Just Your Average Joe
31 million to treat 47000 patients makes GP at hand look like it cost £659 a patient a year to run - if you assume the deficit is purely down to the change in service provision.
Even the hub and walk in service was expensive but not such poor value.
Robbing GP core services of funding - to pay for the worried well in either type of service is management allowing common sense to be sacrificed at the alter of demand.
Not a single actually genuinely sick patient will be dealt with successfully by phone - as all you can do for those is signpost to another more appropriate service, where the costs are duplicated.
If they were seen there without the original costs - savings would be made.
The NHS should be free at the point of need, not free at the point of convenience.
If services like GP at hand are allowed - it should be private only at the cost and convenience of those who pay.
Core GP services should be returned to the Primary care base - where real patients are physically based, so funding is not jeopardised for the rest of the population.
Its no problem - they pay them more than the normal going rate for GMS and they get that advantage.
They then run it at a loss and get bailed out with GP funding which is taken from other patients share of funding.
Huge success of joint working -
Ready to sell onto the US market as soon as those pesky Brexit talks finish and the UK can negotiate a trade agreement allowing the US insurance giants to swoop in and take over.
GMC - Pandering to patients, while persecuting doctors.
You pay to be tormented and tortured by them.
Free at the point of service - should be tax payer funded as they do nothing to help doctors, and run by DOH appointed crony C Massey.
How is he still in a job, how do we vote him out if the GMC is meant to represent the profession?
Record 3500 trained - due to part time work and leakage from profession - you will be lucky to have 1800 Full time equivalents who will not fill the gap of retiring full time male GPs.
2 in needed to replace 1 out - due to social and political factors meaning most now want to take breaks, part time locum/salaried/portfolio jobs, and very few full time partners.
Locally only 1-2 interested in partnership in group of 17!
Politicians, BMA, RCGP and Medical Schools need to look sat who is going in, and how many of those are staying in medicine, and working full time.
Even if 20 GPs leave VTS schemes - allowing for those going abroad, quitting, on extended maternity and childcare leave, and portfolio work, you will be lucky to have even half as Full Time Equivalent overall.
So 20 GPs qualifying will not replace 10 Full time retiring GPs - so even if the numbers training match those retiring there will be a massive deficit waiting to hit home sooner or later.
This imbalance in numbers needs a review in those accepted for training in medical schools and beyond, GP only medical schools, and some sort of golden handcuffs for training medicals students and GP trainees to keep them within the NHS as part of the contract to be accepted.
If not started soon, there will be no NHS GPs to look after the Ivory Tower collective when they retire, though they probably have private cover and don't care.
We Need Mr Barnier to come negotiate our next contract as he has this government by the throat - No deal is better than this deal the BMA has negotiated.
Quarter the price per patient paid to online registrations, and recycle the saving into the helping practices loosing core funding which balanced their books.
The work left behind by Baylon is all the patients with complex medical needs, the elderly and house bound.
The 75% not paid should fund a service to help the housebound and elderly - taking some of this workload away from practices, which will otherwise be unable to function.
The surgeries which lose the fit and young patients will slowly be destabilised and not be able to pay staff/locums and then won't have the resources to provide core functions.
First get enough doctors into the system to allow it to run smoothly.
New medical students will take 10 years to reach the front line, and yes there was a small increase, but the numbers needed don't match those being trained.
Nor does it cover those training and leaving, and the large numbers choosing to work part time.
Stop finding even more ways to take GP's away from front line patient work.
Rearranging deck chairs on the titanic sounds about right for most other plans which don't address workforce/workload issues.
111 waste of time and space sadly. yet to be of use - NHS Direct RIP.
not accepting anything they send without triaging out the junk they redirect for no good reason
This is incorrect - it costs GP practices and partners for DNA appointments. Yes it does allow catch up/breathing time but at a cost.
With increasing recruitment issues, more and more practices are utilising routine locum clinics.
The cost of setting up a locum clinic to ensure adequate number of appointments are available, is borne by the practice.
If the equivalent number of DNA appointments were placed in this clinic, it would not be required = saving the practice the cost of that locum session.
This comes from their own pocket.
Hence in GP practices it is the partners or practices who pay for DNAs.
GP and Hospital DNAs result in longer waiting times for all patients, but hospital costs are borne by the NHS overspends. This results in cuts to front line services with introduction of low priority procedures etc to balance books.
