This is draft guidance out for consultation. This means that those who have registered an interest can comment during the consultation. It is common for recommendations to change as a result of feedback.
As for the GP representation; you can see the make-up of the guideline development group on the NICE website. There are 2 GPs, one is a Prof of Primary Care but the other appear not to hold any ivory tower links.
COI I have served on NICE guideline development groups but have no link to the current topic.
Why just dogs? I have a patient that uses equine-assisted therapy. Am thinking of changing the play area into a stable.
I can't believe you are all so flippant about this. As soon as my CCG (Medway) sent us the spreadsheet with questions such as "How would a powercut affect access to records?"and" How will you prepare for a nuclear winter? " I called a practice meeting and declared that I have appointed myself supreme ruler. It is now compulsory for all staff to watch training films such as 28 Days Later and The Walking Dead. We are stockpiling vaginal speculae to ensure continuity of cervical screening plus Kit Kats (for the supreme leaders coffee breaks). Work is in progress to convert my consulting room into a safe room and I have borrowed a shotgun from a friend. Finally I have reassured the staff that, proving they do as I say, I am unlikely to need clause 17.4 of the contingency plan... compulsory human sacrifice. Frankly:I believe a no-deal brexit could be the best thing to happen to my practice (apart from Primary Care Networks of course)
The 'one off' hit for indemnity is misleading. It lowers the baseline for subsequent increases in global sum.
He is typical of those who think that a mobile phone app approach is modern; hence right. The problem is that most apps interrogate a limited number of databases. By contrast any new systems in the NHS need to access very large numbers of organisations, each with their iwn database. Just look at the marvelous NHS App which I downloaded. It currently can offer me NHS choices advice but not appointments, scripts, repeat access, econsultations etc etc
I tried this but the unintended consequence was those who paid prescription charges were often very unhappy because their items cost less than a prescription charge.
I welcome the fact that he is staying on another 6 months.
He should be praised for his support for failing practices; lauded for emphasising to the press that general practice is the best-performing sector monitored by the CQC and congratulated for presiding over such a light-touch, low-bureaucracy and effective regulatory regime...Nurse!I'm ready for my medication now.
The problem with an approach that says 'follow the guideline' is that it assumes the diagnosis has been made (or there is strong evidence to suggest a diagnosis). In reality GPs deal with often vague and non-specific presentations which need the diagnosis to be narrowed down before referring to the guideline. Many complaints are due to 'delayed' or 'wrong' initial diagnoses precisely due to the uncertain nature of our job.
As far as whether guidelines are a good or bad thing; as someone who has contributed to 4 NICE guidelines I feel they are more good than bad. (I would say that!) They do vary in quality and fit to general practice but they do show what the evidence suggests may be the better management options. As others have said, they are not protocols and the NICE induction process makes it clear that a sinificant minority of cases may not fit the guideline. The problem arises not from the guideline development process but the assumption by others (the ombudsman included) that they are 1) Compulsory 2) always appropriate 3) Should be followed blindly without deviation.
Thank goodness we are not like Man City. Nobody would like us.
Anonymouse3.As the article points out, the same researchers looked at doubling the dose in a previous study and found it ineffective.
It is important to note that the study was in those over 16y old. The same issue of the NEJM has a paper on quintupling the ICS dose in children aged 5 to 11. This "failed to show a reduction in severe exacurbations or other asthma outcomes and may be associated with diminished linear growth"
So we have a sticking plaster to put over the multiple stab wounds that are A/E, £2.6 billion for rearranging the deckchairs on the titanic, £200 million for schemes to restrict patient access to treatment and the rest to be spent on shiny new hospitals and political vanity projects.
In the meantime General Practice is still sinking in the quicksand and is offered...a warm sense of satisfaction that we have a vocation.
Julian Spinks Kent
Knighthood for Tony Copperfield?
The Better Care Fund is about transferring money from the NHS to social care. Given that many CCGs now have delegated commissioning of general practice, the increase in the BCF may involve money being taken out of general practice as part of this transfer.
Yes, it might improve community services and make our life simpler but it is dubious that this could be deemed extra investment in general practice.
The green cards are for speed. The conference votes on over 100 motions,often with multiple parts. As for Mr committee etc, there are all types that attend from old hands down to registrars. This year 39 speakers were first timers.
Don't fall into the trap of assuming that because a motion has been proposed it is going to be passed. The Conference debates the motions and I am sure that all the pros and cons expressed here will turn up in the debate.
Also it is wrong to assume that LMC members and conference delegates are different from the majority of GPs they have been elected to represent. I continue to work 9 sessions as a senior partner and my fellow LMC members include full and part time partners, salaried doctors and locums.
LMCs are democratically elected so why don't those who feel we are not representing them think about putting themselves forward next time the nomination papers come round.
COI Chairman of Kent LMC
The original headline had me wondering if this was part of the master plan to increase GP numbers when, in reality, it is part of the master plan to reduce GP numbers through exhaustion
It is misleading to lump all the anticholonergic bladder drugs together.
Not all anticholinergic drugs for overactive bladder have an effect on cognition. Some do not cross the blood brain barrier so can be used in older patients. They provide an alternative to the newer beta 3 stimulants.
COI GP advisories to The Association for Continence Advice.
The advice given by Mr Dixon is barely any different from an outright ban.
There are very few circumstances, other than an out and out emergency, where alternatives are not available.
The example given by Dr Nabi could still leave her falling foul of the GMC unless she could show there was no prospect of an assessment by another doctor within a reasonable timescale.