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Gold, incentives and meh

Richard

  • Are there too many posh doctors?

    Richard's comment 04 Dec 2019 7:27pm

    More social diversity would be good.

    But sadly huge Student Loan and commodification of students by universities has pushed this completely the other way.

    Only families with significant parental finances to fall back on (which doesn't necessarily equate to posh) can afford the risk of their kids going to Med School and long uncertain career paths.

  • Further small practice set to close in crisis town

    Richard's comment 26 Nov 2019 6:28pm

    Not once you've nominated a CQC registered manager, practice manager, equalities lead, safeguarding lead, contructed a respect anti-terrorism policy, provided 8-8 care, joined a PCN -no time to see patients.

  • CQC chief inspector: no 'concessions' will be made for GP capacity issues

    Richard's comment 31 Oct 2019 10:27am

    CQC should be there to help, not shut down practices. CQC has a large funding and manpower resource- let have some of this on the frontline.

    Their resource needs to be put into practices in areas such as Plymouth to prevent GP services collapsing. GPs don't need to be taken "out of class" for long periods of time to be "told to do better".

    We need an input of additional hands on the pumps. CQC staff could actually be useful - rather than filling in reports and tying up frontline staff in meetings.

  • GPs will not be legally liable for firearms licence approvals

    Richard's comment 25 Jul 2019 8:51am

    Sorry - if GPs are to part of the process, they need payment from the Police / licensing authority. End of.

    There is a charge for a licence- some of that has to come back to GP for the costs incurred +/- liability.

    GPs should not have to be put into a position of conflict (i.e. demanding money) with gun owners who they believe should have weapons licences removed.

    In my view, user pays.

  • GPs must diagnose and treat lyme disease on basis of rash alone, NICE says

    Richard's comment 18 Jul 2019 11:36am

    What about the myriad of patients who have had a tick bite who have a bit of erythema and are well and who don't have the bulls eye rash (yet).

    Do we a)give antibiotics to all b)wait for bulls eye then treat c) test d) Review in a few weeks and test then. e) retest.

    Clearer guidance needed!

  • CQC closes practice following unannounced inspection during Eid

    Richard's comment 10 Jun 2019 6:26pm

    I can't see many circumstances where closing a surgery would make the situation safer for the patients than keeping the surgery and improving it.

    This is a great shame for the practice and patients involved. The report may shed more light.


  • BMA in daily talks over 'extremely damaging' Scottish pensions costs hikes

    Richard's comment 17 Apr 2019 7:50pm

    Another outrageous money grab by the UK government.

    "We are giving the NHS more money" - but taking it back from the employers (Trusts and GPs) by hiking Employers superann.

    The Scape rate increase that this methodology is based is a fiddle. If DOH were genuinely concerned about the NHS scheme not having a fund -they would be investing the additional money in such a fund.

    The scheme is in surplus- no need for a hike.

    Taxing the scheme like this causes members to leave, and then the scheme implodes.

    We will deliver 2% pay award to GP (then have 6% back in superann).

    They really do want GP practices to fold.
    England may have negotiated this for one year, but negotiations need to get going fast on this one.

  • Health secretary given right to suspend GPs' pensions before conviction

    Richard's comment 17 Apr 2019 7:42pm

    Its up to the courts to award financial penalties IF a criminal is found guilty- not the whim of the Health Secretary.

    DOH are very unwise to get involved starting these witch hunts.

    Stopping a pension only punishes the innocent dependants.

  • RCGP received 'significant' donation from Sultan of Brunei in 2013

    Richard's comment 08 Apr 2019 5:15pm

    I'm with you Stelvio.
    Take the gong back.
    He doesn't need the money mind.

  • Dr Bawa-Garba's fitness to practise 'remains impaired', tribunal rules

    Richard's comment 08 Apr 2019 5:13pm

    Great- what a stitch-up.

    So she can't practice because she has been forced to not practice for 3 years while being investigated.

    So innocent or guilty, right or wrong -your career is over, just because "s**t happens" on or near your watch.


  • New data tool will allow GPs to compare antibiotic prescribing against national rates

    Richard's comment 05 Mar 2019 4:46pm

    The problem is knowing which prescriptions were unnecessary.

    Easy in retrospect, much harder at the time.
    We will be the ones in the coroners courts, not the policymakers.

