You would think that those 29% might realsie theuy never needed to see a doctor in the first place!!
NICE simply does not understand clinical implementation. The level of asthma knowledge is really quite poor across the spectrum of care both here and in many other European Countries. A recent paper from primary care demonstrated that about 30% of those with a diagnosis of asthma did not have asthma, after detailed review. It is well recognised that most doctors and nurses do not know how to use an inhaler and are thus unable to check or review inhaler technique. One of the answers is to institute training at practice level on making a diagnosis and performing structured clinical reviews in order to improve care delivery.
I am one of those who retired early; Unrealistic demands, constant CCG disorganisation; inappropriate targets such as well person checks ( no clinical benefit) dementia "screening " (possible harms) the futile exercisee of appraisal and re accreditationsouped up with an expensive and wholly inappropriate CGC inspection and constant deprofessionalisation as a result of guidelines: It would take a lot to tempt me back even to do some locus sessions.
There was a story about a chap called Adolf who believed that he was sending legions out to counter the Russian advance in May 1945.
It is clear that Mr Hunt shares a similar delusional framework, conjuring up legions of doctors and other professionals to provide a seven day service. It is worrisome that he has not yet been dismissed from his post by the Prime Minister given that it is only Mr Hunt and his lackeys who believe that they have all the answers, boding ill for the future of medicine in this country .
One of the BMA's preconditions should be to get rid of this odious little man ( and do everyone a favour)
Is this a process of turning a silk purse into a pig,s ear?
The yield rate is so low with two week waits (typically 5% for GI referrals) that it really has become a case of referring everything. If Patients did not have to wait so long for routine appointments the 2WW system would be superfluous. The downside of 2WW is that it is very resource heavy compounding the problem of delayed access to routine referrals. Furthermore, if the patient does not have cancer they go back to the staring line.
It comes as no surprise to me. NHS England have not exactly covered themselves in glory. The excrement they heap on others should be heaped on them.
Just goes to show what a tenuous grasp Hunt has concerning clinical care.
Well deserved Kamlesh.
Another nail in the rapidly being constructed coffin of primary care. When will the Government learn that dumbing down increases costs while diminishing quality in equal measure.
Conflicts if interest writ large: what would I do if I were not championing this waste of time and energy. Mr Dickson, revalidation is a waste of everything.
Jeremy Hunt demonstrating that he has not a clue what he is talking about. All other skill mix exercises to save money have led to a deterioration in quality and an increase in costs. I retired six months ago and nothing I have seen would drag me back.
Kinsey is a toxic organisation: They were the ones who recommended that GP consultations should only take 6 mins.
Ah, nurse! Clearly lacking in insight.
About time NHS England were made to take responsibility for their diktats.
choose and book continues to be the failure it has always been. Why do some people insist on using it? what are their vested interests? There is more to this than meets the eye. To my knowledge I have never used it.
It is disingenuous of Prof Haslam to state"As someone who spent 36 years in frontline general practice, I absolutely agree that it is essential that GPs are closely and realistically involved in NICE" .NICE actively discourages GPs from partcipating by refusing to re imbrues locum costs or preparation time ( something the salaried members of that institute would not contemplate). He compounds this half truth with the statement ‘NICE has produced several resources to help GPs use its guidance and find out about the evidence that underpins our work. Data is gathered by expert analysts and assessed by our independent committees (including GPs) who have the skills and experience to interrogate the evidence and develop robust guidance of relevance to the NHS – and primary care.’ The independent committees are those who fall into NICE's arbitrary definition as to what constitutes an acceptable participant. Most of those who compose the guidelines are not clinicians and are thus not in a position to affirmm their relevance for primary care ( or in deed any form of care) The time has come to declaim the tyranny of guidelines!!
The guidelines have been only agreed by NICE. They are only guidelines. The methodology of their construction is flawed and many are not applicable to day to day practice. Guidelines are one of the there components of Evidence based medicine, the other components being the individual patient ( their precise need as modified by other comorbidities and prescription medications as well as personal choice) and the clinical expertise of the doctor deploying the evidence, as it appears in the guidelines, and applying it to the needs of the individual patient. Lawyers and politicians must not be permitted to dictate clinical practice. Adherence to guidelines is mono dimensional unthinking behaviour which precludes rational thought and clinical evaluation. Were the scenario described above to become the norm we may as well pass over care to anyone with GCSE level English.
The concept of evidence based medicine and guideline informed clinical practice is too complex a concept for the politicians brain. Guideline directed care as proposed here would be nothing short of catastrophic