agree it is awful -but I asked BMA Pensions (Pamela Moreland) to act on my behalf and made some progress through the 'complaints' procedure.
Unfortunately there is some truth in both above views. What I provide for my patients (NHS general practice) is less than what I would like for various reasons mainly because what can (not necessarily should) be done for patients has no obvious upper limit.
But what we must stand firm for in the NHS system is that there is little or no financial gain for me in recommending one treatment compared to another, or no treatment at all.
You simply can't say that for private practice.
my AW8 has been accepted :)
there is how I think our French friends would respond to eg 'fourtnightly care home visits'; "bien sur, demain peut-etre" with a Gallic shrug.
The latest missive from Nigel Watson (Wessex LMC) says 'The LMC is very supportive of PCNs...' and 'all GPs would support the 5 service specifications' but 'In their current format we do not think that these are supportive of General Practice'.
PCNs are for trying to help secondary care by keeping patients out of hospital. Thats the easiest way in which their 'success' can be measured. From the government's point of view, in the great NHS scheme of things, General Practice is expendable.
Was recently off for a week with food poisoning and last winter with flu or something. Patients with appointments get contacted to let them know their appointment has had to be cancelled.
Curious thing is they never seem to mind much. It's the getting the appointment in the first place that they rate so highly!!
time to start a serious conversation about how general practice can be replaced. If Pulse want to make me an offer to write an article...
too late to go back to the halcyon days of personal lists of around 1800. The future is to get rid of the primary/secondary care divide and for all newly qualified doctores to work for at least 5 years as generalists and then all to specialise in 2 areas -current GPs like myself are essentially geriatricians and psychiatrists. Higher trained practice nurses will be the fist point of call, the new GPs.
we can't turn back the clock and be 'proper GPs' because the system won't pay enough of us an appropriate hourly rate to do things properly.
General Practice wasn't designed to work with. mostly patients with multiple complex problems and hardly anywhere to refer to.
So the whole system needs redesigning without GPs.
PCN = P retty C rap N ews
Eleanor, can you re-write this article so it is clear?
anonymouse3 you don't work in Gosport by any chance? Sounds like our exact experience..
I think MCCD is cause of.. not confirmation of..
Always been an idealistic also-ran. Think it was destiny rather than choice though.
But don't worry, the PCN-funded pharmacist will solve all these problems....
I remember in the 1980s as a junior doc we were being berated for NOT TREATING PAIN PROPERLY. The analgesic ladder was published in 1986 and eventually anyone at A&E with a sprained ankle or even undiagnosed pain was sent away with some co-codamol 30/500 or similar. And the rest is history.
all these algorithms are the beginnings of replacing GPs altogether: Dr Babyloogle says you need to: take some paracetamol and review tomorrow, see nurse practitioner, see ENT specialist, see physio/dietician/pharmacist, on-line CBT etc etc etc.
I'm not worried about my job -GPs will just morph (if they can pass some proper exam -ie not mrcgp) into the elderly medicine consultants and psychiatrists which themselves are endangered species
Re privatisation; I think all doctors working in the NHS should be having a serious discussion about the future of the NHS (especially with USA chomping at the bit to muscle in after Brexit).
The NHS can't provide, 'effectively free' every known treatment for every known condition.
So we have to elucidate what it is about the NHS we want to save.
I think it is something along the lines of:
The person offering or recommending treatment X (or investigation X etc)should have NO financial benefit (or career benefit etc which amounts to the same thing) from that treatment etc being the one the patient has.
The NHS more or less has this and I don't think any other health system in the world can truly say this.
by the way I don't want to be considered a troll so I just want to mention my real name is Paul Burgess and I work in Gosport
I've been F/T partner for over 30 years and yes the variety of stuff you see must be unlike any job in the world BUT the status of the role, which I think Marshall is hoping can be improved, as still low such that it is taken for granted that you have to try and do in 10 minutes what should really be done in 30 so you have to learn to cut corners knowing mostly no-one will know or care, and patients still see it a fair cop and to whinge and complain about me. And this takes it toll eventually...