  • BMA in talks over who will foot bill for pensions contributions hike from 2020

    Richard's comment 05 Mar 2019 4:31pm

    This is welcome news for one year- but the whole uplift thing seems to be to be as scam.

    The SCAPE discount rate -a complex fudge mechanism set by the treasury, was set up to compare the value of a state backed scheme (without a fund) like the NHS, with a private invested pension fund. This is just a notional comparison that was supposed to be reviewed 5 yrly. If interest rates drop, a private pension fund returns might drop, and so the amount needed to obtain the same pension goes up.

    The NHS scheme was said to be in surplus when employers contributions were set at 7%. This should be even more so (so long as members haven't all left). So there is no need to keep reducing or applying the SCAPE discount rate, which was reduced 2 years ago.

    It would appear to be being used as a clever way of seeming to invest more in the NHS, but extracting it back our of trust in the form of NHS employers contributions. Usual smoke and mirrors stuff.

    If this is extracted in 2021, it could wipe out most of the gains of the new contract review.

    The balancing agreement needs to take this into account- i.e. should be two way.

  • 80% of GP antibiotic prescriptions for respiratory conditions 'are too long'

    Richard's comment 01 Mar 2019 3:16pm

    We are all agreeing! Who writes these guidelines?

    3 day course of UTI don't work - generate multiple appointments. I've never met a GP yet who agrees.

    Only OOH services and Pharmacists give 3 day courses- but they never have to see patients again -they come to us.


  • LMC warns against GPs using practice address to register homeless patients

    Richard's comment 08 Aug 2018 9:52am

    Perhaps we need to be able to register people with NO address -without dishonestly filling in address fields. One for NHS Digital to sort.

    Then secondary care (or others) will realise that the patient is homeless and will have the same difficulty contacting them that Practices do.

    Maybe another reason for national ID cards -we just need to know who the person is and that they are entitled to be registered.

  • GPs petition for resignation of NHS England's top GP after Pulse comments

    Richard's comment 02 Aug 2018 4:53pm

    Apology or resignation needed. Complete conflict of interest as representative of one of largest GP groups which has been absorbing small practices. That model may work in wealthy London -but in cash and resource strapped rest of UK, we depend on many small organisations goodwill.

  • Dr Arvind Madan: ‘Practices waiting passively for change will not suffice’

    Richard's comment 01 Aug 2018 5:39pm

    Really sorry -Dr Madan uses all the meaningless admin-speak that is the hallmark of the out-of- touch.

    You can count them up -grassroots...direction of travel..vision...scale.

    Completely misses the point about GP at hand. This service is not just about choice of GP. It doesn't offer the same services as a GP - so should not be able to hoover up patients.

    How do you see a patient requiring examination, blood tests, cervical smears, immunisations, dress a wound, blood pressure with a mobile app? -you can't. Allowing services such as this to hoover up patients just removes the funding from functioning practices.

  • 'Indemnity fees are killing our profession' - sign this letter to Jeremy Hunt

    Richard's comment 12 Sep 2017 6:35pm

    Fully agree

    Dr Richard Greenway
    GP
    Bristol

  • GP numbers down because of 'millennial' working hours, says training chief

    Richard's comment 22 Jun 2017 9:28am

    Ah the good old days -yes pre-CQC doctors spent more time seeing patients, less time covering their backs and doing meaningless risk assessments.

    Consultations were quicker, demand was less, work intensity much less. Doctors told patients what to do, and patients did it or got told off!

    Doctors work very long hours now and then. Yes we have more female workforce - so none of this is a suprise.

    Whats the solution- I agree crown indemnity /or better no-fault compensation such as New Zealand http://www.acc.co.nz/
    Far too much of NHS budget spent on litigation maybe 25%- much of this going to solicitors, not patients. If we could recoup £1Bn or 2 for GP -who knows what we could do with it.




  • NHS England considers ban on 'low value' and over-the-counter prescriptions

    Richard's comment 29 Mar 2017 8:23pm

    Since when has Fentanyl been bad? Or Doxazosin, or Lidocaine.

    Mind you agree with Gluten Free foods which are now widely available, and T3 is questionable.

  • Mr Hunt! I know where your 5,000 extra GPs are

    Richard's comment 09 Mar 2017 7:12pm

    Brilliant -spot on!