultural differences may be responsible for a pass rate difference in IMG's is one thing, but citing that as a reason for difference for UK BME's almost makes one wonder; is this issue a class/socioeconomic thing? Are pass rates going to be different based on where one went to university & school in the UK? Isn't that just innately wrong in itself for a UK cohort to have differential results based on class/region/race/sex? We still do not have an answer!
Having personally sat in court (for part of the proceedings) and hearing some of the things that were being said; I find it surprising that the judge agreed there was a cause for concern but yet passes a judgement not in keeping with that concern. One has to wonder if perhaps the question that was being asked was one that was not appropriate.
Being a new member of the college, I want to belong to an organisation that is fair, which the court case has shown is, yet the figures don’t. I want to belong to an organisation that takes its members seriously and acts on their concerns, to an organisation that doesn't need to be taken to court to acknowledge that there is indeed a problem, to an organisation that doesn't need to be told by court they may be open to a future challenge!!!
“However, the judge added that the college must now act upon the recommendations of the various reviews, and added that any failure to do so would leave it open to a future legal challenge.”
Endless amount of research has been commissioned to date with no solutions or action points, it has taken a court case to effect action. And so: “He said that the claim – made by the British Association of Physicians of Indian Origin – was made in ‘good faith by an organisation acting in the best interests of the public’, adding that BAPIO had ‘achieved, if not a legal success, then a moral success’.”
I feel it almost imperative to state that I am indeed a college supporter and never wished for a court case, however it has taken a court case for them to finally sit down and take this matter seriously.
I look now to the future and the changes it may bring.