My patient had a Cardiology appointment moved from July 2014 to Feb 2015 when the Cardiologist due to some reason did not come to work when he visited for his 6 month follow up. The service Manager advised me that he can't be seen earlier as they had shortage of Cardiologists at Medway. He was referred to Dartford as urgent where he was seen in October and died 2 days after admission.
This is the new NHS reality, we have no escape! As a GP I had to look into the bewildered eyes of his young children who arrived in UK to collect the remains discuss ask what had gone wrong with their father's care. Till date the CCG has not investigated the matter - it's more than a year and half.
Anything right for GPs can't be right for them- could have been a listing from Murphy's law.
Ever seen a mad dog chase it's tail? That's what turning around may mean in NHSE terms.
BTW, thank you for a 2p per month increase to my patients who appreciate that this government treats them like third class citizens. Much appreciate your governments stance towards deprived areas !
Mr Stevens, don't make promises you can't keep. You have no control over NHSE and that is the reason why this one Practice can't get paid as per Exeter statements. Do you have nay plans to look into manipulation in Exeter payments at local levels? You may wish to start with that else all payments will go to the local Boys' clubs instead of being evenly distributed.
Really raises the question whether we are or not Independent Providers.
The GMS Contract does not give a carte blanche to NHSE to impose pilots and activities not agreed esp as in this case it is a pilot that would be paid for separately implying a service beyond contract.
Go for it and breach it.
Say NO to bullies and rest it on patient safety concerns which you may have getting involved in this due to your Surgery circumstances. I guess that would be the most likely reason why the Practice would be loathe to join the pilot as most do when they have staffing issues or work overload.
Welcome to my world of Kent and Medway...I could compare this with Hillsborough the Hillsborough cover up considering repercussions for Practices.
My patient's always ask me whether the government considers that they don't pay equal taxes or are they in a deprived area and rich areas are eligible for payments. Like the one in posh Esplanade in Rochester with 1400 patients which has been paid for 1600 patients annually? 10 patients less as compared to last April and list is weighted down by 200 patients - no Carr Hill Formula will do that or 15 patients leaving and weighted list reduced by 71 patients.
Why won't anybody look into concerns and given evidence of reason for disregarding Exeter statement data.
NHSE is showing hypocritic concern and when a problem has been raised with Exeter statements showing Total payment units for Practice to be 4700 and last year 4900, this has been disregarded for one Practice in Kent and the PCA in Kent has not been able to explain why they are paying the Practice for only 3600 patients last year and only 3400 this year.
There is a complete cover up with GP not allowed to access HSCIC Helpdesk and PCA having lied once that they raised concern. There is further refusal to give a copy of a 'repeat' call they logged when pressed by HSCIC and myself so one could see that the right issues raised by Practice have been flagged up.
The response to this 'repeat' log from HSCIC was inadequate as it said ' Our software is working properly. So what was the call logged about- the issues raised by Practice or asking them about software function.
This gives credibility to what the Exeter helpdesk had said last year that data of my Practice was being manipulated at the local PCA level.
Total payments payable to Practice were mentioned as 4900 on Open Exeter statements last April and went down to 4700 this year as the list size fell by 10 patient in April this year. This in itself proves that payments are being calculated and should be paid.
What I can't understand is the reluctance of Kent PCA ( now Capita) to clarify and make available to the Practice a plausible explanation and a copy of the call they logged with HSCIC getting an inadequate response.
HSCIC claiming they cannot talk to a GP Practice or take up concerns from a Provider directly. Like the old time, ask NHSE the time and they say 'JH was cool wasn't he?'
I think it's time to talk sense looking at arguments of both sides.
Yes, I would consider encouraging an obese person to lose a bit of weight before hip or knee surgery and would stress on the futility of doing anything if the persons joint crumbles under the increasing body mass post surgery.
Evidence or no evidence, the decision should be made by the surgeons jointly with patients. It is unacceptable that a CCG or NHSE put a blanket rule of fixed BMI. You do have groups of people, for example those with metabolic syndrome or PCO who will struggle to lose weight. What becomes of them?
I'm still relishing his 2p per patient uplift. The rest of the money's gone to the New York banks, has it?
NHS Fraud should crack down on NHSE at local levels as that is where the most likely source of manipulation is as suggested to me last year by an Exeter helpdesk member.
Last year on 1st April the list size was 4003 and weighted list was around 3600. This year the whole uplift was erased for the Practice as the list size on 1st of April was 3992 - 10 patients less but weighted list went down to 3400.
Number of above 75s reduced only by 4 patients but there was a baby boom in the Practice. The Practice that does not have an MPIG should have got most of the 3.2% uplift.
