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Gold, incentives and meh

Just Your Average Joe

  • Practices will have to provide information requests for free under new legislation

    Just Your Average Joe's comment 19 Nov 2017 6:53pm

    Thanks to Brexit - can we shelve this policy with the Tamiflu left over from a couple of years back!

  • Private provider appointed to run three practices

    Just Your Average Joe's comment 19 Nov 2017 10:52am

    Agree this is a financial question and is about equality and discrimination.

    Why do patients in a neighbouring practice have GMS payments given to their GPs to provide sevices on a much lower tariff per patient than an APMS practice.

    This hugely uneven playing field allows different budgets to be put in place to staff them, with unfair discriminatory problems also, as GMS practices have to offer the BMA contract to salaried GPs but APMS practices for some reason do not.

    APMS practices can suck out the money from a practice and run it into the ground, and hand back the contract as it is no longer financially viable, with not a single thought of what will happen to the patients they leave behind, and what will hapen to them.

    The bottom line is these APMS practices in the vast majority of cases are run to suck out as much money from the NHS and slowly privitise primary care.

    If privitisation is not the goal, then prove it by funding partnerships to have GMS contracts with the same funding.

    If you did look at the pound per patient in every APMS contract awarded (Pulse please to the research/freedom of information requests needed) - why pay for a service with worse patient feedback, and higher levels of admissions as shown by seeing different doctors, and provide poorer value for money!

    Anyone from Mr Hunt, the DOH down to NHS England managers responsible for handing out these APMS contracts should resign - as clearly they are responsible for destroying Primary care piece by piece with these contracts.

    It is still not too late to reverse this trend - but the longer it is in place the harder it will become.

    The bollsh!t that European law requires all contracts to go to tender will hopefully be laid to rest with Brexit, so lets move towards a sustainable Primary care on a even funding.

  • Ground-breaking court ruling paves way for doctors to take GMC to tribunal

    Just Your Average Joe's comment 17 Nov 2017 8:09am

    The GMC is clearly at fault - once the case at the trust collapsed and they were found guilty of discrimination etc, the GMC case should have been immediately dropped - and any common sense involved would have surmised there was no case to answer - and the referral was almost certainly vexatious and part of the campaign against the doctor involved.

    This highlights the robotic, outdated and pointlessly drawn out bureaucratic GMC processes in place.

  • Gabapentinoids to be kept in a safe under Government proposals

    Just Your Average Joe's comment 15 Nov 2017 8:01am

    Really frustrating as pain clinics, psychiatrists and witch doctors keep prescribing these drugs to patients and they think it is a lifelong badge of entitlement to as much of these drugs as they want, and ramp up use to beyond reasonable dosages and claim they are in too much pain or stress to reduce.

    Tried referring to drug team to detox them but patients decline to reduce so they just discharge them back to Gps.

    Time to stop prescribing these meds before its too late to stop the flood.

  • How can it be right to hit us with a £265k bill for premises costs?

    Just Your Average Joe's comment 13 Nov 2017 2:49pm

    NHS Property services are currently being run like a loan shark business, raising rents and charging massive increases in rents like they surgeries are running as commercial ventures with commercial rents.

    Many practices are being caught up and should all send unsigned letters resigning/returning their contracts to our beloved PM via Mr Corbyn and his Wednesday PMQ session and raise the public profile of this problem.

  • Almost two-thirds of GP practices will see funding boost from new contract

    Just Your Average Joe's comment 13 Nov 2017 2:34pm

    80000 a year for 40hr a week over 52 weeks - works out at less than £40 pounds an hour.

    Sure that it sounds like a good idea to health board who would have to take over returned contracts and pay at £100 plus an hour for just surgery time - so all the behinds the scene work, visits etc would need separate funding/people to do the work.

    So 80000 a partner looks like the cheap option - sadly the 20% of colleagues for whom this is an uplift - need to be valued greater and paid their worth regardless.

  • GP minister: ‘The health system is Ponzi-like: we need honesty’

    Just Your Average Joe's comment 09 Nov 2017 11:32pm

    Worry about NHS pension - waste of energy as it will be unilaterally changed by governments until you get it on the day you die, after doubling the amount you pay, taxing your contributions twice by also reducing and taxing lifetime allowances.

