"we as a health community were prepared to take"
I'm pretty sure the health community includes the GPs.
And the GPs were not asked about being prepared to take on the increased risk or doing hospital work for free.
Was just grandstanding by the government. The health minister (or even better a random minister picked out of the hat) should personally have to pay all the costs involved, regardless of whether it was him/her personally who made the decision,
It doesn't matter if they are guilty or not of making a terrible decision, they should just have to pay anyway.
That is justice.
Are they really going to close 2 surgeries (main and branch) because they refuse to give name and addresses to the PCN? That is the only outcome that the CCG have from contract breeches, I don't think the practice have to accept a fine etc.
I don't know the finances of practice and neighbouring practices, but unless they are extremely high earning I would continue not to comply. And if I were a neighbouring practice, I might join them in solidarity.
@Neo - I don't think people think the hourly rate is too high (on here anyway). It is more that they were paid (whatever figure) to be there for 12 hours and saw 7 patients.
It is a vanity project - which should be slashed away with the funding directed to core GMS services.
For a few more add in:
-most the PCN nonsense
-NHS health checks
-anything to do with having a named GP
-Anything to do with dementia screening/ dementia numbers/ etc
-Any enhanced service that has tried (and failed) to reduce hospital admissions.
-Funding related to e-consultations.
-Having a dedicated phone line for care homes/ ambulance to use (do we still have to do that?)
etc etc - all that effort could have gone in to core funding and actually made a difference to GPs, GP workload, retention etc.
Would it encourage me to work longer (in comparison to the current rules)
Only completely abandoning the system would make me work longer.
@TruthFinder - although your sentiment is correct, your comparison is wrong. You are quoting the retail rate (i.e. the price when actually doing work) for the lawyer, compared to the salary rate of the doctor.
The retail rate of these Christmas Day doctors could be £2750 per hour (assuming 10 mins per patient), which is why running this service is ridiculous.
All the extra work must be tied to increasing GP numbers.
6000 extra GPs is what is needed to maintain current services. You can add in an extra 500 per year for increasing demands in appointments, increasing chronic illness etc.
Any extra work needs to be represented in top of that. And the increase in numbers must be achieved before extra work can be added.
So if 6000 extra GPs are needed now.
and 2500 extra over the next 5 years - just to maintain the status quo - that is 8500.
The first specification can be started IF there are 10000 extra GPs over the next 5 years.
If there are 12000 extra GPs then 2 specifications can be activated. etc etc.
We all know the chances of boosting GP numbers by that amount is pretty close to nil
@ Terry - I don't think it is the BMAs fault that GPs decide to work for peanuts.
It is fairly simple - just say no.
No to ECGs.
No to phlebotomy
No to ear wax treatment
(If you feel that the payments are not enough)
In some places the payments ARE enough - and you should obviously say yes!
In our area the service is bundled, but the payment is very significant. So we do it.
As some have said if you refer ever ECG to cardiology - there will be a better funded DES very soon.
If you refer every suture, sprain and scrape to A+E a better enhanced service is around the corner.
But if you do it for 1 pound per time, don't expect them to increase it.
Fairly simple set of circumstances:
The current offer of increased funding is only going to stabalise the workforce and GP services WITHIN the current workload.
No more workload can be added. The idea that the new funding h as to come with an ever increasing amount of work is not correct and was not the intention when the long term funding was agreed.
IF they want to add more workload they need to link that to hitting two targets:
1 - Additional funding, not already agreed with the PCNs.
2 - More GPs in place before the extra work exists. Give us 10000 more GPs and we can absorb extra work.
There is a community incentive levy - but it does not specifically help the local practice. NHS England collect and administer the money on a regional level - perhaps through the CCG. They will of course elect to invest that money in the practices in the 'region' that need investment the most. I don't directly have a problem with that.
But that still means that if the development is near a surgery that is not in sire need of renovation or expansion - then the residents/ patients need to be 100% aware that the service will get worse as a result of the development. And planners need to be honest with residents if they decide that is an acceptable price for the other residents to pay.
Double black alert level a billion at my practice.
All patients diverted to hospital!
Sceptic has a point.
There is some talk of Boris' own seat being up for grabs. There is a big push by an opposition candidate. Normally that would not be enough - but it might be if you add together:
- Labour voters
- Voters who hate Boris and specifically want to vote for someone who might beat him.
- Protest voters, who will vote for anyone but Boris.
That third group though has a choice - between the main opposition, Lord Buckethead, Count Binface and so on.
Seem hard to believe but Lond Buckethead might be the difference between a Boris led government and a different way.
A big announcement of action before the election.
Then delivered after election night with a whimper.
Nobody believes a word Boris, or his team, say on the matter.
It will work if:
GPs are give a significant incentive to push for immunisations
It allows consented decline and pays the same for a decline as a completed immunisation. Same profit, so not the cost of the drug.
It is funded through removal of other work that actually takes time and effort.
And idea of funding this through removing funding linked to work that has to continue, or removing admin type work; just won’t cut it.
- It was compulsory to have appropriate indemnity against litigation for your NHS work. That is now covered by the NHS indemnity scheme.
As much as it is a conflict of interests for the MDDUS to announce it, I do agree that it is essential to have an MDO membership. You must be way to confident if you think you are above any errors or accusations that might put you in the coroners or GMC's firing line - regardless of how justified (or not) those accusations are.
The TWO biggest changes for primary care needs to be:
1 Encouraging people to work in General Practice for longer. That means
1a - Less bureaucracy to work (CQC, revalidation, etc)
1b - Return to seniority payments, perhaps beefed up.
2 - Encourage people to work closer to full time. Which means
2a - Pension problems sorted
2b - Abolish crazy tax system around/ just over 100k earnings
2c - Abolish any other penalties for working closer to full time (for example tiered pension contributions).
It is amazing how often discussions are happening and plans are in place when there is an election coming.
This has been a problem for 5+ years and you really expect us to believe you when you say it is going to be sorted 4 weeks before an election?
Health secretaries, and in fact everyone working at the department of health should have to apply to be on a GMC register, and face the same scrutiny as doctors.
Or in fact the slightly stricter enforcement by the NMC.
Would see quite a few struck off for dishonesty.
Does practicing at the top of our licence mean we can tell politicians and other health care professionals to get lost when they say GPs are best placed to:
- Do welfare checks
- Check the central heating
- Address loneliness
- organise blood tests
- coordinate social services
- fill in referral forms
- Address DNAs or bounced referrals
None of those tasks are working at the top of our licence -and all those tasks should be shelved and passed on to someone cheaper. The ONLY reason they are done by a GP is that the unique way GPs are paid means that it seems to come across as 'free' if the work lands at the door of a GP.
There really should be some control areas.
Like a few areas where the same amount of funding was given directly to practices, with a review in 6/12/24/36 months to decide which way works best.
I (and almost every GP in the country) would agree that giving the money directly to practices is more efficient. I would automatically save thousands per practice in:
-clinical director costs
And mean that practices would be able to be more agile with their spending decisions. Maybe one practice could do with a pharmacist, another with a physio.
Maybe one practice has too many clinical staff already, but patients struggle to make appointments/ get through on the phone - they need a receptionist not another pharmacist.
And practices who struggle to recruit one particular professional can spend the money where they see the most efficient outcomes.
Anyway - we wouldn't want evidence to get in the way of policy, so best not to trial it properly.