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Independents' Day

Andrew Jackson

  • How GPs have used the independent model to adapt in the pandemic

    Andrew Jackson's comment 08 Jul 2020 8:01am

    I would guess that most of us who are seeing advantages of remote consulting have a decent amount of primary care experience under our belts.
    Learning medicine in the early stages of your career and in training can’t be done well remotely and we may not see the effects on the workforce for a few years.
    How many of us would have chosen general practice as a career if we knew we would be sitting on a phone or video for hours? It’s not a great long term offer.
    I do however agree with those who say this isn’t the new normal till we have got through a winter.

  • Jeremy Hunt finally admits he wants 'talk before you walk' A&Es

    Andrew Jackson's comment 02 Jul 2020 4:48pm

    Does this timing coincide with up and coming PCN DES OOH requirements?
    Don’t say people didn’t warn you about the small print

  • Professor Clare Gerada's letter to the CQC on restarting GP inspections

    Andrew Jackson's comment 27 Jun 2020 12:01pm

    Any reasonable body would find it difficult to disagree with the content of this letter

  • There is racism in the NHS – and we need to address this

    Andrew Jackson's comment 23 Jun 2020 3:54pm

    I am white and from the north east and have never had to deal with any obvious discrimination.
    My son applied to a college at Oxford and was steered to another more suitable college for a northern state school educated pupil.
    It left such a sour taste in all our mouths that I can’t imagine what it must be like to have this happening throughout our lives.
    I can only apologise to our BAME colleagues if they are experiencing this kind of behaviour through out their lives-it must be awful and we should all try and help change for the better.

  • Quarter of GPs prescribing ‘unsafe’ strength of immunosuppressant, study finds

    Andrew Jackson's comment 23 Jun 2020 3:41pm

    Important and simple to correct with a pharmacist led audit
    This is the kind of stuff pharmacists should be doing not the pointless DES stuff.

  • CQC will restart routine GP practice inspections from this autumn

    Andrew Jackson's comment 17 Jun 2020 5:56pm

    I'm looking forward to them coming in the Autumn as I need some help sending off all the referrals that are stacking up because the rest of the NHS has stopped.

  • Widespread confusion over face masks in general practice

    Andrew Jackson's comment 15 Jun 2020 11:11am

    Is there anybody involved in these high level discussions that has ever spent any time in a GP Practice?
    A group of coal face GPs would convert this kind of confusing guidance into something workable fairly quickly and not ask for a gong in return.
    As masks are going to be prevalent in many settings including secondary care and transport we are asking all patients to attend with a face covering and any non clinical staff member that walks into an area where patients are to briefly wear a mask
    It doesn’t impact on our back office functions and hopefully reinforces a mask measure without wiping out our PPE supplies

  • Face masks to become compulsory in GP practices

    Andrew Jackson's comment 13 Jun 2020 1:44pm

    We have exhausted our ability to source PPE from the NHS portal and have 9 days of PPE until we run out if we follow this guidance

  • GP NI contract reforms could keep 100% triage and Covid centres

    Andrew Jackson's comment 11 Jun 2020 12:53pm

    Starring Powerful GPs who should know better
    Extras : Coal face GPs
    Produced by PCNs, RCGP, BMA
    Directed by NHSE

  • Nine in 10 GPs want to continue with remote consultations after coronavirus

    Andrew Jackson's comment 10 Jun 2020 11:01am

    We have had good IT function so have been able to incorporate remote consultations within our working day and I have enjoyed the option of using it and mixing it into F2F when required.
    It has made all of us really reflect on when an examination is needed and why we are doing it.
    Long term it’s hard to predict what GP land will be like.
    I think it will break in the winter when the incidence of pyrexial illness increases and the quick mopping up of extras that the current system relies on to survive will be decimated by the increased consultation time that donning PPE will bring. Maybe remote working will help us avoid this.
    The additional staff through the PCN recruitment strategy have even less experience of the risk carrying of remote working which will also decimate the predicted capacity we all hoped they would add.
    I am worried long term for us and we will need a contract that takes work away from us very soon which we clearly have never achieved recently.

  • All shielded patients should have named clinical lead, says NHS England

    Andrew Jackson's comment 02 Jun 2020 11:35am

    Is there a coal face GP anywhere near NHSE at the moment so a sensible conversation could be had before these plans are sent out to keep the good ideas (if any) and stop the terrible ones

  • GPs to provide Covid antibody testing for patients who have bloods taken

    Andrew Jackson's comment 31 May 2020 7:04pm

    If there is value in knowing the status from a population prevalence point of view then the lab could just test everyone anonymously when doing any blood test.
    Otherwise we will of course end up spending unresourced time communicating and explaining the results if done in the proposed way.
    When will NHSE realise there aren’t enough Drs to do basic primary care work, especially as we move out of lockdown and demand goes up again.

