This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

GPs buried under trusts' workload dump

Timothy Sullivan

  • Schools require GP's note for pupils to skip PE lessons

    Timothy Sullivan's comment 22 Jan 2016 9:38am

    Charge for these type of things and they soon stop - just need to guts to charge...

  • AMoX5ORNOT: a new scoring system for antibiotic-prescribing

    Timothy Sullivan's comment 10 Jul 2014 1:18pm

    Brilliant! This valuable predictor-tool will be going into each of my partner's pigeonholes first thing in the morning.

  • Hunt sets out plans to 'rethink' primary care as BMA demands urgent talks over out-of-hours attack

    Timothy Sullivan's comment 26 Apr 2013 10:42am

    The problems with individual GPs and practices taking back 24 hour care are:
    1. The British public are now much more consumerist than 30 or 40 years ago - they want immediate solutions to often non-urgent, even minor, problems. There would be a lot of abuse of GP after-hours services. The only way to reduce that would be attaching a cost to provision, but no UK politician has the balls to make patients contribute to the cost of NHS services.
    2. Younger GPs both male and female have chosen general practice because they didn't want to be up all night as a medical registrar, and wanted family friendly hours. Older GPs are tired, burnt out and disillusioned by falling incomes and pensions. Neither of these groups are going to agree to go out at night to look at broken fingernails or head-lice, or the more A+E type stuff.
    3. After hours care wasn't properly funded in the past, isn't now, and won't be in the future if this government has anything to do with it.

    Unfortunately the health secretary and his minions seem to have bought into the idea that they just need to get GPs working all night again, and that will be a cheap solution to over-crowded A+Es.
    Unless the BMA, RCGP etc are really ready for a fight this time, there are going to be a lot of very p***ed of GPs.

  • I worry that 'micromanaged' GPs will simply walk away from the NHS

    Timothy Sullivan's comment 20 Apr 2013 2:12pm

    By the time I finished working in general practice in the UK, I had realised that it was impossible to fit in the patient's agenda as well as QOF (and QOF plus in our PCT) in a 10 minute consult. I now have the luxury of 15 minute consults, which allows a much deeper exploration of the patient's concerns, and hopefully better outcomes, less medicolegal risk etc. also seeing few patients in the same working hours means less risk of burnout. GP in Australia isn't perfect, but for me it's not far off.

  • Madam, I’m a GP, not a plumber

    Timothy Sullivan's comment 04 Apr 2013 1:27am

    Now working in Australia, home visits are entirely at the discretion of the GP. Some GPs just don't do them at all and there's no obligation and no fear of complaint. I visit the extreme aged housebound, and palliative care patients only. Everyone else is seen at our clinic or we see them in our local A&E which we are fostered to cover. Not having to do unnecessary home visits is one of the advantages of working over here.

  • Only quarter of medical graduates rate general practice as first choice

    Timothy Sullivan's comment 10 Feb 2013 5:58am

    Now working in Australia i love general practice again. Longer appointment times, much more hands-on (and with that the respect from patients for a doctor that can actually do something rather than just script or refer), hospital in-patients to look after, skin cancers to excise, fractures to set, A+E department to run (on a rosta with my GP colleagues). General practice has de-skilled too much in the UK - out here some GPs can still deliver babies (even by C-section) or give a GA. There's no QOF to worry about - and you can make 200, 000 GBP per year (not unusual). I don't think Clare Gerada can turn the situation in the UK around. To the younger GPs who are disiilusioned with the way it's going in the UK - come on over while you can!

  • Accountants advise GPs to reduce drawings by up to 10% to prepare for contract imposition

    Timothy Sullivan's comment 12 Jan 2013 3:38am

    Australia: FT GP income is nearly $300000 = 200000 pounds. No QOF to worry about, 15 minute appointments, much more 'hands-on' with skin excisions, suturing and plasters all expected to be done in-house. Sadly there's no way I could go back to NHS general practice now.

  • Accountants advise GPs to reduce drawings by up to 10% to prepare for contract imposition

    Timothy Sullivan's comment 12 Jan 2013 3:38am

    Australia: FT GP income is nearly $300000 = 200000 pounds. No QOF to worry about, 15 minute appointments, much more 'hands-on' with skin excisions, suturing and plasters all expected to be done in-house. Sadly there's no way I could go back to NHS general practice now.

  • Digoxin raises risk of death ‘by 40%’

    Timothy Sullivan's comment 02 Dec 2012 4:18am

    given that beta-blockers are now first-line for rate control, it's likely that patients on digoxin have a more resistant (i.e. more severe) form of AF. Unless the researchers have taken that into account, I'd be cautious about changing practice.

  • What the NHS needs is a 'Fair Use' policy

    Timothy Sullivan's comment 28 Nov 2012 11:16am

    Australia: emollients, anti-fungal creams, NSAID gels, anti-histamines and a host of other non-life saving medications are OTC or private scripts. The government script scheme has essential meds only. There's a small charge for each item, even if you're a pensioner or unemployed - so no popping in to see the GP for paracetamol for your toothache or sore throat. Many practices will also charge a 'gap' to those that can afford it. It all encourages sensible use of healthcare, and makes people value the service more than they seemed to in the UK. It also makes the funding of healthcare more sustainable into the future - rather than the unlimited demand on the NHS.

  • Using a glitazone second-line in diabetes 'reduces mortality by 30%'

    Timothy Sullivan's comment 09 Nov 2012 10:52am

    What happened to MI, heart failure, osteoporotic fracture and bladder cancer risk with glitazones? Honestly the evidence changes every week - how are you supposed to keep up? Should the people who sued over avandia pay back the money?