Please consider net profit rather than gross income when signing up to this new Network DES. The 7 new national service specs, plus the Investment and Impact Fund conditions, will need huge amounts of extra work. And check clause 7.8 about the Balancing Mechanism to reduce GP partner earnings.
Clause 7.8 describes the new Balancing Mechanism whereby GPs earning too much will be penalised the following year by cuts to their global sum. A marvellous way to improve recruitment and retention.
@d in vadar NHS GP health does help people who are less severely unwell and in fact about 75% of patients are much lower level mental ill-health i.e. anxiety, depression, burnout, physical illness impacting on ability to work, stress relating to life events/GMC complaint etc.
Like treating bleeding oesophageal varices with a mop.
NHS GP Health already exists and has been very busy since it started in 2017. It's being rolled out for all doctors soon.
NHSE/'The Centre' fails to recognise how its culture of blame and fear is at odds with its alleged desire to create psychological safety within the NHS.
Myriad reasons are behind why these very resilient individuals are now breaking. It will take many systemic changes to mend things.
We need to look at places and practices where GPs aren't breaking, and ask why it's working.
What are thriving practices doing well? There are some around - what's their recipe?
Is core general practice a loss leader now? It's clear that the value we're adding as GPs isn't widely understood - how do we measure what we're doing and get paid for it?
No good deed goes unpunished in the NHS. I hope the arm-twisting was accompanied by a significant premium to attract clinicians to the service.
Matt Handapp and his digital cock - you have surpassed all previous genius with this Dr C. I am still giggling. But then, it is my lunchtime...
How about 2020 GPs by the year 5000.
If it doesn't cover GMC hearings, what does it cover? And if you found yourself charged with manslaughter, like Hadiza Bawa-Garba, you wouldn't be covered either. I think I'll stick with the day job, ta.
I think everyone in Salisbury is seeing their GP about neck pain from looking up at that 123 metres of magnificent spire.
Mass individual resignation will happen instead. Meanwhile BMA relocates to the Atacama Desert to facilitate further powder dessication.
The rigid working pattern of being a partner or salaried GP mean that I won't ever return to full-time GPing. Locum Chambers offer peer support and some stability but most importantly flexibility e.g. I can choose 12-20 minute appts (unlike retainer scheme), work less in school hols, work during a school day, and then much more intensively some days/evenings to minimise childcare costs. I don't want to risk personal bankruptcy,so left before I was the Last Man Standing. I also want to minimise my indemnity by doing other non-clinical work and some non-NHS work. There's no point doing more clinical GP sessions if you pay a higher indemnity, higher pension band and overshoot your annual pension allowance. Look at profit per hour, not income, and the maths massively disincentivises partnership. The aren't just two options. Many GPs are making a personal choice to save themselves, after much sacrifice of their own health, and they will not be tempted back by either the Watson model, nor the salaried industrialised cog model.
Have a look at the reGROUP study which Exeter Uni are doing. The accumulating evidence suggests that larger practices, with a greater mix of staff, are more likely to fail. This is industrialised, dehumanised primary care, and those 120 GP chairs are going to be challenging to fill, since essentially you will be a GP cog in a large Primary Care Machine, with little autonomy and control, except via your contract.
What I'd like to know is how to stick to the low carb diet given the toxic food environment. The willpower required is incredible, in the face of a busy lifestyle where availability of good quality low carb food can be sparse e.g. inner city corner shops where a cheese slice and a packet of peanuts are your best option. I've seen this diet work brilliantly for patients with fatty liver and Type 2 DM but it's sticking to it that's the challenge, for them and me!
GP federations could sort this for 30-50,000 patients but privately. £20 one ear, £30 for two.
Most stigmatized of all are doctors with mental illness. I know GPs who have been severely depressed and suicidal, yet their partners describe them as skiving or inadequate, even subjecting them to a practice meeting where their mental health was assessed, like a nightmarish occupational health appointment. Start with our own stigma about our own mental health: self-care and self-compassion to begin with. GPs are emotionally drained and exhausted, so how can they deliver mental health support to their patients?
You can offer all you like, Ara, but I'll stick with my locum Chambers, thanks.
Everyone has a magic idea to mend general practice - we need multifaceted solutions not just random untested ideas.
10,000 new practice staff - but where will they all sit? And where is the evidence to say they don't cost more in the long run, and increase the demand on other practitioners. A 'micro-team' is all very well, NHSE, but where does the buck stop and who pays the indemnity?
GPs will have to have a portfolio career from the start of their careers to provide variety and protection from burnout over a 40 year career. GPs also need the equivalent of SPA time. But who will run these partnerships except GPs from wealthy backgrounds, as all others will struggle to get loans on top of mortgages after qualifying with huge debts. Who wants to risk being last GP standing? We have to rethink the model of a GP just sitting in the same room seeing the same patients for 40 years as very few young drs want to sign up for this. There are so many systemic factors causing the demise of GP: a few lone improvements will be ineffective, even if the funding improves.
This, next to the headline about how too few people are prescribed anti-coagulation for resolved AF. Prescribing too many antibiotics for 'viral' infections - naughty GPs! Prescribing too few antibiotics for sepsis - naughty GPs! Rocks and hard places...