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Gold, incentives and meh

Just Your Average Joe

  • GPs team up with hospitals to take over health budgets for 200k patients

    Just Your Average Joe's comment 17 Jan 2018 9:01pm

    'Dr Sanfey said the budget for the population of 212,000 has yet to be finalised but could be between £200m and £300m.'

    GP712 stole my thunder!

    the difference between 200 and 300 million is a whopping increase of 50% of the original budget.

    If the NHS had 50% of the original budget - the NHS managers would be awarding themselves pay packets like the bust Carillion. No wait they do that already!

    Seriously they ridiculous range of financing could make something work really well if baseline cost 250 million with 50 million being used innovatively to improve care (with 300 total), or if baseline cost 250 million, and only 200 million budget, would mean overspend and deficit of 50 million, and sacking of all involved.

  • GP trainee claims he was reprimanded after highlighting A&E safety concerns

    Just Your Average Joe's comment 17 Jan 2018 8:52pm

    Where the F*&7 are CQC in all this winter crisis?

    If they visit almost any hospital in the South East - it is like a war zone, and can't imagine a single hospital would pass inspections with patients lying on floors in corridors, with no access to beds, oxygen, call buzzers etc.

    Staffing levels down and operations cancelled causing huge negative feedback and distress for those involved.

    All because some DOH moron decided to close beds in the past, which roughly equate to the number of beds we are usually short now.

    Nurses down, no thanks to removal of the nursing bursary and pay freezes for NHS staff.

    So again I ask where the f&*7 is the CQC?

  • GPs asked to prescribe antivirals to 'well' patients in care homes to prevent flu

    Just Your Average Joe's comment 11 Jan 2018 12:23pm

    1 - This is not a core service, so Don't do it as it is unfunded, and even if they offer funding see 3.

    2 - There is no proof the Tamiflu even works with the current outbreak.

    3 - Do no harm - there is potential harm from Tamiflu in well patients, as the side effects are unpleasant, sometimes can manifest as bad as the flu itself.

    4 - There is no capacity in Primary care to offer this without harm to usual patients who may not get the care they need.

    5 - Public health has doctors and nurses sitting in their ivory towers - free to go to care homes and do this work if they wish it to be done.

    6 - Simple - Problem solved.

  • 'Close to collapse' GP practices cut clinical services and routine appointments

    Just Your Average Joe's comment 10 Jan 2018 9:51pm

    Payment for work - not block contract - no incentive for DOH to stop dumping work on GPs as free and secondary care paid per service provided.

    We need a payment system that matches workload

  • Mr Hunt, your apologies won't help those waiting for surgery - like me

    Just Your Average Joe's comment 09 Jan 2018 8:22am

    Best wishes for your health and hope your operation goes ahead soon and successfully.

  • Civil Litigation Bill could lead to increased GP indemnity costs, MDDUS warns

    Just Your Average Joe's comment 06 Jan 2018 12:54pm

    Take all lawyers out of medical negligence claims - have an independent panel that assesses cases and awards compensation like the criminal injuries system.

    No lawyers and faster payouts where deserving, and stops chancers as the panel will stop speculative claims, and pay where harm has occurred.

    Simple and effective and would save money by the billions.

    What chance politicians looking out for their legal system buddies will put this in place? None as they are corrupt like the 3rd world dictators they look down their noses upon.

  • Revalidation – why it is time for a rethink

    Just Your Average Joe's comment 05 Jan 2018 8:25am

    If a large percentage of GPs just refused to do it, they can't stop thousands of GPs working and replace them, so it would die its own death.

    Non compliance would kill it, if only enough would do this at the same time to stop the ivory towers picking off the brave few souls who set the process in motion.

  • ‘Revalidation doesn’t make us better GPs’

    Just Your Average Joe's comment 05 Jan 2018 8:25am

    If a large percentage of GPs just refused to do it, they can't stop thousands of GPs working and replace them, so it would die its own death.

    Non compliance would kill it, if only enough would do this at the same time to stop the ivory towers picking off the brave few souls who set the process in motion.

  • Online GP providers to start receiving CQC ratings

    Just Your Average Joe's comment 04 Jan 2018 1:21am

    Would love a freedom of information request looking at prescribing practices of online GP services vs CCG targets and local practices.