The GMC needs to step in and stop the non sense of Locum GP's refusing to do visits and other core work like signing scripts etc, especially when they are employed to cover small practices where they are the only GP presence for the session.
Where is their duty of care and requirement to consider the needs of patients. Yes their working terms and conditions/demands are known up front, but where the alternative would be no GP at all, practices are being held to ransom, and patients are put at risk.
GMC do something useful for once.
Capita should be fined 500 million and this given to all GPs, as they have inconvenienced everyone's tax returns and caused stress to everyone.
They should be forced to hired adequate and qualified staff to process all the data, complaints and requests for information within the next 3 months and get themselves back on track - at a cost to Capita.
Once done they should be relieved of the contract.
Capita should then be on a banned list and never awarded another government contract again.
Community Support officers in their best days are not police officers but were drafted in as cheaper options to cut costs.
Any lack of GPs in the UK is down to financial decisions not to provide adequate medical school, then training places to fill the retiring black hole of GPs leaving the profession.
Any help from colleagues is welcome, but if they take all the simple cases GPs will never manage the complex and multi-morbid patients left to them in 10 minute slots - it is the law of unintentional consequences.
Eventually those GPs will burn out as they can't operate at that level all the time.
If the 20 billion directed to the NHS did create a whole new medical school dedicated to just creating GPs, and funded the postgraduate training pathways - then eventually GPs would come out the other end.
Yes it will take a long time, and yes you could treat the ones here now with more care and respect to try and keep them for as long as possible. If they don't start now, it might be too late by the time they realise they lost the best and most cost effective part of the NHS.
Home visits need to be paid as an item of service fee, as the demand for them is out of control. It can't be managed in the current payment per patient given.
The partnership model is far from perfect,but the unlimited all you can eat buffet sold to patients by the DOH - is run on the back of partners working long hours and well beyond anything a salaried GP will dream of doing in the GMS BMA salaried contract.
If the partnership model switches to a salaried service - expect to need at least double the number of GP's working to strict sessional contracts and safe workload limits.
This if you can find them, at a market rate where the costs for the DOH will spiral out of control, as they realised when they took back OOHs and can't run them on the shoe string budgets left, with the new workload produced.
It is as much in the DOH's interests to keep the partnership model going as anyone wanting a NHS primary care service to continue.
You have to increase funding beyond what you pay for a years pet insurance to have care for an ageing population where Babylon cherry picks fit and young patients, who subsidised the service for everyone else.
Use quinolones a handful of times a year when only choice with resistant bugs and have no real issue with restrictions for safety reasons.
As mentioned - the vast unchecked quantities being used in agriculture and abroad need sorting out. Something the EU should have sorted out years ago and would have help restrict antibiotic overuse in non medical circumstances.
Commercial companies need to swallow the losses and continue to provide cover until the contracted notice period is complete, unless some moronic manager from NHS England left no withdrawal period clause in - the allied company behind this are liable for some financial penalty.
As likely limited liability, the directors will probably wind it up leaving the losses and obligations in the gutter.
Private companies are only after fat profits from NHS contracts, and if there is no feast then they run. Not a way to run our beloved NHS, with profits sucked out and away from crucial services, and then left in lurch with NHS to pick up costs of failure.
Stop privatising the NHS and put the right funding in place to run services safely.
Most OOH are run by a skeleton staff and are unsafe, especially overnight when there can be 1 visiting GP for possibly hundreds of thousands of patients, but the government keeps telling people they can have 24/7 care.
Most evening and weekend users and OOH demand is from things that are either non urgent, or duplication of care that has seen, or will be seen again by their own GP.
Cough/colds and sore throats can all wait until the next day, or as many years gone by they waited week and were often resolved.
Culture of worried well, and just in case lobby, along with make doctors liable for all risk and errors, all to blame for this debacle.
Simple solution. CCG knows its population, they order enough stock and pay for it for all jabs needed.
GP practices and pharmacies order stock from them, and there is now enough for everyone, no over ordering, no excessive risk to practices, and they can return unused stock to pharma companies at end of season.
Win for all
Anyone thinking of awarding Capita any contract in the NHS or government in general should automatically be sacked for gross incompetency and negligence.
Thanks BAP - enjoyed that video as learnt something new.
Wish I knew what to connect the dressing to! The video ended on a cliff edge!