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Gold, incentives and meh

Geepjul

  • GPs should not prescribe antibiotics for impetigo, says NICE

    Geepjul's comment 15 Aug 2019 10:56am

    This is draft guidance out for consultation.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.

  • GPs urged to review 'no dogs' policies

    Geepjul's comment 11 Apr 2019 10:37am

    Why just dogs? I have a patient that uses equine-assisted therapy. Am thinking of changing the play area into a stable.

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

    Geepjul's comment 11 Mar 2019 7:47am

    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)

  • What the new five-year contract means for GPs

    Geepjul's comment 02 Mar 2019 8:27pm

    The 'one off' hit for indemnity is misleading. It lowers the baseline for subsequent increases in global sum.

  • Matt Hancock’s vision for IT is the worst idea I’ve heard in a long time

    Geepjul's comment 19 Jan 2019 9:36am

    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

  • Could knowing the price of NHS treatments help patients grasp their true value?

    Geepjul's comment 20 Oct 2018 10:40am

    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.

  • Chief GP inspector set to leave CQC in March 2019

    Geepjul's comment 25 Sep 2018 11:42am

    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.

  • GPs defending patient complaints to be asked which guidelines they followed

    Geepjul's comment 03 Sep 2018 1:11pm

    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.

  • No one likes us – and we don’t care

    Geepjul's comment 14 Apr 2018 11:14am

    Thank goodness we are not like Man City. Nobody would like us.

  • Severe asthma attacks reduced by quadrupling steroids, finds study

    Geepjul's comment 08 Mar 2018 12:49pm

    Anonymouse3.As the article points out, the same researchers looked at doubling the dose in a previous study and found it ineffective.

  • Severe asthma attacks reduced by quadrupling steroids, finds study

    Geepjul's comment 08 Mar 2018 12:46pm

    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"

  • GPs overlooked as Government finds hundreds of millions to bail out hospitals

    Geepjul's comment 23 Nov 2017 10:25am

    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.

  • 'Indemnity fees are killing our profession' - sign this letter to Jeremy Hunt

    Geepjul's comment 02 Sep 2017 10:01am

    Julian Spinks Kent

  • Jeremy Hunt 'wants to boost GP morale by awarding more gongs'

    Geepjul's comment 11 Oct 2016 11:21am

    Knighthood for Tony Copperfield?

  • How the GP Forward View has split opinion

    Geepjul's comment 21 Apr 2016 10:45am

    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.

  • GP contract could be set for 'radical' overhaul as LMCs back payment by activity

    Geepjul's comment 22 May 2015 6:56pm

    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.

  • GPs to vote on introducing a 'fully salaried service'

    Geepjul's comment 01 May 2015 7:05pm

    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

  • GPs told to investigate potential TB in new registrations as part of £12m NHS strategy

    Geepjul's comment 19 Jan 2015 2:31pm

    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

  • GPs urged to review anticholinergics use in elderly

    Geepjul's comment 03 Aug 2014 11:28am

    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.

  • Letter: GMC has not banned doctors from treating family

    Geepjul's comment 12 Jun 2014 12:02pm

    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.