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The waiting game

Peter Swinyard

Peter Swinyard

GP. National Chairman of Family Doctor Association.

  • Locum GPs forced to claim benefits as work dries up

    Peter Swinyard's comment 21 May 2020 12:22pm

    For many years, locum GPs accepted that their freedom to pick and choose work meant that they were not always fully occupied - and their reaonable fees gave them an income less than the partners, who invest heavily of their own money into a practice - and accept the risk involved of joint and several liabiity for practice debts, should they occur. There was no real market for salaried doctors before the 2004 contract, as a GP Assistant (as they ere then) could only be engaged uner the Red Book in particular circumstances, did not attract the Basic Practice Allowance and was seldom used.
    After 2004, salaried models became very much more common. With the increasing stresses and strains of partnership, many made a perfectly reasonable decision to work only as a locum and supply and demand meant that high fees could be charged - one of the commentators above made £130,000 last year - no doubt hard earned, but higher than many partners' incomes.
    The pendulum is swinging again and more doctors are choosing substantive roles - in Wessex recruitment for partners and salaried doctors is buoyant. I think this will pan out as far fewer locums, genuinely providing the cover for holidays and sickness as it always used to be, and more substantive doctors working in practices in various roles to the benefit of continuity of care and job satisfaction.
    There will be a transition painful to many but the end reault should, I think, be better.

  • Government introduces 'drastic action' against coronavirus

    Peter Swinyard's comment 17 Mar 2020 11:38am

    I didn't think being on a ventilator exempted you from appraisal. Which is why I shall deregister when I retire at the end of May...

  • Family Doctor Association to close following 'financial viability' concerns

    Peter Swinyard's comment 05 Feb 2020 12:43pm

    I'd like to thank all who have supported us over the years - and all who we have supported with education, pastoral care and the friendship of an unique organisation. Not just in small practices but with factsheet learning on current problems such as QOF changes, of use to all in general practice.
    We cut our costs to the bone yet still could not remain viable. A very sad day for general practice.

  • A third of GPs suffer from ‘compassion fatigue’

    Peter Swinyard's comment 28 Jan 2020 10:54am

    Dr Hodges, you are a cynic Sir.

    Shame that you're also right.

  • GP concerns over network DES will form ‘basis’ of talks with NHSE, says BMA

    Peter Swinyard's comment 13 Jan 2020 9:28am

    and not once in the PCN Draft DES document is Continuity of Care even mentioned.

  • GP concerns over network DES will form ‘basis’ of talks with NHSE, says BMA

    Peter Swinyard's comment 13 Jan 2020 9:26am

    It is sad that I have moved on, after 35 years as a principal, to being salaried in the practice I founded in 1995. I would no longer relish the challenge of running the practice, coping financially with the much higher overheads which have come (pension contributions) and which are coming (national living wage) and the ever increasing expectation of outputs from an ever diminishing working pool of GPs.
    PCNs had the opportunity to help in all sorts of ways. This PCN DES is not it. It is poisonous. So many parts of it demands "GP Leads". In my book, leads have an owner on one end and a lapdog on the other.
    GPC - we don't need lapdogs, we need Rottweilers. Until some teeth are shown to the administrariat, nothing will change. Nikki Kanani, as National Medical Director for Primary Care (and a real GP) understands but I think that she is being bounced into accepting this gold-plated specification when practices just lack the workforce to manage it, in conjunction with their core job of looking after the sick.

  • Just because you’re paranoid…

    Peter Swinyard's comment 29 Aug 2019 1:50pm

    Yes. Paranoia is not sectionable here. The Family Doctor Association is happy to use its national influence to help preserve smaller practices for the benefit of its members. All practices in good standing with the FDA will get all our support to the best outcome - we are happy to engage with the bureaucrats on their behalf and provide vital support.

  • The King of Complaints

    Peter Swinyard's comment 05 Aug 2019 12:10pm

    Some years ago, a PCT "mediator" visited me re a rather vexatious complaint. When he visited the patient, one entire wall of their living room was covered in bookshelves bearing bound copies of notes he had made of every single encounter with anyone from "authority", be it local government, doctor etc. Truly bonkers.

  • Professor Martin Marshall named as new RCGP chair

    Peter Swinyard's comment 15 Jul 2019 10:28am

    Congratulations to Martin. Academic? Yes. Front line GP? Yes. A healthy mixture and the Family Doctor Association looks forward to continuing friendly relations with the College.

