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
The whole sorry affair is a direct result of failure to invest in an expansion of primary care. The 2004 contract recognised that the whole system was under duress and gave us big pay raises to shut up. This gesture was not accompanied by any forward planning, but did result in many alternative, very expensive initiatives ( community matrons, NHS direct, walk in centres, increased numbers of paramedics, increased role for pharmacists etc) each of which was incapable of meeting the objective of getting it right first time. The net result has been the creation of a tidal wave of unsatisfied need with an escalation of the concept of urgent as being something NHS111 cannot deal with right now: Semi skilled people making semi skilled decisions leading to grave errors each of which adds burden to an overheated system. There is no short term answer, as there is no spare capacity in the system. Long term solutions include a massive expansion of primary care paid for by getting rid of the very costly alternatives which have been put in place in order to avoid making such an investment.
Discretionary activities may of course be the yearly grind of catching up on QOF targets in order to be paid to run the service. Or maybe identifying the demented, of which there is a great supply of examples in Westminster and NHS England.
What parallel universe do these people live in. It is their ilk who have created the problem by systematically failing to invest in primary care ( as advised by highly paid, special consultants, who are of course unaccountable).
Would anyone in their right mind believe HEE?
It beggars belief. Primary care has been systematically deprived of funding for development for a decade, while successive governments have thrown money at hospitals. Our local trust is one of the most indebted in the country and seem unable to find their way out of their continued inefficiency. The thought of them making as big a hames of primary care, not their area of expertise, as they have of hospital care fills me with despair. Once agin the planing is lead by highly paid bean counters on high salaries who have no comprehension of the clinical and social realities.
These uttereances demonstrate that Hunt is part of the problem and not part of the solution. The BMA and RCGP should both condemn his actions roundly....that is if they manage to get their riposte into the press which is deaf to doctors ( although there appears to be a little easing in that front)
It is truly amazing. There is very clear evidence in the literature hat health checks have absolutely no impact on outcomes, let alone "save" 8000 lives. Perhaps the doctors at NHS England should be reported to the GMC for quackery and bringing the profession into disrepute.
Cash for dementia diagnoses ‘draws attention’ to under-diagnosis, says NHS long-term conditions tsar
The problem with these tsars is that they are beholden to their political masters; they learn to spin and lie. I am always suspicious of the term best practice, promulgated as it is by nurse managers with clip boars demonstrating just what an oxymoron that precise term, nurse manager, is!!
The problem is that NICE while being National , and certainly an Institute, is not remotely clinical and definitely not excellent. I have visions of Geeks locked in a darkened room devising ever more obscure an inane algorithms which they believe have any relevance to anything other than their own fevered imaginations. Why would any sane person wish to follow their guidance? An example, perchance, of the blind leading the deaf!!!
If primary care were already salaried the system would have collapsed years ago. The salaried option means the end of innovation, independent thinking, and professionalism. It will be bad for the profession and awful for patients who will be dealing with under skilled robots following algorithms devised by people who believe in 'best practice' who do not understand the human condition.
Strange as it might sound the GMC is in fact a charity: Yes this arms length instrument of government control is a charity funded by compulsory annual subscriptions from doctors.
It is time is that this was rectified.
It is becoming increasing clear that NHS England is not fit for purpose!
I rather suspect that this study underestimates the level of increased and unnecessary activity which have been as a direct result of patient disempowerment following successive government initiatives.
Furious GPC negotiator predicts revalidation 'revolt' as GPs spend more than 40 hours preparing for appraisals
I have been revalidated. I foundit immensley stressful amd lost sleep over it. It took me considerably longer than 40 hours to input the data and ten to reflect on absolutely everything. My appraiser was sympathetic and kind but had fully bought into the monstrous nonsense of a system which is not fit for purpose.
I do nknow and acknowledge that some GPs particualrly salaried doctors find it helphul and in principle I am in accord with the need for it, but it needs serious redesign.