I have done about 3 home visits in 3 years, scheduled as part of surgery time. Patients here seem to be able to get in to the surgery and some of them live 20-30 miles away in a very rural part of New Zealand down variable roads subject to landslips. I haven't noticed lots of bodies littering the streets.
Perhaps visits aren't quite as essential as some seem to think.
Wait times here can be same day or 1-2 days when busy but then again we charge patients. BCCs can be diagnosed in surgery and then removed the following week in a minor op session for the appropriate charge.
Of course that is the New Zealand system and we are in one of the most under-doctored regions in the Country. Fees to see a doctor are not huge, but it does make a difference.
Over here patients pay for a driving medical exam, which is much more straightforward than the UK one, and utilises the same form for HGV,PSV and all vehicles. If you are unsure you can recommend an Occupational Health assessment where the patient has to book a driving session with an OT for driving to assess their functioning behind the wheel and makes a recommendation. This is then submitted with the licence application.
It may be that they are adv not to go above 50KMH ever and not to drive outside their local area and this is then endorsed on their licence. If they break that, the licence is revoked. It is much simpler.
I left 3 years ago and emigrated. I now have two houses where I am, one overlooking the beach which I rent out and one with an acre plot in the country where I live. I work part time doing plenty of locum work and people are pleased to see me.
I don't do appraisal and I don't work Christmas or OOH. There is a World shortage of skilled medical staff.
You have a choice but as the chap above says, 'the cavalry ain't coming'.
I am now an observer from abroad having left 2 1/2 years ago. The BMA has made a mess of such a huge mandate. All I can see happening now is that JDs only have the option of resignation which many of them will now take and you will have a slow, steady haemorrhage of staff as the NHS dies. New Zealand has plenty of vacancies and will value you all and an upper age limit of 55 but look beyond Auckland.
I think Jeremy Hunt has won a Pyrrhic Victory and the public do not realise how dangerous the NHS will have become with the New Contract until the next North Staffs comes to light.
The thing that puzzles me is that politicians need health care and private care in the UK is primitive compared with the Antipodes as it cherry picks rather than providing comprehensive cover. So what do they plan to use when they get ill.
Glad I moved abroad.
Ideally one person in the practice needs to learn to use a dermoscope, something like a dermlite 4 which is oilfree. Having moved to NZ, the difference in managing moles is striking in that everybody uses dermoscopes and is properly trained to use them. Skin lesions are usually clearly identified at first presentation or referred quickly to somone who can and anything remotely suspicious removed. The diagnostic accuracy with a dermoscope is so much greater but only in trained hands. We tend to follow the Australian 'Chaos and Clues' guidelines for identification.
Plenty of space in New Zealand for GPs. MCNZ is very different to the GMC. Defence fees of £700 per annum.
It could work, but you have to increase salaries at least by a factor of 10 to compensate. Not sure it'going to save any money
I used to work 100-120 hrs per week also and worked in GP in the UK until about 2 years ago. I now work abroad and will not be returning. If you are negotiating with a party that refuses to negotiate you really have only the alternatives of strike or leave.
From the Government's pointof view, theyshould consider that youcan control 2 out of 3 parameters in any commodity. They are 2 of price, quality and quantity. They always try to clumsily control all three in which case the decision as to which one gives is left to random events with a mixture of all three. I suspect they have already lost too many staff to sustain the service with this dispute.
Can I help it if the builder installed strong electromagnets into the door frames of the Consultation Rooms.
My local surgery has the following charges
Under 6 yrs Free
6-14 yrs $35.50
15-24 yrs $45.80
25-44 yrs $56.00
45-64 yrs $56.00
65+ yrs $53.00
These charges are for a standard 15min appt which is state subsidised. Go over that and you pay full rate which is nearly double for the next 15mins. Evening appts cost $20 more. They are open on Saturday and Sunday morning for walk-in appts at a further $20 on top.
Anyone who thinks this can be done for free is bonkers.
Oh and the surgery has had two new Drs from England, the last one in the last 3 months.
So as I see it from looking at the document they want us to do more weekend work, be responsible for Complex patient discharges at any time, be paid according to outcomes no matter who has been treating them. They want to develop QOF more, give more power to patients, reduce bureaucracy by getting us to produce more comparative data and boost CQC and the new GP Inspectorate. They also at the same time want to open it all up to AQP.
What's not to like? Should have the new recruits dashing to join. Just include a pay and resources cut and the problems will all be solved.
Thankfully I am now in my 50s. Last one switch off the light please.