This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day


  • GMC to restart fitness-to-practise investigations this month

    copernicus's comment 03 Jul 2020 1:27pm

    How have numbers of doctor suicides been going while GMC and CQC furloughed? Asking for a friend

  • CCG extends GP funding deal to ‘stabilise’ practices in absence of Covid fund

    copernicus's comment 30 Jun 2020 11:34pm

    round here it was 30p per patient CoVid fund for GP (and NHSE even backtracked on giving us that after promising 'no strings')

    A stamp is 65p

    It's just an insult

  • GPs look set to face 'unprecedented' flu vaccine shortages

    copernicus's comment 25 Jun 2020 9:14pm

    Deliveries delayed to practices every year as first batches go to the pharmacy chains who buy in bulk and distribute through their own networks.

    GPs pay top whack, for the leftovers.

    If pharmacists are so good at flu jabs, why don’t NHSE ask them to do the lot? See how they get on with the frail and housebound

  • BMA: GPs face ‘tsunami’ of extra work due to poor IT infrastructure in hospitals

    copernicus's comment 23 Jun 2020 3:00pm

    Matthew Shaw 2:16 you’re absolutely right, it is now stated policy in so many webinars and restoration plans. GP to prepare patient for appointment, hospital 10 min chat on phone, GP to manage and refer on to next speciality. Have heard this for diabetes, cardiology, heart failure, gastroenterology, mental health, colorectal, respiratory. Only people not dumping on GP are the dermatologists who can do everything by app, and then with specialist nurse, plastics, or gen surgery to cut it out.
    It’s a Tsunami in so many ways, and will drown us metaphorically. A professor of endocrinology summed it up, ‘I think we’re all agreed that general practice needs to open up’

  • GP bureaucracy that was ‘poor use of time’ should not be reinstated, says NHSE

    copernicus's comment 22 Jun 2020 7:20pm

    418 TURD days to go - time until retirement (working) days, unless they take away a few more of my bank holidays

    scale down QOF, scrap Appraisal and CQC, and Kick out Hancock
    I would stay on another 10 years, otherwise going at 55

    That's a promise to the NHS of 1,760 QuACK days

    Let midwives give iron tablets to pregnant women without me having to prescribe it, and I'd consider a couple more years after that.

  • BAME health checks should start at 25, says Government primary care adviser

    copernicus's comment 19 Jun 2020 9:29pm

    I'm still waiting for an NHS health check to deliver a single useful diagnosis. Could we scrap all the ones we do now to free up a bit of time to do some useful ones?

  • Delay CQC inspections for at least a year to protect GP mental health, say top GPs

    copernicus's comment 19 Jun 2020 9:24pm

    I completely agree with Dr G's comments. But this strongly worded letter business has absolutely no effect.

    We need strong actions. Newsflash: CQC NHSE CCGs GMC and all the rest don't care tuppence about your letters

    I've been in loads of webinars this week (in my own time in addition to 56 hours telephone and computer Ive put in in 5 days) hearing about all the plans to restart LTC (long term condition) follow-up. There's a general theme: specialist services like doing telephone reviews rather than seeing FTF too, but they need someone else to tee it up for them. Lost count of the number of comments I've seen from hospital based colleagues saying that GP 'needs to open up' and suggesting that our nurses should be doing the weights, BPs and blood tests for all the diabetic, heart failures, cancer referrals, post-op follow-ups etc, as it will allow secondary care to be more efficient. This is the new tsunami of work that is arriving at our doors. The CQC will be a minor irritation against this backdrop.

  • Government halts planned rollout of test and trace app

    copernicus's comment 18 Jun 2020 8:53pm

    I'm not an epidemiologist, but I always thought that the Isle of Wight was a stupid place to test the app anyway. No big towns, relatively low pop density, 60,000 homes, demographics very skewed toward white elderly living in small family units, low churn in practices, limited transport links (couple of ferries). No ITU, acutely ill patients flown to the mainland, 4th worst performing A&E in UK (according to

    I would have tested it in a densely populated conurbation with higher BAME proportion, with younger population that could actually use the technology and who were actually going to commute, work and infect one another. A local full emergency hospital with staff living and working in community.

    Which 'experts' came up with that s**** plan? Was plan B the Isle of Sheppey?

  • GP confidence in Government's Covid response plummets

    copernicus's comment 18 Jun 2020 4:58pm

    Does that mean that 40% of GPs still think everything's going OK?

    Must be all the ones sitting on CCG boards and LMC meetings, who spend all their days in webinars and generate endless contradictory guidelines

    Can't be the ones who looked after all the care home patients, that's for sure!

  • Do you want fries with that antigen test?

    copernicus's comment 10 Jun 2020 8:26pm

    I’ve got the elbow too!

