Nikki, I am sorry to burst the bubble in which NHSE PCN directors live, but I don't think any of the specifications in the draft DES were offering "evidence based improvements". There isn't a single GP I know who is "broadly supportive of the aims" (of this wacky proposal).
Last sentence holds the anticipated punchline.
Other LMCs have now done own analysis and issued advice.
Essentially- don't sign up to this madness until negotiations have been completed.
In it's current form this DES is unworkable lunacy, as far from reality in England, planet Earth, as is the subject of this analogy, the moon.
This can not be accepted by any GP, even one session of patient facing activity per week "leader", or even half brain dead, traumatized, over worked worker-bee, no time for reading any bs proposals, let me just sign and get on with it- usual GP.
The future is bleak and uncertain under the rule of this delusion. We may get responsibility for OOH and God knows what else.
No- is the only answer I am prepared to offer.
This DES should be rejected until something meaningful is negotiated by GPC
"Finally, the pension tax paid by the few GPs who are still seeing patients will result in their being forced to sell their homes and move in with their children."- which might result in those pesky GPs actually living longer due to not suffering from effects of loneliness and social isolation. Something would need to be done about that!
In last two years I have given references to three GPs who have emigrated to Oz and Canada, and I personally know two more who have also done so. That's probably around a quarter of GPs I know personally or work with. Good luck to the rest of us who are still here for whatever reason
Should Carr-Hill formula include not only patient demographics, morbidity eyc, but also doctor's posh factor? What impact on funding should it have?
It's a very good and thought provoking article. But it takes us to questions with no answers
Great! I shall carry on with my usual practice, which is not to prescribe this bs pseudo-medicine, as per usual
Harry, thank you, for typical examples of reasons for (home visits) requests. Few years ago, we agreed a policy that in our practice reception and triage nurse discussed requests for visits with duty Dr before it was offered to patients. It has cut numbers of home visits by some 90%, just asking if patients are really housebound or had real medical need. Like someone said, grow a spine and decide where you are needed most...but work would be better if this unnecessary distraction (visits) was completely removed.
I am glad that some of us enjoy the support of community nursing, palliative care, frailty teams, as evident from Dr Cannon's article. But what about areas that do not have such support? Where I work, in Wiltshire, there is no functioning social services or district nursing team. We don't know who our palliative care nurse is and local Hospice ignore our referrals. Acute services are so crap that patients choose not to bother with attending AE even with barn door obvious life threatening symptoms like collapse/bradicardia or cardiac chest pain. We spend endless hours seeing these patients and trying to magic up some safety nets around them. I simply don't have time to drive half an hour each way any more.
way I see it, there's no problem with the duration of training. Learning doesn't stop after qualifying. There's a problem with unrealistic ludicrous standards of RCGP assessments, which give trainees a skewed view of real practice. Turning them into protocol droids, portfolio social workers, anything but GPs. Of cause we also live, and practice, in the age when it is incredibly difficult to act as good doctor. Much easier, and safer from medico-legal prospective, to follow a policy, guideline, protocol.
Populist and short sighted idea. So when wanacry 2 strikes and all fancy new software is down, and I am unable to send an urgent referral digitally or by fax machine, I will suggest my patients who is responsible for delays in their assessments or treatments.
Matt, mate, my best advice, go back to playing Fotnight, this is all you seem to know. Best to leave grown ups to do grown up job.
thank you Prof Majeed for highlighting this abhorrent practice by our regulator. Just illustrates what I thought all along: GMC do not consider Doctors rights to be as important or equal to Patient's rights.
I don't know... just because (mostly) poorly educated on the topic of European integration majority voted to leave, doesn't mean that any opposing views should automatically seize to exist. And it is reasonable for body like RCGP to be concerned with questions of workforce planning in general practice and with patient safety too. Both would probably be adversely affected by Brexit. Brexiteers seem to show a lot of concern about democratic process where it comes to respecting the result of the referendum in 2015, but have no problem shutting down any (democratic) debate about very legitimate concerns about problems that Brexit will bring.
Headlines should say: "UK patients ten times as likely to eat pork pies (in massive quantities), smoke and drink excessively as those in Japan"
Bet dreaded GMC would make one reflect and convince themselves that it's all their fault for daring to disagree/upset/not fully satisfy the client. After all, Client is always right.
After gimmicks of BG case, I expect anything from that bunch.
Stabbed in your surgery?!!!
That's indescribably horrible
dumping will continue, but may change from direct requests to more of "I hope your GP would be agreeable to refer/book/follow up"
This boy visibly enjoys his toys. Doubt he understands much about healthcare or NHS (with its many problems). Doesn't really inspire confidence.. no more than Teresa's brexit preparations