  • How will AI chatbots cope with the heartsink patients?

    Just Your Average Joe's comment 19 Dec 2017 9:54am

    Quality!

  • ​Anger as GMC tries to overrule its own tribunal and strike off junior doctor

    Just Your Average Joe's comment 06 Dec 2017 2:15pm

    When 74 errors made by organisational failures are kept from the jurors as issues resolved! how was her conviction for manslaughter even fair!

    She worked and learned and did good for many over the 5yrs she continued to work - hopefully rebalancing the scales massively towards helping people to outweigh any horrendous error she may have made - when working under pressure, and potentially without senior support herself.

    She never should have been convicted, and this double jeopardy farce from the GMC shows exactly why it is not fit for purpose and should be scrapped, and all Doctor payments should seize for this kangaroo court of discriminatory and rabid behaviour towards colleagues making errors, not malicious acts.

  • Practices should remove earwax causing hearing loss, NICE recommends

    Just Your Average Joe's comment 06 Dec 2017 12:27pm

    The 'Ivory Tower Experts' have done their cost analysis and it came out at the record lowest amount in their history.

    Foist the ear wax removal onto GPs never ending open contract and it will be done for free - forget the fact its not part of the core contract and there is no payment/resources/expenses/medico-legal cover for this.

    Commission a service for ear wax -and then the money saved from referrals to secondary care - would fund Crown indemnity for all GPs and NHS staff.

  • The real problem with Babylon

    Just Your Average Joe's comment 02 Dec 2017 12:47pm

    Babylon is a private company not a NHS GP service - poaching from precious NHS resources.

    Nigel I feel you are missing the point or underplaying it.

    Advertising has never been permitted in the NHS, nor has poaching patients from your colleagues practices in blatant underhanded ways - ultimately likely to lead to destabilisation of those practices and potential folding of essential services for all other patients.

    Yet adverts for this Babylon service are plastered everywhere and are already stealing patients from other practices - but only the nice and simple ones who probably need almost no real effort to look after, and minimal resources, hence the set up of this service.

    I am not a Luddite and am willing to embrace change within the NHS - but there has to be a fair and level playing field for all - and services which are non discriminatory for patients - or the same advantages available to all NHS GP practices (though this is not good for patients).

    For every fit and young patient of working age they steal - they are paid the GMS fee - which is taken from another practice. The all you can eat buffet contract currently in place in Primary care - is set up on the foundation of payments for patients is a standard set fee(aware of some weighting - but this is in reality a million miles from true cost to practices of the needy).

    If those patients rarely attend, and cost minimal resources, then that time and resource subsides the frequent attenders, young and unwell, elderly and palliative, and housebound - most of which need huge costs or time and manpower. They are only financially within GP's ability to look after as the subsidy from young/fit patients allow at economies of scale cross payment for that service to continue.

    Loose resources as Babylon takes the cherry from the cake - and the young/fit are no longer available to subsidise the ill/needy, then you would not have resources to maintain GP's or nursing/support staff.

    The remaining patients demand and need would outstrip what the practice can safely offer, and may mean they simply would be swamped with lower staffing levels, and some patients could no longer be seen at home, just because there are not enough hours in the day, and too many complex patients left - leading to potential burn out, and higher hospital and A&E attendances as services start to fail.

    Many overwhelmed practices would find it equally helpful to be able to tell patients wanting to register that they may not be suitable for the practice - turning away the pregnant, the needy, vulnerable, the elderly, housebound and palliative. All the patients who need lots of time and care.

    Since Babylon have a NHS practice to support them, they should be providing this back up services for any patients not suitable for their on-line service.

    No Babylon is not the final straw to break Primary care in its current format, but it could be another large and deep cut, of those thousand small cuts that are slowly bleeding it out.

    There is solution where Babylon subcontracts its services - and as example its 5 pound a month (60 pound a year private fee) could be subsidised and negotiated with a practice, to subcontract out this additional option for patients within their own practice to have access to on-line services, but that would be down to a practice to sign up to this, and would be less destabilising to the whole GP market.

    This would be harder for private companies such as Babylon to penetrate the market and is likely against the politicians privatisation agenda - required as part of the dormant trans-atalantic trade treaty with the US.