  • Managing the impact of Covid-19 on psychiatric problems in primary care

    copernicus's comment 09 Jun 2020 7:53am

    The author needs to spend a few days in general practice

  • GPs can now get personal tasks done for them by volunteers

    copernicus's comment 08 Jun 2020 7:26pm

    I only referred 2 people for help, and they were both rejected because they were 'vulnerable', whatever that means. So they were only allowed to help people who weren't vulnerable, who presumably were helping themselves.

    This scheme is a solution in search of a problem. I have a voluntary stool sample that needs delivering to The Secretary of State for Health. Will they be able to help with that?

  • BMA 'in discussions' around QOF payments for this year

    copernicus's comment 05 Jun 2020 7:06pm

    oh oh
    Saw this coming!
    'protected' 19/20 payments when we'd alreday done the work. Lies from the political masters

    Time for the BMA to pull out their signature big guns: the fabled 'strongly worded letter'

    Watch out appraisal fans, hope you've collected your CPD, reflections and fan-mail during the last few months, because come September the appraisers are back too and they'll be raring to shaft you too

  • DHSC working on ‘better’ risk algorithm for shielded patients

    copernicus's comment 05 Jun 2020 6:54pm

    The first version was like a lottery-style random risk generator, so anything would be an improvement

  • GPs told suspected bowel cancer patients required positive FIT before referral

    copernicus's comment 04 Jun 2020 11:20pm

    I'm more worried about the people I referred with a positive FIT test, who have been telephone triaged and told they don't need urgent investigation because their test is only 'mildly positive'. Is the threshold suddenly different?

  • Should remote consulting remain the default option post-Covid 19?

    copernicus's comment 04 Jun 2020 7:23pm

    I miss the people. I just like people. I miss hugging the bereaved, taking the hand of the dying, shaking a hand to conclude a transaction, holding the newborn. I miss the sharing of the moment. I miss singing with my choir

    If I want to solve puzzles without meeting people I can do sudoku

  • Care home Covid deaths may be 'under-reported', suggests PHE review

    copernicus's comment 03 Jun 2020 8:11pm

    Could it be something to do with all the elderly, frail, poorly people who were dumped out of hospital beds into overrun Care Homes at the end of March, before they were fit for discharge? Some probably carried CoVid and seeded it into those land-locked cruise-ships. We will never know for sure, because testing wasn't available. What was clear was that many of those folks (especially those with dementia and severe frailty) didn't exhibit 'typical' symptoms but just faded out. My heart aches for the bereaved familes, and especially for the carers who have been deeply traumatised. Now there are lots of empty care home beds, the hospitals have embarked on a second wave of early discharges. This time those discharged are screened negative, but they're going into a bed where someone else has just departed, hope they bring their own pillows

  • The follow up questions I would have asked Hancock

    copernicus's comment 03 Jun 2020 7:57pm

    Having demonstrated his clown mathematics so well in the past (all those nurses who added to the numbers by not leaving), I would have asked Matt about the Covid test counting: if they count all the tests they send out, and then add all the tests done by the lab then all those tests are being counted TWICE, once when posted and once when processed. Could this be why we have not seen the number of people tested for the past 10 days? Has the penny dropped?

  • Can we talk about death?

    copernicus's comment 03 Jun 2020 7:39pm

    Great column. It's not a universal sentiment in people though, some people are pragmatic and realistic and understand the futility of medicalisation of the end of life, particularly HCPs! They just have less impact on us than the conflicted boomers whose sense of entitlement sometimes knows no bounds (for themselves and their nonogenarian parents). A caller recently complained (formally and with threats of litigation, which is a real ballache) that the GP was not flying in serum from CoVid survivors in the USA to prophylactically infuse into their aged relations. Is that even a thing?

    Personally Copernicus wants no PEG feeding. I'm much more fearful of being left in that twilight zone than anything else that a doctor might do to me. If I can't eat my dinner, let me go.

    My neighbours are hellbent on putting a defibrillator in our local red phonebox, which I would much prefer to be a library. In a village of 80 people, I think a defib would be used successfully about once in every 100 years. Copernicus (ever the scientist) has argued to put it in the pub, if they have to put it anywhere, as that's where all the arrests traditionally happen around here. His suggestion of a syringe of naloxone being much more useful was met with derision :) they don't believe in the County Lines around here, too posh.

  • GPs told to 'assess' treatment 'delays' and resume chronic disease care

    copernicus's comment 01 Jun 2020 7:25pm

    What is happening with QOF? It was 'suspended', but sounds like we now have to catch up.

    What's happening with appraisal? It was 'suspended' whatever that means.

    I'm now busy facetiming our 200 care home patients scattered over 40 homes, at about £1 a call (less than minimum wage anyway) for this 'vital' new work

    Something has to give. How are the 5000 new GP's going Matt?

    Does anyone have a plan? If so could you announce if over a bank holiday weekend