    Ooops! its all happened already, apart from the 1st bit - just wit for it though.

  • Revealed: How online GP company Babylon can sign up millions of patients

    Just Your Average Joe's comment 09 Nov 2017 11:20pm

    I am going to get a stack of Babylon leaflets and hand it out to patients who want repeat prescriptions for controlled drugs, sleeping tablets and those who are suicidal and ring for advice at 6.24pm.

    They are all part of the population who will benefit from 24/7 access to a GP.

    Also the ones who come in with a sore throat for 27 mins, and the just in case brigade.

    Once I help them find the access they strive for, I will open up some space to see the chronically sick and unwell - what I trained to do!

  • Online GP provider makes push for patients to switch from their practices

    Just Your Average Joe's comment 09 Nov 2017 11:19pm

    I am going to get a stack of Babylon leaflets and hand it out to patients who want repeat prescriptions for controlled drugs, sleeping tablets and those who are suicidal and ring for advice at 6.24pm.

    They are all part of the population who will benefit from 24/7 access to a GP.

    Also the ones who come in with a sore throat for 27 mins, and the just in case brigade.

    Once I help them find the access they strive for, I will open up some space to see the chronically sick and unwell - what I trained to do!

  • 'We have a number of serious concerns about the GP at Hand service'

    Just Your Average Joe's comment 09 Nov 2017 8:21am

    This should have discussed and resolved before they were given the go ahead for this model and started their advertising campaign.

    They didn't as they knew it is harder to put the genie back in the bottle.

    Whoever authorised this should resign immediately.

  • 'We have a number of serious concerns about the GP at Hand service'

    Just Your Average Joe's comment 09 Nov 2017 8:18am

    This idea will potentially lead to other practices folding, as they will have to cut staff as they will loose capitation from young infrequent attenders which effectively subsidises care for the sick, elderly and care home patients.

    Also the less heavy worload of the type of patients which sykpe can deal with, are exactly the shorter easier consultations which subsides the multimobidity complex patients with 4 problems that allow 10 minute consultations to continue without being soul destroying for a GP.

    Unless the funding for this Worried well and potentially NHS destroying policy is found elsewhere and turns this Babylon project into another White elephant Walk in like situation. There it just unearths hidden unmet demand - and duplicates services already given, where they are told see your GP for review/examination anyway often.

    Destroying the NHS piece by piece, and this will take another chunk.

    Cynically the thought of a 10 m boundary and take all young patients and leave sick and elderly without care will be the future if the precedent of Babylons model of discriminatory care is not stopped now.

    Of course NHS England will try and allocate patients to other practices, but Babylon will be allowed to cherry pick easy work, which is exactly what the private sector did when sent in to help hospital wait lists and took all the quick easy cases leaving the sick and challenging cases for NHS trusts, unbalancing their books, leading to deficits as they couldn't earn money from the easier cases.

  • Revealed: How online GP company Babylon can sign up millions of patients

    Just Your Average Joe's comment 09 Nov 2017 8:13am

    This idea will potentially lead to other practices folding, as they will have to cut staff as they will loose capitation from young infrequent attenders which effectively subsidises care for the sick, elderly and care home patients.

    Also the less heavy worload of the type of patients which sykpe can deal with, are exactly the shorter easier consultations which subsides the multimobidity complex patients with 4 problems that allow 10 minute consultations to continue without being soul destroying for a GP.

    Unless the funding for this Worried well and potentially NHS destroying policy is found elsewhere and turns this Babylon project into another White elephant Walk in like situation. There it just unearths hidden unmet demand - and duplicates services already given, where they are told see your GP for review/examination anyway often.

    Destroying the NHS piece by piece, and this will take another chunk.

    Cynically the thought of a 10 m boundary and take all young patients and leave sick and elderly without care will be the future if the precedent of Babylons model of discriminatory care is not stopped now.

    Of course NHS England will try and allocate patients to other practices, but Babylon will be allowed to cherry pick easy work, which is exactly what the private sector did when sent in to help hospital wait lists and took all the quick easy cases leaving the sick and challenging cases for NHS trusts, unbalancing their books, leading to deficits as they couldn't earn money from the easier cases.