    Allowing Babylon to continue as it is - is breaking the stability within primary care - and will eventually lead to severe harm to vulnerable, elderly and housebound patients as the service as it is will become non viable, and a move to payment by interaction - which insurance and private companies desire will be closer to realisation, but financially impossible for the NHS - eventually leading to privatisation by the back door (exactly as some politicians have planned all along).

  • Proper state-funded indemnity would reduce NHS demand

    Just Your Average Joe's comment 30 Nov 2017 10:48pm

    So many politicians lawyers, and others owe their re-election funds to lobby and special interest groups.

    Lawyers make millions out of long protracted cases so no impetus to change status quo.

    Medical compensation board independent and lawyer free would cut red tape, save millions if not billions in wasted legal fees, and speed up compensation to deserving wronged patients.

    This would also stop fishing expeditions from people looking to exploit the NHS and the no win no fee brigade.

    As it is cost saving and eminently sensible - not a hope in hell JH or this Tory government would put this in place, and use savings for crown indemnity for all NHS staff and recycle rest of savings into patient care.

    Win/win for everyone if they did something altruistic and patient focused now.

  • Even Mugabe might have got the message by now, Mr Hunt

    Just Your Average Joe's comment 27 Nov 2017 8:34am

    Hunt is still owned by Murdoch!

  • Even Mugabe might have got the message by now, Mr Hunt

    Just Your Average Joe's comment 27 Nov 2017 8:33am

    225 parliamentarians have recent or present financial private healthcare connections
    145 Lords have recent or present financial connections to companies or individuals involved in healthcare
    124 Peers benefit from the financial services sector
    1 in 4 Conservative Peers have recent or present financial connections to companies or individuals involved in healthcare
    1 in 6 Labour Peers have recent or present financial connections to companies or individuals involved in healthcare
    1 in 6 Crossbench Peers have recent or present financial connections to companies or individuals involved in healthcare
    1 in 10 Liberal Democrat Peers have recent or present financial connections to companies or individuals involved in healthcare
    75 MPs have recent or present financial links to companies or individuals involved in private healthcare
    81% of these are Conservative

    http://socialinvestigations.blogspot.co.uk/p/key-facts-of-lords-and-mps-connections.html

    Old but shows how deeply rooted the corruption in out political system runs.

    Lobby groups have power and influence which cannot be justified when MPs are meant to represent the electorate not line their pockets.

  • CCG launches #helpmyGP campaign

    Just Your Average Joe's comment 27 Nov 2017 8:22am

    DOH won't take responsibility for this in case something goes wrong - easy to make it a GP problem like they used to do with antibiotics - thankfully they finally relented with national campaign advertising reduction in antibiotics - same needed for this or other changes.

  • Four clinical signs can improve GP pneumonia diagnosis, finds study

    Just Your Average Joe's comment 25 Nov 2017 11:31am

    Bear Woods

  • GP numbers decrease by more than 1,000 over past year

    Just Your Average Joe's comment 22 Nov 2017 8:25am

    Sad truth is that male full time partners are being lost, and replaced by new GPs coming out - who are wanting to work part time at best, or sessional work or go abraod.

    1 out is not being replaced by 1 in -actually 1 out needs around 2 in to replace the number of hours worked!

    Please don't shoot me - but with predominantly female GP trainees wanting a work life, and family balance, you are never going to get 1 out/1 in.

    So those 5000+ new GP and replacing the additional losses - actually needs closer to 10000 new GPs!

  • GPs asked to do early home visits to avoid 'surges' of patients at A&E

    Just Your Average Joe's comment 21 Nov 2017 8:32am

    It is very difficult to sort out the pointless from the needy these days - with carers requesting visits - just in case.

    Add to that, guilty relatives living hundreds of miles away and never see their 'loved ones' who live alone, also calling for visits so someone (a GP) can check on them, when all they need was someone to help look after them when they are poorly, but not so unwell they would need a GP/hospital if they had family around.

    Home visits are no longer viable - we have so many requests it takes all day to get through them.

    A visiting service commissioned and run by CCGs is the only solution, as a flat change to force families to bring them in won't work as there are often none locally any more.