PCA in Kent did not log a call to Exeter when I queried this but sent an email statement that they had done so. After repeated denials by Exeter that they had not had any incident calls logged, PCA logged 'another' call unable 'to find record or number' of the first one. A copy of this call log was never sent to the Practice despite repeated requests.
Exeter response to PCAs log was ' Our software is working normally'
Despite my clarification what was the content of call logged, there has been no response.
There are 5 Practices in the vicinity with a similar population but only one - my Practice -has weightage reduced by 15%.
Three years ago there was a massive attempt by NHSE to force me out of the Practice and an APMS Medical Director 'advised' me to make a deal with the PCT Contractor under the threat of being struck off by GMC via a complaint from PCT. When I publicized this, the Contracts Director instead of explaining he had nothing to do with the threat, sent a letter saying I was 'an unreliable partner for the PCT and therefore my Practice would be closed in 5 weeks. I'm still here and repeating this stale story on this forum.
The fact remains, the effort to strangle the Practice financially by reducing payments, refusing funding even for a stair lift has been on-going since then.
IT IS NHSE THAT NEEDS TO BE INVESTIGATED BECAUSE IN ALL PROBABILITY THAT IS WHERE THE PAYMENT MAYHEM STEMS FROM.
We need transparency and not arm twisting and eye wash.
1. Payment for every patient registered with a Practice. Not acceptable that for a list of 4000 - payment is made only for 3400.
2. Same global sum payment per patient to every Practice.
3. Transparent payment system for services and interest for late payments.
4. Same rent per sq meter in same locality for all Practice.
5. Crown Indemnity for all.
6. Liquidate CQC and NHSE
7. Compulsory declaration of local contracts given to CCG and LMC members' Practices/Federations
8. Payment from 106 moneys from developments to be given to Practices for whom they are given to NHSE with criminal persecution for embezzling of these or using for other purpose.
9. WITHOUT TRANSPARENCY NOTHING WILL WORK.
He was not available for comment yesterday for the ITV news reporter. Trying to lie low after stirring a hornet's nest, eh!
Dilution rather, depends on how you look at it. Irrespective - it's going down the drain vehemently flushed by our leaders.
@3:27- Stoic belief in the system? Oh no, I lost faith in the system years ago when I was hounded by the local PCT and NHSE officials who boasted things like 'I don't care what patients say' and mocked me at meetings in presence of my LMC negotiators with ' Dr Juneja, you are finished, you watch me mate'.
These people are still around me so my belief is one- The system is corrupt at the top and till you don't dismiss the incompetent and conniving lot at the top, you won't achieve anything.
Au revoir it is. I am in the process of finding a replacement and putting the purpose built premises on sale by the end of May. Let corruption prevail because it is sanctioned by the government- it's not for selfless, hard working doctors to fight this phenomenon which has permeated the whole fabric of NHS.
What other explanation can you have if after highlighting that you have been threatened by a formed medical director of a London PCT to accept a 'good exit deal' from the local PCT Contracts Director and leave the Surgery or 'they would get me struck off', I find these people still being promoted? This former medical director who was working for an APMS Provider bragged that he had had a difficult doctor like me struck off in Harrow PCT as he wouldn't play ball!!
Could I still have faith in the system?
Yes, I believe you can turn things around in all situations because this optimism was implanted in my brain as a child and has led me to where I am today still seeking the solitary ray on a soggy day.
My understanding is that most of the GPs feel this way and are clinging on to hope that the aftermath of the crash is nigh and we'll see some progress maybe after a change at the top in government (after the EU referendum?). I wish them luck.
But yes, my time has come as I touch my 55 in September.
Cheer up, you finally got me saying 'finito'!
I think there are certain factors to consider:
1. Yes, there is a shortage of GPs but on the other hand there is a surplus of locums with more moving out from salaried and partnership posts.
2.Locums also choose where they work and they usually get a raw deal with some still earning £70 p/h while the Agencies charge 95-120 p/h.
3. Locums need respect and treatment as equals and they don't like being pushed around so respecting them as professionals helps.
It is easy to get a GP Locum if you treat them with respect and even negotiate with the Recruitment agency to pay them higher rate by reducing their margin. Most of the Agencies are willing to do that if they know they will have a locum for longer term working for them and a client happy to take the doctor on.
Personally, I have been running the Practice with an additional locum for 3-5 sessions weekly for the last 4 years and no problems except at holiday time when it indeed can be difficult.
'...says influential group..The group included representatives from the GPC, RCGP, social services and nursing, and from the Department of Health, Social Services and Public Safety.'
Bright chance they will make a difference after contributing to the present mess.
The thief wants to liquidate competition:)
Whistle away my merry boy,
With happy heart and face of joy...
(in secret services of NHSE)
But what are they looking for?
Heads should roll !