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CAMHS won't see you now



I'm just a simple man trying to make my way in the universe

  • Outgoing RCGP chair to head new social prescribing academy

    Bornjovial's comment 24 Oct 2019 8:50am

    Maybe her practice needs same. Their overall GP surgery satisfaction is way below national average.

  • NICE and BTS/SIGN to produce single set of asthma guidelines

    Bornjovial's comment 26 Jul 2019 8:28am

    NICE in concept is wonderful and is essential in a government funded health system but has lost its way over the last decade.
    To stay relevant maybe they can have standards that are divided as standard which everyone has to follow and a gold standard which recognised trail blazers can follow would be an option.

    Eg. FeNO testing is made optional where resources/circumstances allow and traditional diagnosis for the rest of us.
    If they stick to what can be implemented in every part then it will be quick race to the bottom

  • Boris Johnson pledges to reduce GP waiting times in first speech as PM

    Bornjovial's comment 25 Jul 2019 10:30am

    Hi Christopher Ho,
    If they wish to have a state service only for those who are at the lowest economic group, the options would be to subsidise Insurance for those who can take private Insurance or ability to transfer part of NI payment towards health Insurance and have an NHS for the "rest".
    That left over "NHS" would quickly deteriorate and maybe able to provide only basic health service.
    NHS is trying to be everything to everyone and that is not working.
    Without a significant funding boost to NHS budget it cannot continue as it is. The cost of funding more for NHS would be less budget for other departments -Schools. defence, social care etc- so there we go again

  • Boris Johnson pledges to reduce GP waiting times in first speech as PM

    Bornjovial's comment 25 Jul 2019 9:00am

    It will be you notorious video consultation platform available for everyone and hey presto waiting list solved.
    Never mind the one who truly need our help will not be covered by this.
    I hope they increase funding for the ones truly needing help lots of ill people will suffer

  • Hammersmith and Fulham CCG to ‘welcome’ Babylon single network

    Bornjovial's comment 30 May 2019 5:22pm

    If non geographical grouping was allowed, may practices would have joined up from non contiguous sites. they need to postpone the deadline for registering networks as now many more options have opened up.

  • GMC to spend ‘bulk of resources’ on supporting doctors

    Bornjovial's comment 29 May 2019 6:16pm

    GMC is a registered charity Charity no. 1089278.
    With regards to it’s effectiveness - Apparently only 18% of doctors felt confident in GMC in a survey conducted by the GMC!!!
    If doctors have a mere 18% of their patients having confidence in them, they would have lost their license to practice a long time ago....
    It is an irony that they are pushing for annual patient survey.

  • Pariah practices have patients that 'deserve care’, says RCGP chair

    Bornjovial's comment 27 Mar 2019 8:13pm

    It is a it rich that the chair of RCGP - a partner in a two star practice and in the lowest quartile in overall satisfaction in the the whole on England calls other practices as pariah practices.

    Pot calling the kettle black.

  • MDOs warn of 'substantially' increased costs from reforms to indemnity schemes

    Bornjovial's comment 28 Feb 2019 3:15pm

    My understanding is the new NHS Indemnity scheme would NOT cover
    1) Good Samaritan acts
    2) Non NHS work (Any private or fee paying work undertaken)
    3) GMC proceedings
    4) Coroners cases
    5) Criminal investigations
    6) Patient complaints from past medical treatment provided

    This is a tentative list and we await for clarification of the scheme as it is made up as we go along.

  • Sometimes only a patient complaint will work

    Bornjovial's comment 27 Nov 2018 5:32pm

    Agree with Dylan,
    There are not enough doctors to sit and explain every test face to face. Although it is not our fault that the situation is that way, we have to make the best of the available resources and arrange for follow up via any appropriate medium - including Nurse clinics, Phone calls from junior doctors, SMS to inform scan/test was normal etc etc.
    What is NOT acceptable is allowing patient to be on tenterhooks about a result with no follow up booked in as it seems to be often the case at present

  • Partnership model may be ‘contributing to recruitment crisis’, suggest GP leaders

    Bornjovial's comment 13 Nov 2018 6:03pm

    Partnership model is not contributing to the OOH crisis, is it?

  • GPs should refer patients to Skype outpatient appointments, says NHS England

    Bornjovial's comment 09 Nov 2018 3:20am

    Used carefully this can be an useful tool in select patients in selected circumstances.
    However To a man with a hammer, everything looks like a nail - should not apply it indiscriminately.

