NHS England did not want or value continuity of care.
The stated aim was larger, merged / federated practices. If a practice is struggling -merge it. Small practices with high continuity of care not valued.
Spread the existing workforce over longer days, multiple areas and enforce attendence to outside meetings, PCNs -and this is what happens. No surprise.
That is why continuity of care is going!
On the plus side -good to get some PPE.
On the minus side -not sure why GPs only need FFP2 (i.e. surgical) masks, aprons and normal gloves -whereas hospital staff need gowns, long gloves FFP3 masks sometimes coveralls and visors.
Obviously GPs are lower risk or more replaceable.
Anyone also spotted that the PPE recommendations in the latest action plan have been downgraded for GPs- we only need FFP2 surgical masks, aprons and normal gloves -whereas secondary care need full coveralls/ gowns, FFP3 masks, long gloves.
Also Reception staff have no need for PPE!?
Persuming we are either cannon fodder, or they think we have some innate immunity.
I know -bring in the retired less fit workforce to fill our shoes once all our staff are in isolation- that should work.
I've read the advice for Primary Care -no mention of PPE. We are obviously deemed inherently immune or cannon fodder.
Clearly - in "containment mode" makes total sense to diver the goverment PPE stockpile to specialise areas in centres.
But there needs to be a coherent plan for phase 2 when the virus will be out there, patients will present to normal GPs and to A&E.
This must be a CENTRAL PHE strategy- not every man for himself, competing for minimal stock avalabilty.
Most GPs are seeing 20-30+ patients per day. We will need a huge volume of PPE plus to remain operational.
I agree C
PPE strategy for Primary Care needed.
We can't assume that no-one will come to us as is being shown.
1. Let us do the job we are trained for
2. Pay us more
3. errr thats it
Chaos in Bristol.
Recent suspected case presents to use -rings 111 -told to self isolate, they would organise swab - then TOLD TO CONTACT GP for further advice.
We rang 111 -unable to give me advice on their case, PHE - same. No communication so far.
No sensible advice on what we should do with secondary contacts of index case. Swabs apparently take 72 hours to turn around.
No PPE distributed to primary care -and everyone out of stock.
Presume this will be Hospital doctors, Consultants and Managers too....
Jo Churchill's qualifications from wikipedia entry:
Churchill was the finance director of a scaffolding company and served on Lincolnshire County Council.
Should be useful for propping up a dangerous unstable structure like the NHS
I've read the DES. It doesn't up -new money for Social Prescribers, but mandated GP weekly/ fortnightly "home rounds" (presumably not being done by social prescribers), more command and control -Clinical Leads (GPs) for this and that- GPs to take the rap when al the "metrics" don't add up.
And unless I'm very much mistaken Practices (i.e. GPs) will be paying the unfunded 30% of salaries.
IT failures like this all too common I'm afraid.
Subcontactors working to "upgrade" our N3 lines to HSCN (supposedly faster) managed to destroy our phone system for 3 days -and did a runner. Absolute chaos.
How awful. When you looks at sentencing for burglary ,robbery, and assault we see people given non-custodial sentences, it amazes me that this level of "crime" should punishable by prison.
There but the grace of god go all of us. No coincidence that the victim here was male, and BME -clear presumption of guilt on both counts.
We should have seen this one coming. Mandate PCN membership then foist huge compulsory workstreams onto PCNs that they can't deliver.
Or PCN is run completely on goodwill -it hasn't even got one proper empployee yet.
So every nursing home patient gets 26 home visits per year mandated (plus presumably ones when we get called) What's the average consultation rate -say 6/ PppY.
Delays in cancer referrals are really not at our door. Urgent appt - 1 day- Decision to refer -2ww referral -form / letter -maybe further 1 day= 1-2 days. Hospital 2 weeks to see ,then further 4 weeks to start treatment. So GPs have a named person to carry the can for failures they have no control over.
If this goes through -practices need to closely look at benefits vs risks of PCN membership, unless these are properly funded with real GP workforce.
Wouldn't it be good if the workforce of CQC could be mobilised to help struggling practices? They could lend manpower maybe help implement policies that work -save practices time reinventing the wheel.
Much better than a critical punitive approach that damages morale.
Inspections don't work- if you're good already it just tells you what you know, if you're bad they've only just discovered it and the damage may be done.
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.
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 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.
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.
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!
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.