  • A noble RCGP cause we can all get behind

    Just Your Average Joe's comment 05 Nov 2017 8:53pm

    Saving hours and hours of preparation time writing pointless evidence to prove your alive and neurones fire when you think/learn - write down what you thought and felt as you did it.

  • A noble RCGP cause we can all get behind

    Just Your Average Joe's comment 05 Nov 2017 8:52pm

    Scrap them - have a appraiser come and watch you in a half day surgery live with patients - it would take the same amount of time and they would see exactly what you can do, and what your knowledge is and what you do if you don't know something. Cost for appraiser same as current report and time equal or less.

  • GP leaders prepare for explosive vote on practices leaving the NHS

    Just Your Average Joe's comment 05 Nov 2017 8:46pm

    This is what Politicians have been aiming towards for years now.

    The whole US transatlantic trade agreement required the opening up of the NHS to private markets.

    This is the wrong step - despite my support of a free NHS, it is not feasible with current demands and expectation, stoked up by CQC and marketed rights for complaints for minor issues and when patients feel kicking the practice for things outside their control (Ie Referral blocked by CCG referral triage services)

    Sadly I feel no choice now - its time for co-payments of £20 pounds a consultation for walk in patients to GP, free if we call them in for chronic disease checks.

    Same with A&E - £100 walk in charge - refunded/waived if significant medical problem which did require admission.

    For those who want to consult 3 imes for every cough/cold etc they can but the time wasted is paid for, the rest get the same level of service with shorter waits for the remaining unwell patients who would have struggled for appointments.

  • GPs to test patients' blood before prescribing antibiotics in pilot scheme

    Just Your Average Joe's comment 05 Nov 2017 8:36pm

    Anyone stopping the antibiotics pouring into our livestock and farming production?

    GP antibiotic prescribing is a drop in ocean of that unregulated use.

  • Trusts to have three GPs in A&E streaming service at one time

    Just Your Average Joe's comment 03 Nov 2017 8:16am

    The GP in A&E - will start acting like A*E team - due to medicolegal risks - if something goes wrong - 1st question will be why didn't you do bloods/xray when freely available in the department - this would have changed outcome!

  • Trusts to have three GPs in A&E streaming service at one time

    Just Your Average Joe's comment 03 Nov 2017 8:15am

    GP reception: We're full. Go to A/E.A/E GP: This doesn't look like an A/E issue go to your GP.


    Actually - what needs to happen is - there is nothing seriously wrong with you - go home and rest/recover, and don't come back with self limiting Cr0p please. See pharmacist, or get help from your gran or online etc.

  • Thanks, Jezza, for the gift we never wanted

    Just Your Average Joe's comment 26 Oct 2017 10:45pm

    Just use the B%115h1t that comes out of JH's mouth when he speaks - many part of the 3rd world rely on just that for fuel.

  • Practices forced to re-open lists in crisis area leading to patient safety concerns

    Just Your Average Joe's comment 26 Oct 2017 12:53pm

    If all the practices handed back contracts and resigned - leaving providing the care in the hands of commissioners - and then they had to find staff or leave practices with no care - in a difficult to recruit area market forces would come into play.

    If no-one was prepared to locum for under £200 per hour (perhaps initially more realistically £150 per hour), then the same GPs would be paid to do some work, and loose the stress and day to day worries of targets, QOF and enhanced services etc, and just do a session's work and go home to rest.

    There are not enough GP's in the UK and perhaps this is the best way for GP's to be valued at their true worth, rather than begging JH and DOH for an extra couple of pounds, when millions are wasting in pointless reorganisations, PFI black holes, and hospital deficits.

    I am a long standing supporter for partnerships, but sometimes you need to loose something you value before its real worth is known.

    A few brave souls who take this path and just like the measly amount the DOH valued OOH provision, they will realise the true cost of handing partnership contracts to Private providers who are given huge APMS premiums which are not available to GMS/PMS colleagues.

    APMS practices can take £125 per patient as a baseline when GMS is sitting on less than £80 for providing GP services - hardly a level playing field.

    If practices did hand back contracts GP funding would need to double to provide a much poorer and hap hazard level of care.

    If anyone with a brain from the DOH is reading this - act now to save the NHS by investing in the partnership model.