  • NHS unable to guarantee medicines supply in the event of a no deal

    Peter Swinyard's comment 02 Jul 2019 4:23pm

    What a bizarre and evidence-free contention. Why would Brexit, with or without a "deal", slow down medicine supply? There should be no "at-the-port" obstruction on our side. So why is extra capacity needed? This is soundbite heaven from a remainer and Project Fear.

    We have enough problems with supplies of common medications as it is - pages of commonly prescribed drugs that our patients just cannot get. Sort that out, Mr Stevens.

  • Halving pension contributions 'not enough' to avoid tax charges

    Peter Swinyard's comment 04 Jun 2019 10:48am

    Did you understand all that??? Me neither! That's why we need to employ the services of Paul Gordon or Sean O'Connell (usual disclaimers)

  • The CQC does more harm than good

    Peter Swinyard's comment 30 Apr 2019 9:47am

    CQC inspection this morning. I will leave Kailash's headline on my right hand computer screen when they come in to see me and, as always, ask for evidence of their effectiveness, usefulness etc. They managed to register "Better Health Partnership" in Swindon - the group of 5 IMH practices (including what was mine) as an entity a month before they became a legal entity. Quite an achievement.

  • GPs the target in the fight against antimicrobial resistance

    Peter Swinyard's comment 01 Apr 2019 10:28am

    so, 7-23% of antibiotic prescriptions are not needed. The art, of course, is working out which 7-23% you are in... and to fail to prescribe when you should risks the patient, increases the risk of scarlet fever etc etc. We are already doing better than any other sector of the health economy at prescribing well. Stop blaming GPs and try to attack the hospital sector, where they (presumably) see their inpatients every day...???

  • GPs who took up MDU 'half-price' indemnity offer will not need run-off cover

    Peter Swinyard's comment 26 Mar 2019 4:42pm

    Careful here - this was announced a few days ago. The cover is valid if you retire AT YOUR NORMAL PENSION AGE. For members of the 2015 scheme, that could mean you have to work to 68 to be safe or pay 7 years' run-off cover premium. How many of us will stay in this job until the age of 68???

  • CCGs are trying to 'manipulate' formation of networks, warn GP leaders

    Peter Swinyard's comment 12 Mar 2019 10:55am

    DrDr quite correct. Time for others to fit in with us rather than dictating what we should do. This is intended to be a GP led initiative, whatever you may think of "working at scale"! Look out for Family Doctor Association factsheet series coming to your practice manager's inbox shortly to give you the rules, untainted!

  • ​GPs asked to provide Brexit plan and practice lead in case of no-deal

    Peter Swinyard's comment 05 Mar 2019 10:24am

    1. Show me the regulation on which you are relying to say that I must produce a Brexit plan. The government has failed to do so in 2.5 years. I plan to take the same time to produce one.
    2. Convince me that the world will fall apart with a No Deal - or WTO-rules - Brexit
    3. Remember the Millenium, when all the great and good went and hid in bunkers expecting civil disturbance (GOK why) and all computers were expected to fail? I worked the night, had little to do and enjoyed the fireworks.
    4. Don't waste time on this when we should be concentrating on forming Primary care Networks to bring more money into our practices and improve patient care.

  • NHS England issues 'letter of comfort' on OTC prescribing for GPs

    Peter Swinyard's comment 12 Feb 2019 11:13am

    What a fudge! Do I need a letter of comfort? I've not been accused of a criminal offence! We either prescribe to all or refuse to all - leaving us to decide if someone can't afford it is really unacceptable. We will always get the "entitled Grauniad reader" patient who insists on a script and has the time to make life miserable as the complaint process (usually direct to NHSE thus involving the PAC) grinds through. Let's just get the clarity of NHS prescribable or not.

  • New GP contract to mandate practices to join primary care networks

    Peter Swinyard's comment 07 Jan 2019 3:04pm

    Just for once this is not something to get all worried about but a mechanism for getting money into groups of practices. The redevelopment of the Primary Care Team as a Multidisciplinary Team at PCN level is very welcome and will reduce silo working where we are working against district nurses etc instead of with them.

  • 'Innovative' single-hander wins GP of the Year award

    Peter Swinyard's comment 04 Dec 2018 11:07am

    So delighted to see Dr Hendow win. Shows how good a small practice can be with a devoted, vocational GP at the centre of the practice. As one of the judging panel, I was highly impressed with the quality of entries - most of whom would be deserving winners any other year,

  • Sympathy for the Devil

    Peter Swinyard's comment 04 Dec 2018 11:05am

    I would do a "routine" referral to the podiatry clinic for patient 3. Worded to make it sound urgent to the lay reader and give the appropriate messaging to the provider.