  • GP appointments in April down by 27% compared with last year

    Andrew Jackson's comment 28 May 2020 10:14pm

    There is some kind of weird guilt going on amongst GPs that during Covid there has been less appointments and hence work to do.
    We have briefly been the quietest I can remember in the last 20 years but have offered a good service, the job has been enjoyable and the ability to have time to interact, plan and speak regularly with colleagues has been wonderful.
    Most of what I have done has been real medicine instead of dross.
    It won’t last so if you have had the same experience as us don’t feel guilty and don’t look for work that doesn’t need doing unnecessarily.
    Maybe there wouldn’t be a recruitment crisis if this was the norm.
    We don’t have to be burning ourselves out all the time.

  • Number of fully qualified FTE GPs drops by 2.5% in a year

    Andrew Jackson's comment 28 May 2020 7:40pm

    I have 3 children, none of which even contemplated medicine despite 2 parents being GPs
    I read this headline out loud and my 20 year old son asked why doesn’t anyone want to be a GP?
    I could only answer ‘ because the job is crap’
    General Practice is no longer a professional full time career option which is shocking.
    Every one of my friends works full time in a career
    We have leaders and influencers everywhere supposedly.
    No other professional group would allow that to happen.
    It is finished as a career as all the available money has gone into PCN staff and there won’t be any extra.
    All we can do is hang on as long as we can tolerate it till it falls apart.

  • Over 300 GPs urge police to investigate Dominic Cummings

    Andrew Jackson's comment 27 May 2020 8:27am

    This group dispises the elites yet thinks Drs are elite enough to be more offended than the general public and carry more influence with a letter
    This isn’t our fight!
    There are many things we need to fight for professionally that require us to sign letters like the future of general practice
    Groups that propose to represent us need to stay within their remit

  • GP bureaucracy must not return after pandemic, says RCGP chair

    Andrew Jackson's comment 26 May 2020 8:02pm

    The PCN DES is a monster of bureaucracy

  • PCNs opting out of Network DES due to workload concerns

    Andrew Jackson's comment 06 May 2020 9:41pm

    I enjoy the variety of general practice and that includes providing care to patients in nursing and care homes
    EOL, dealing with families in an organised resourced way not having to fit a whole load of rushed visits in at lunchtime
    Covid has led to all our care homes having video links both with practices and an OOH team of GPs supporting care and preventing admissions. We currently do a video based ward round weekly.
    It is rewarding to work like this-I haven’t stepped into a NH for over a month but the care is great.
    Achieved by local commissioning not the PCN DES.
    As I commented, the aspirations of the PCN DES are good but the idea of achieving it is flawed.

  • PCNs opting out of Network DES due to workload concerns

    Andrew Jackson's comment 06 May 2020 4:58pm

    @davidjenner has it so right
    There are PCN DES bits which are really good but should be negotiated locally so primary care ends up better not trapped in something which had lots of terrible parts that don’t outweigh the good bits
    The DES framework and funding could be easily used as a framework for the CCGs to commission bits from us
    Too many of us think it can’t be renegotiated but it can

  • 'We propose an alternative to MRCGP exams process'

    Andrew Jackson's comment 01 May 2020 12:45pm

    I have been training for 15 years now with a mix of strong and weaker trainees.
    If a Trainee has been progressing well throughout their full training scheme and are coming to the end of ST 3 I have no problem them being waved through.
    Those on an extension often have a history of struggling throughout their scheme and should be expected to prove their competence and not just be waived through.
    They do however need a guaranteed funded post till they are able to prove themselves via their external assessments.
    Perhaps we could go back to submitted video consults rather than CSA.

  • GPs told to start 'virtual' weekly care home rounds from next month

    Andrew Jackson's comment 29 Apr 2020 4:55pm

    The first of the (predicted) PCN DES chickens to come home to roost.
    We have actually started this already as a response to Covid thanks to good IT support, good CCG support but most importantly the ability to make the care homes use video consults as there was no other way of their residents receiving care. This was never possible when we couldnt refuse to visit!
    It does however show you can't trust the DES as far as you can throw it.
    Just wait till OOH kicks in.