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A faulty production line

Just Your Average Joe

  • NHS 111 to book GP appointments directly starting this year

    Just Your Average Joe's comment 08 Jan 2019 1:08am

    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

  • Who bears the cost of patients not attending?

    Just Your Average Joe's comment 05 Jan 2019 12:11pm

    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.

  • A&E ‘streaming’ competition is causing locum shortages for quarter of GPs

    Just Your Average Joe's comment 05 Jan 2019 12:02pm

    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.

  • How GPs have been left dealing with the pensions pot fiasco

    Just Your Average Joe's comment 03 Jan 2019 11:53am

    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.

  • Time to make the term ‘noctors’ a relic of the past

    Just Your Average Joe's comment 25 Dec 2018 12:41pm

    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.

  • Partnership review? Oh no it isn’t!

    Just Your Average Joe's comment 13 Dec 2018 9:09pm

    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.

  • Partnership review? Oh no it isn’t!

    Just Your Average Joe's comment 13 Dec 2018 9:07pm

    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.

  • GPs could face quinolone antibiotics prescribing restrictions from next year

    Just Your Average Joe's comment 28 Nov 2018 9:10pm

    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.

  • Urgent care company collapse leaves GPs just 10 days to find out-of-hours cover

    Just Your Average Joe's comment 28 Nov 2018 9:04pm

    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.

  • 70% of GPs unable to secure enough flu vaccine for over-65s

    Just Your Average Joe's comment 16 Nov 2018 12:23pm

    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

  • Capita waited months to tell NHS England about cervical screening letter issues

    Just Your Average Joe's comment 16 Nov 2018 12:21pm

    Anyone thinking of awarding Capita any contract in the NHS or government in general should automatically be sacked for gross incompetency and negligence.

  • All this help is making me feel a bit ‘hypo’

    Just Your Average Joe's comment 15 Nov 2018 7:59pm

    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!

  • Perfection in an imperfect world

    Just Your Average Joe's comment 15 Nov 2018 7:37pm

    We need to row back hard on the patient has free rein and encouragement to complain as much as possible and over misunderstandings and miscommunication.

    If serious harm, then complaint should be made and investigated, learnt from and ideally shared to try and prevent recurrence.

    A panel to make a fair compensation payment if appropriate when serious harm took place, but in a no lawyer environment so no wasted NHS money defending nefarious complaints from ambulance chasers.

    This is a world were colleagues can continue to work and thrive., and patients will be happier too.

    Recycle all the wasted money from Quangos and lawyers into improving patient care.

  • NHS England says GP practices to blame for over-65s flu vaccine chaos

    Just Your Average Joe's comment 14 Nov 2018 8:13am

    You might find the opening out to pharmacies to give the jab in a haphazard way, so you have no idea how many patients will actually come to you and need a vaccine, so if you over order you will be left holding thousands in stock is the problem.

    Pharmacies still in droves fail to inform in a reasonable time period who they have vaccinated, so valuable time and resources wasted trying to catch people who have already had it.

    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

  • GP point-of-care testing 'effectively reduces antibiotic prescribing in children'

    Just Your Average Joe's comment 08 Nov 2018 8:18am

    Should be provided and distributed free for use in GP surgeries as its use would be offset by savings in prescribing budgets.

    Not free, forget implementation.

  • Just one in 10 locum GPs interested in future partnership role

    Just Your Average Joe's comment 02 Nov 2018 11:28am

    Hire as many trainees as you like - need 2 to replace each full timer retiring,and you still won't plug the gaps fully.

    New trainees don't want to work full time, work long hours, see more than a limited set number of patients, and no Home visits.

    The bottomless pit of partner workload is unattractive, but they don't want the lower limited salary of salaried GP.

    Locuming lets them set their own workload and terms and earnings are higher than salaried - win/win for them - loose/loose for patients and NHS.

    Have to put money into partnership or the same shock to politicians will occur as when out of hours work was underestimated, and huge gaps in funding and provision appeared.

    Partnerships are keeping primary care afloat with loads of extra work, if it all goes salaried, double the number of GPs needed to do the same work.

  • Open Surgery: Recruitment warp drive

    Just Your Average Joe's comment 26 Oct 2018 12:49pm

    And they don't have to have taken or passed the CSA exam!

    Speaking English or understanding the NHS is also usually not a pre-requisite.

  • GPs forwarding mail to Capita are putting patients 'at risk', claims NHS England

    Just Your Average Joe's comment 26 Oct 2018 12:36pm

    The only thing Capita is concerned with is costs not patient safety.

    Capita is the only organisation which is aware of the currently registered GP so should have all inappropriate mail sent to them to redirect.

    Capita is only concerned with the workload and cost this generates for which they failed to cost and include in the tender they submitted to win this contract.

    Capita is a failed organisation which only wins contracts due to high level cash backs and jobs for boys. Despite repeated failures, this allows them to continue to be awarded contracts despite abysmal track records in the public sector.

    So the correct thing is to forward letters to Capita to redirect to the new GP in a timely manner.

  • GPs deal with almost 400,000 dental patients every year, finds study

    Just Your Average Joe's comment 24 Oct 2018 10:33am

    Yes you are risking being sued.

    Dental work should be seen by dentists - but patients are afraid of charges so turn to GPs in hope of free care for antibiotics and analgesia, and hope things will be controlled.

    If if you guide them to see dentists for review, they will say the dentist can't see them for the underlying cause until treated with antibiotics so they want you to prescribe.

    However the danger from this, is that they often do not go to the dentist and simply hope the antibiotics will keep things in check. Things can go wrong or get worse in this time period.

    Simply say no and guide them to 111 who can signpost to their nearest NHS dentist. Save a load of appointments for patients who need them for medical issues.

  • Health boards go into deficit to sustain directly-managed GP practices

    Just Your Average Joe's comment 24 Oct 2018 10:20am

    The DOH and the politicians are slowing destroying the partnership model - and siphoning funding to far more expensive models of care.

    We all know walk in centres are black holes, and APMS contracts were paid at a huge premium to the baseline funding for GMS practices with around 50% extra funding in their money per patient often around £120 per patient.

    Running practices with cheaper Noctors is not cost effective when you try and foist partners work, and heavy patient loads on salaried doctors. Once the simpler cases have been cherry picked by the Noctors, the remaining work can be back breaking and complex.

    Locums are a valuable resource when supply is outstripped by demand. The amount of work partners swallow out of good will, and do above the baseline hours expected, would never be done unfunded by salaried or locum colleagues.

    Rightly so, all those hours extra will be chargeable and will unsurprisingly push up costs.

    It is not too late to put a smaller amount to make Primary care work effectively, than the poison pill to come if the plan to destroy partnerships is continued.