The real (only) actual argument against publishing the video is related to intellectual property. (except those publishing pictures to comment on looks - that is clearly wrong!)
Essentially in a consultation I am paid to provide advice for a patient. I am not paid to make a video for an audience. If they want to pay me to make a video for an audience, they can ask me how much I am going to charge - like one of those lovely TV doctors.
Publishing a secret recording of my consultation is no different than publishing a secret recording of a film at the cinema. If secretly recording a musical when you go to the theater and publishing it online. You can watch the film and tell everyone about it. But if you record it and publish the film on the internet you are stealing someone's intellectual property.
I don’t think it takes a genius to work out that undeefunding primary care leads to increased costs in secondary care. Cuts to primary care must be the absolute definition of false economy.
I don't know about different countries rules enough to advise people. Perhaps there should be an office which has information about foreign countries and commonwealth countries where they can contact for advice. We can call it the Foreign and Commonwealth Office and direct everyone there.
Excellent that Mr Hunt has realised this just before the DDRB delivers it's report for the 2018/2019 uplift for GPs (and all doctors). The current situation is that the DOH will consider that report and consider applying any uplift suggested from April 2018; but clearly now, whatever the report suggests the DOH will give GPs a much higher funding boost - that is what is required to improve GP numbers.
In the entire history of the NHS the only thing which delivered a massive increase in GP numbers was the pay increases which came in with nGMS in 2003. At that time a payrise of 25% above inflation resulted in a 20% increase in GP numbers. That is what is required now.
"Their departures are set to leave 6.5 full-time equivalent GPs to cover the practice’s 14,000 patients"
- In terms of patients/ FTE GP - I think that is pretty good - probably in the better half of all GP surgeries.
Qualified GPs use fewer resources when compared to an F2 working in A+E? Certainly the work of very junior staff is likely to skew the results.
A better comparison might have been GP V A+E consultant or GP V very senior A+E registrar.
Had a patient who's dentist told him he cannot prescribe antibiotics for people who are allergic to penicillin, because he only knows about amoxicillin. I though the dentist was at least being honest, but still it is not acceptable to be a dentist and not know about the treatments needed to adequately look after teeth.
Sent hime back with a little note and my old copy of the BNF.
To me, it just looks like the number of patients/ GP in affluent areas is already maxed out, therefore when more pressure is applied to the system, the area most likely to lose GPs is the area with the fewest number of patients/GP.
Is it really true that patients in deprived areas need TWICE as much primary care as patients in rich areas?
Honestly they should ignore anyone who has any link at all to politics, the BMA, CCGs, NHSE and of course the RCGP.
They should really just pick a few names at random out of the performer list (for GPs) specialist register (for consultants) and the rest of the GMC register for training/ trust grade doctors etc. It is much more likely to get a representative group.
Wow! A private company performs less well than the partnership model.
Who would have thought it?
I would say that the 'rules' of compensation should not be generated by Capita and NHSE alone.
Someone needs to do a test case.
1 - stop doing the items that are no longer funded. For example pull out of shared care agreements and pull out of DOAC initiation and monitoring.
2 - Vote of no confidence in the CCG board. They are supposed to represent you (GPs) and you have the right to vote them out if they are looking after federations more than patients.
I think for each time a GP has to payout for litigation (albeit often not an error, but settled because that is cheaper than contesting the claim) there have been many other (maybe 10) cases where a GP could have been litigated against and that has not been persued. The main way of preventing lots of payouts is to stop claims before they reach a lawyers desk.
The problem is that I think the public are much more likely to take that step of contacting a lawyer for a BME doctor, than they are for a white doctor.
Similarly at a lower level I think patients are much more likely to complain to a hospital trust or practice manager with a BME doctor compared to white doctor.
If I am correct about that I am not sure how it is ever going to be possible to balance out the unfairness. If you were completely blue sky thinking you could ask for:
White doctors who are litigated against pay an extra penalty which goes in to a fund which helps cover the expenses of BME doctors who are litigated against. Or white doctors have an extra insurance premium to reduce the cost associated with extra claims against BME doctors. (As it is okay to charge more for extra claims but not charge more ethnicity, even if there is a link between ethnicity and the likelihood of a dispute becoming a claim.
Then as for regulation BME doctors would need more leniency in GMC cases or employers investigations. Perhaps 2 lives for gross errors and an extra couple of lives for more minor errors when compared to white doctors. Remember this does NOT represent them being less good, just representing the fact that a White doctor making the same number of errors would have faced 'half' the number of reports/ claims or investigations. Clearly more research is needed to clarify the numbers involved.
I am sure we can all agree that both ideas are ridiculous. But if anyone has a reasonable way of balancing out the inequality from patients, then it would be nice to hear it.
The ONLY way this will change is if there is money involved. If hospitals were charged (fined?) for dumping workload on to GP practices and GPs were rewarded for taking on that workload (or better still rewarded for reporting the dump but bouncing back the workload) then the problem would stop instantly.
Anything short of that is not going to work.
Does that mean that the second period of sickness does NOT require the initial 2 week absence without reimbursement? Surely if you are considering them together like one continuous absence, then there should not be a requirement for 2 weeks absence first.
Also the way the funding limits work means it is totally unfair on full time GPs.
Why should a 4 session GP off for 2+26 weeks have their locums covered in full (apart from the first 2 weeks)
But a 9 session GP off for 2+26 weeks be 56k out of pocket for the same period of sickness?
Assuming a locum cost of 433.5 GBP/ session.
And what about an 8 session GP who works at one GP surgery.
And an 8 session GP who works 4 sessions at one surgery and 4 sessions at another surgery.
My calculations are that if they both took 2+26 weeks off, the second GP would be 45k better off.
Are we really in the business of encouraging more and more GPs to move to part time, while complaining about the shortage of GPs at the same time?
I missed the last word of the headline and just read this:
"New laws will see 700 paramedics trained to write"
Which I thought was a little bit rude.
Then realised that I just needed some training to read.
If they claw back the money - then they have a duty (to the patient) to make sure that the initial problem is resolved?
Is that not correct?
Someone actually needs to speak to GPs directly. I know a string of GPs who have made a decision to retire or a decision to reduce hours considerably as a result of the pension tax rules.
Correcting that would be the equivalent of gaining (not losing) 2000 GPs immediately. It might seem a lot of work, but 2000 GPs is worth 2 Billion pounds in training costs.
This comment has been moderated
1% pay rise = 2% drop in pay after inflation.
That must, 100% be linked to every practice reducing the total number of appointments available by 2%. Everyone who cannot get an appointment should be told to go to A+E.
If that formula is applied, then suddenly those in power will understand the value of general practice and cherish it. Unfortunately, there is unlikely to be enough agreement around the country to apply that principal.