Don't worry there aren't any out there to recruit. (except pharmacists, whose useful roles are pretty saturated already).
There are ideas, we all have some, that would be constructive. And for each there are ways of sabotaging them. e.g. MDT: In-house small MDTs can be focussed and productive. MDTs for 50,000 town populations tend to be a monumental waste of time!
If it is to work we need to be allowed to focus on productive work. And it will be hard, given all the reforms, workload and workforce issues already on our plate. Any distraction, adjustment, new 'initiative', additional requirement and each change will waste energy and damage trust.
If someone wants can they can lay off or re-employ their receptionists and just use 111? I shudder at the thought!
Giving 111 access to an e-consult triage slot may be one more workable option?
1.4% global sum uplift
£1.92 EH old
£1.45 EH new
Long list of imposed unfunded obligations...
Someone show me the upside!
Oh yes, acute physio assessment is nice to have but routine physio is now a 6 month wait! Remember in a system working beyond capacity, any change is at the cost of something else....
We use paramedics and nurse led triage and home visiting. We have minor illness hubs and minor injuries units, we have OOH GP and 111. We have community pharmacists. The only easily recruitable AHP are pharmacists and we don't need any more of them. Networks in our areas will have negligible effect, except to suck up more headspace and distract already over burdened key clinicians. Anyone want to bet another topdown revolutionary reform with be here in 12-18 months?
I wonder is NHS really keen to have a OOH 111-like telephone support? This seems funded to about that level, (not clinical F2F!) but duplicating 111 or MIU seems pointless
Been trying to get a pension statement in vain since 2017. NHSBSA say PCSE still not updated 2015. PCSE say all up to date (eg Mar 2017). So round and round we go. ICO/FOI, Pension ombudsman and Pension regulator involved now but not yet helped.... and as the NNHSBSA/PCSE usual process is to close complaints and requests unanswered... which camouflages the situation for them
Await impact on fees of 20/3/19 DoH statement that any cover will be discretionary... GPC a reaction please?
Another new kick in the pants. Almost as though the SoS has just realised the cost of the scheme and is now trying to find a fig leaf for a U-turn? Will the GPC go back to the negotiating table for the whole new contract and network deal??
EH is a deal breaker. 8-8, 7/7 is madness on steroids, and proof that the top down agenda trumps coal face efficacy and patient benefit
We have some very non conforming PCN proposals already... no value whatever as no overlap with any other community services. Almost proves futility of the concept. I wonder if topdown diktat will now follow. There are ways to make this work but it'll be hard work. We'd need trust and grassroots primacy... neither of which we have (nor are likely to get).
2019 and NHSE is still pushing for scares capacity to be deployed to cover minor illness sunday capcity - so less complex chronic stuff can be seen... weird logic!
Cuts but not from hospitals?
2019: lets now offer £1.45?!? How does that compute? And how do we also manage to cut hospital beds too?
Sounds like budget is decided then decisions are made and evidence to support it found. Good Strategic Review to associate expectations with budgets is needed! The current divorse may protect politicians for a while, but the reality will be more and more apparent with time.
No capacity for EH in under-doctored areas. And new contract reducing finding further for EH makes it even less practical!
Unless DOH do some thinking the pressure will just get work and worse.... Some kind of 'Strategic Review' to associate Expectations and responsibilities to budgets!
Where else will the belt tighten? CCGs are going to have to balance the books somewhere? And yes, patient care will suffer, but can't run a deficit forever! Question where next hospital cuts too...
Trend is steadily getting worse. Soon be urgent book on day capacity only. Complex cases for routine review can't be fitted in, too complicated, off to A&E with them.... oh wait...