GP partner in York, North Yorkshire LMC member
Dr Andrew Field
York Medical Group
The last complaint I had was from a similar patient. I told him outright it was inappropriate for him to be seeing me. He ranted. I held my ground. DONT BACK OFF
It would be great if you had published a link to the consultation. I for one will be writing to oppose. It is absolutely imperative that we can all speak to our GP without fear of mishandling of the information. As a GP potentially open to investigation I will be less likely to divulge important information to my own GP if I am struggling psychologically and seeking help. That is not acceptable. The sale of information to private organisations is also a concern. And to be paying more for the privilege is rubbing salt into the wounds. It's very difficult to remain at all positive about the process of regulation even though as a partner I can attest to some definite improvements in my surgery, although costly.
Welcome Zoe. I'm with you. No doubt if you took most of my typical and sometimes frantic consultations squeezed into that 10 minute slot with time left for typing they would fall well below par of many objective assessors. And these are the snapshots we will potentially be judged on - out of context, taken in isolation, low quality records of the episodes when things didn't go at all well. Personally, I can't wait to go viral.
I look forward to seeing the incentivising package that will make me do all the extra work I do now as a partner when I'm salaried. #pieinthesky
Yeah, but it's repeated time and time again on a daily basis in my practice and practices throughout the land.
Lovin' this - and the comments!!! Can I come and sit in with you please Tony? If only there was more time to laugh between patients. What's so great is that it's so obvious Tony really cares and he's successfully using the only tool we have in our bag to save our mortal souls from despair. Top man
Well said Shaba.
A robust Union would be great as would union of purpose...........as in an organisation of workers coming together to achieve common goals such as protecting the integrity of its trade, achieving better pay and working conditions, safety standards and sufficient employees to perform the trade. What a fantasy! The "constituency" doesn't want this and so our leaders never need to move towards truly flexing any muscle. In all honesty, how many of us would break the terms of the contract in an industrial dispute? Even for, say, 2 hours? Our pay is shrunk, our pension pot raided, our work force depleted, our name besmirched. Forget the RCGP - why do they even bother getting politically involved? The GPC is the organisation of resolve and we should empower our leaders therein to be bold and strong by lobbying LMC's and being active locally and nationally and letting them know how much we care and how united we can be.
Personal grievances and upset, conspiracy theories and privatisation agendas abound. Vitriol and contempt are inevitable.
My view is that the take home message lies in the following paragraph laying out the immense problem and cost of major organisational change:
"However complicated the arrangements may have to be, there is no excuse for lack of a clear understanding of statuses, roles and relationships. It is not acceptable that the Department of Health took more than two years to update its “accountability system statement”. This left accountability relationships unclear during a period of major organisational change": Exactly!
It is the repeating cycle of major organisational change and the confusion of multi-agency accountability and remit that is at the heart of the NHS' problems. I think this is well known and it has to stop or the NHS will crumble into nothing.
Is privatisation the only conceivable outcome of the need to create efficiency and depoliticise the NHS? Unless a genuine political alternative is found the service will definitely be fragmented and the core of the whole service delivery ethic lost, never to be recovered. The real legacy following on the heels of Olympic triumphalism will a patchwork postcode lottery of fragmented non-comprehensive care, increasingly unaffordable and incoherent for future generations.
We desperately need modern solutions to meet the increasing flow of demand, much of which is minor and self limiting and could be managed by other services or remotely. Only this can free up primary care to perform the higher end functions (demand also increasing steadily) and deal with work coming out of secondary care. This represents a potential culture shift in the way the public engages with the NHS in general. I believe most people are up for this from perspective of pragmatic utility and economic necessity. Sadly, centralised attempts to achieve this have not been enormously effective (NHS Direct, walk ins, 111) and so we find ourselves where we are with all of the coalfaces (not just primary care) straining. I say invest in primary care to allow it to find the solutions. Innovators are out there. Back them more
Scandalous story. Are the member practices taking this lying down? Surely they don't have to - after all a CCG is not a PCT. Surely votes of confidence are in order or approaches to neighbouring CCG's?
I agree with Dr. McGregor's comments
More info needed! Were these practices part of the federation? Was closure part of a rationalisation or genuinely because of failure to recruit? Can the federation not manage to come up with a different access model rather than primarily GP led?
Having asked those questions there's no doubt about the recruitment crisis - we're experiencing the first showers before a mighty storm even in a place like York where people really want to come an live. Hope this beings some sense to the extended access agenda which is a totally unworkable and unnecessary nonsense in my opinion and will hold back the access innovation agenda enormously.
Andrew Field, GP Partner York
Very negative comments!!!!
Ask questions: Even in a palliative care situation do you EVER tell your patients that it's all gloom and there's no hope? Do you EVER tell your patients there's nothing they can do about their situation? Are we REALLY in a palliative care situation in GP? I don't think so. All the doom and gloom does not help. My response is to mobilise - get organised, start alliances, find efficiencies, work smarter, engage ethically and sensibly with change. It may not change the political outlook but it feels a whole lot better and guess what, it makes for a lot better accounts meetings.
Andrew Field, LMC member, Alliance Director
Love 'em - hapless and hopeless 16-25 yr olds making morning appointments, ne'er do wells failing to appear on sunny afternoons and overweight dole bludgers when the weather's bad. All part of the thankless task
Reflexology steps up as homeopathy on the NHS is deemed ‘madness’ - but should we simply follow Cuba’s example?
Sorry to say but I think we're overlooking the value of homeopathy as a completely harmless but powerful placebo. It works for people somehow. Why not employ it? Better than poisonous polypharmacy
As long as funding streams for hospital and community care are handled separately, the NHS can never function properly
Excellent article and comment from Joe M. I think it's possible that ultimately, where Foundation Trusts are dominant and robust and GP organisations actually become cohesive and commercially organised that cooperation could arise between the 2 sides of the primary-secondary divide. This would be driven by a need to protect local medics livelihoods, perhaps to protect services, but certainly as a rational way to self protect against political interference and private provider cherry picking.
All designed to allow private providers into the information chain. Resist
We can all smell the central interference and imposition of "local" priorities from on high. Member practices will need to be very careful what they agree to and use their LMC wisely.
For example in Vale of York, mentioned in the article, referral management is on the agenda. It won't be popular.