    I offered to pilot Skype/ Conference consultations between patient, GP and lipid clinic consultant who almost never needed to examine a patient more than a GP can.
    The hospital was not interested as they don't get paid HRG tariff!!!

  • GPs 'should stop co-prescribing mirtazapine and SSRIs for depression'

    Bornjovial's comment 02 Nov 2018 10:28am

    NICE has accepted that Mirtazapine and SSRI combination in its previous guidelines as one of the few exceptions where 2 antidepressants are used together.
    Obviously we need to consider the study effects.
    We need to note that SSRI`s themselves have very high placebo effect (in excess of 50%) and we still use them, so I hope the study had enough numbers to be statistically significant

  • ‘No benefit’ of lowering hypertension treatment thresholds, finds major study

    Bornjovial's comment 01 Nov 2018 10:39am

    Common sense prevails at last.
    However few caveats on this conclusion- its only 40,000 patients which for a low risk population by definition does not a high confidence interval of accuracy for the billion people worldwide who are estimated to have hypertension.
    Data from GP records is based on in clinic readings. In future validated measurements from patient held machines which can generate lot more data (?accuracy) would be used to model outcomes with a bigger dataset.

  • Superpractice partners with Push Doctor to offer GP video consultations

    Bornjovial's comment 11 Sep 2018 11:17am

    I think the CMO of Push doctor Dr.Dan Bunstone has resigned as chair of a CCG after majority of practices in the CCG expressed no confidence in him according to HSJ.

    Also interesting to note the comments from LMC on this compared to their choice of words when Babylon wanted to start recruiting in Birmingham.

    Don't we live in interesting times

  • Government to ease red tape for Australian GPs to work in the NHS

    Bornjovial's comment 24 Aug 2018 10:49am

    Most of my GPVTS cohorts went to Australia ,New Zealand or Canada.

    Most are not coming back even if they roll the red carpet out.

  • GP at Hand improves health access for migrants and homeless, finds review

    Bornjovial's comment 16 Aug 2018 8:37am

    As long as they have a the latest iPhone/android phone with unlimited data package, speak fluent English and have private Insurance.

  • One fifth of GP appointments avoidable, finds NHS England audit

    Bornjovial's comment 20 Jul 2018 9:41am

    This is a retrospective decision. What we need is a prospective trial of triaging into alternate practitioners and then see how many they are able to manage and what proportion is reverted back to GP`s.
    One should also look at vicarious liability.
    I have come across patients with unusual presentations like a heartburn which was a acute MI (in a 40 yr old lady), a sore throat which was acute leukaemia, an "asthma flare up" which was Eisenmengers reversal, 2 shoulder pains which were lung malignancies etc. Admittedly these are rare but the medical negligence costs will have to be weighed up against the saving. 1 significant missed diagnosis would offset years of savings by offsetting workload to alternate health professionals and GP`s carry the vicarious liability now.
    Obviously if the government underwrites all medical negligence then this becomes more interesting.
    The "doctor as a medicine" concept is also lost but some patients prefer 20 min with the nurse rather than 10 min with GP partially offsetting this.

  • Patients to book GP appointments through new app by end of 2018

    Bornjovial's comment 02 Jul 2018 12:47pm

    Today I have been told
    "There is a national problem with Patient Access in that it is very slow and patients struggling to access it today. Being investigated"
    The app would be single point of failure for primary care for the entire country and single point of infrastructure attack for any hostile entity which wishes to cause chaos in England.

    20% of our patients are booking their appointments online and this will increase with time. However there are several access points such as telephone, a visit to the surgery as alternates to book appointments.
    There are positive sides to this as well as there is standardization of access to practices, albeit for digitally enabled citizens.
    As with anything new, it does not flatten the playing field but creates new winners (app developers, IT staff, more control of primary care by NHS) and new losers (GP surgeries, elderly patients).

  • E-consultations resolve ‘40-60%’ of GP consultations without attendance

    Bornjovial's comment 24 May 2018 3:02pm

    We are trialling e-consultations in our practice very very carefully.
    This may increase, decrease or have no effect on available appointments.
    Extremely small reductions have be noted in some studies while in others it had no statistical improvement.
    Significant reductions in appointments are likely to be fantasy of some vested interests.
    If it were so successful NHSE should pay practices extra 40-60% of primary care budgets ASAP to implement this

  • 150,000 patients with resolved AF 'should still be on anticoagulation'

    Bornjovial's comment 14 May 2018 10:30am

    even resolved AF has risk of recurrence and increased risk of CVA (exception being lone atrial fibrillation which has no evidence). So yes this consistent with known evidence regarding AF.