Don't see the problem here. You see the patient, make your professional judgement as to whether they need admission based on clinical impression of their condition and the context of environmental/social factors. If you then think admission is needed, you gather the data for the NEWS score, which after all is only a communication tool like the GCS, and use it when calling the ambulance/hospital. I haven't admitted a child all winter so far, but another GP I know admitted 5 from a single session which I suspect was at least partly due to defensive use of the NEWS score. Neither of us an outlier in terms of adverse outcomes...
So far, PCNs have saddled my practice with the extended hours DES which we had previously opted out of, ie 6hrs a week of extended access cover for our 12000 patient practice (and even more than this to backfill the deficit left after the festive bank hols), the clear and present danger of a fortnightly GP visit to all 4 of the care homes on our patch, and the even bigger threat of OOH coming under the PCN after 2021. Our OOH service is struggling to fill shifts as it is, so if I stay in the job, I guess it'll be back to the dark days of doing our own on-calls. No brainer...?!
A board level person in charge of staff well-being? How does that work in your average GP practice? And who do you think would have had to see the 37 patients I have booked in today if I'd have taken a sickie? Sensible solutions from previous contributors but would only work if we all go salaried and government puts in the funding. Guess superdocs will have to fight on to the bitter end...
This is Glasgow not the Outer Hebrides. If someone has an urgent problem that really can't wait until the next day, they can pitch up at A+E or call an ambulance. If they're not sure, why not try the NHS App?
Doesn't look to add up to me. You need 600K to pay 30 GPs a 20K each golden hello. There is only 300K for this, and only 175K of that spent so far. If it is pro rata, these 29 GPs are very part time, surely? Hopefully whatever wte you have recruirted will stay beyond the 3 years though!
About time someone reported the ambulance chasing lawyers and insurance companies who make SARs for trivial reasons to the ICO as well I say.
I agree this is all just a load of empty rhetoric so I thought you might as well all have a laugh at 2 examples which happened to me over the years: 1. One of my drug users stabbed another with a screwdriver he happened to be carrying with him during an argument in the waiting room of our local CDT clinic. They barred him from their premises. He ended up in court and the judge issued a court order that he had to see his GP for treatment. We referred him to our local violent patient scheme but were told that "as the violent act was not committed on your premises, we cannot take a referral from you". I ended up with him in my consulting room waving his court order and demanding medication, with my staff hovering outside and a finger on the panic button. 2. Patient allocated to my list with a history of violent conduct (no info from previous GP as Crapita had lost the notes) threatened me on a home visit. Rang NHSE for advice on how to get him removed as I was apprehensive about seeing him agsain. Response to my PM was "can't the GP take a nurse along next time?"
I ask you...
I haven't had any complaints because I stick to my contract and prescribe anything which I feel my patient needs that is available on FP10. If the government don't want me to do this, they can change the GMS contract accordingly or blacklist the drugs. End of.
Hey, where do you work fed firstname.lastname@example.org? Here in Rochdale we get about £85, and have been running our 13000 list with 4 GPs until this year... Stinks if you ask me...
Well, I only refer patients when I do not feel competent to handle their conditions myself, so by definition I am not competent to prescribe medicines they have been issued in hospital. Therefore I should not sign any.
Not many of the few new GPs coming through the system want to enter into building ownership. Not surprising as the next generation are having enough trouble funding houses to live in. Solution is to buy us all out of our premises and run all practices as if they were in state owned health centres. Non-clinical partnerships are too difficult, how do you divvy up profits in proportion to workload if some are not seeing any patients?
He is quite right of course, but the realities of the system make it impossible to practise medicine in this way.
Can I just ask knowledge is porridge @11.28am, how do they keep a lid on their walk-in surgery? If I did that here, there could be as many as 60 walk-ins on a Monday morning! I agree telephone triasge is not the whole future, but once your calls are booked, they are booked. I also worry about these online consulting tools - I could come in to find about 60 online history submissions, and if even only half of them needed seeing, we would be overwhelmed. A cap on our workload is the only future that is acceptable.
Come on guys!
The RCGP has just found a way to wash their hands of Babylon after the GP at Hand debacle made Babylon "persona non grata" because of their cherry-picking of easy to manage patients, which they did because of lack of facilities for face to face/examination if it becomes needed following telephone consult.
All's fair in love and war...
Replacing one big waste of time with another one if you ask me. Home visits by GPs are a thing of the Dr Finlay days. paramedics can deal with acute visits, ANPs/palliative care nurses can deal with end of life care, and pharmacists can do planned med reviews for housebound/care home residents. However I don't feel that using the freed up time for 30 min appts would be any good. In my practice we have a "duty doctor" on the busiest days of the week. They don't visit, but can get through at least 10 telephone consults in the same amount of time.
Credit to BMA NI for being frank with patients over there. I am a partner at the practice featured here:
No-one in England seems to have the balls to directly tell our patients how it really is the way they have done.
Well my place would be on black alert every day then!
Whilst I agree there needs to be more transparency about how the MDOs work out the fees they charge, I think we need to reserve the "regulating" for the fatcat ambulance-chasing lawyers and vexatious patients who make stupid claims on "no win no fee". Sometimes things do go wrong, and people have a genuine case, but they are in a minority if you ask me, and we all know one when we we see it...
Ha! Still wouldn't trust them though...
We have had various bodies like Connecting for Health and others up before the health select committee before. I am not aware any of them have ever had any action taken against them after revealing such failings. Just a toothless PR exercise.