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GPs buried under trusts' workload dump

Nick Mann

  • LMCs call for GPC to reject PCN model in favour of new GP contract

    Nick Mann's comment 13 Nov 2019 7:57am

    PCNs should be disbanded.

  • GP leaders to call for removal of home visits from contract

    Nick Mann's comment 11 Nov 2019 7:16pm

    Same LMC branch with same motion as last year? I'll vote against.

    Let's refuse to do pointless DES contract work first, rather than ditch clinical work which serves the most vulnerable.

    As for some comments suggesting we get patients to self-pay for home visits... I'm shocked at this attitude from doctors.

    Did you leave your values in Belgravia?

  • GP practice warns new patients they will not routinely prescribe opiates

    Nick Mann's comment 06 Nov 2019 7:36pm

    We're all paying the price for opiate Pharma companies' desired effect of their illegal hyping and marketing of their products, but we do need to be careful to avoid reflex pendulum overswing.

  • I've a shortage of patience

    Nick Mann's comment 26 Oct 2019 12:04pm

    Yes, this is exactly the grim (un)reality of general practice now.

  • CQC chief inspector: no 'concessions' will be made for GP capacity issues

    Nick Mann's comment 25 Oct 2019 12:00pm

    #HostileEnvironment. This cannot end well.

  • Judge finds in favour of GP practice that refused to post medical records

    Nick Mann's comment 21 Oct 2019 8:31pm

    "Stelvio | Locum GP21 Oct 2019 11:33am

    Making records available within the Practice fulfils your SAR obligation. You can charge under Medical Records Act if you supply copies."

    If Stelvio is correct, then I'd go with the idea of - in the case of any third party request for medical records - providing a SARS copy directly to the patient. Third party can get it from patient, or pay for a further copy.
    I agree it is an issue for BMA.

  • PCNs are a chance to redefine general practice and feel empowered about the future

    Nick Mann's comment 12 Oct 2019 11:42am

    Contractually, logistically, operationally and politically, PCNs are a fool's errand.
    The recklessly forced timescale, future uncertainty of GMS with new PCN contracts under ICS/P, usurping of GP model by Govt-backed cowboy 'digital first' private sector companies, and the "last chance" threat to the GP model by NHSE from the outset... should sound alarm bells and demand a more circumspect purview.
    As future funding and more forced activity are increasingly channelled through PCNs via non-evidenced DES, NHSE will have us exactly where it wants us.
    Remember : "H&SC Act will put GPs in control"... many of us knew what would follow. We were right, and will prove to be right again.
    Sorry Krish, I know you mean well. Please stop and think again, for both GPs' and patients' sakes.

  • Four in 10 GPs in favour of charging patients for appointments

    Nick Mann's comment 11 Oct 2019 5:18pm

    Some quite bizarre answers from those supporting charges... implying the NHS is free and comparing Health services to plastic bags.

    Charging doesn't seem to have put off many in the private sector, but of course poor people can't go there.

    I sense some pejorative attitudes towards patients in these comments. Patients are not time-wasters or commodities. Ditch the zombie narratives and start pushing upwards. Patients are the easy target, but not the right target.

  • Four in 10 GPs in favour of charging patients for appointments

    Nick Mann's comment 10 Oct 2019 5:03pm

    Before comparing oranges with apples, note that France/Germany put £20-24bn more per annum into their health services than does UK.

    Charging is for zombies. Costs more to administrate than is recouped (see prescription charges).

    Not a single commentator anywhere ever seems to have noticed, let alone counted/costed/analysed, the proportion of GP time/appointments occupied by forced initiatives from NHSE....all the healthy people on whom we do NHS health checks, 'proactive' appointments, care plans, bloods, reviews etc etc etc.

    No evidence, no analysis.

    My suspicion is that the money doesn't end up covering the extra work and staff required. Same for the new work of PCNs.

    It's time we checked our own backyard properly before blaming and punishing patients.

  • HEE to push for five-year GP training pilots in every deanery area

    Nick Mann's comment 25 Sep 2019 11:33am

    I can see the attraction of geography-based training for general practice, but I am concerned about the quality of medical/surgical knowledge available from purely GP-based training.

    As a GP with 30yrs experience, I rely on a daily basis on the knowledge I accrued from hospital practice and specialty training.

    In fact I would say that most of the core skills which now underpin my practice as a general medical specialist were learned in hospital practice, then later developed over years in the community.

    I think it is a mistake to assume that medical training in hospitals is not relevant to general practice. Medicine is Medicine, with a number of steep learning curves along the way.

    The key medical/learning and experience from hospital training is easily transferrable to the GP environment, where we learn to adapt our practice in light of community/family/psychosocial factors. Almost all GPs I've spoken to agree that their practice benefits from the mutual insight gained from having experience from the hospital perspective.

    We need GPs to retain a high degree of medical/surgical knowledge and I sincerely doubt that wholesale transfer of GP training to the community will be able to achieve this.

  • General practice responsible for £88m of fraudulent behaviour, claims NHS report

    Nick Mann's comment 17 Sep 2019 11:40am

    Capita dumped medical records they had been paid to deliver, diverted money that should have been paid into pensions etc etc...
    So when NHSE said they would hold Capita to account but then did nothing, NHSE became complicit in NHS fraud.

    This constructive insinuation from NHSE is the lowest of the low: a resurgence of Jeremy Hunt's calumniatory attempt to undermine Junior Doctors' reputations in 2017.
    BMA response needs to show a very large, qualified, middle finger.

  • Artificial intelligence blunts any residual patient intelligence

    Nick Mann's comment 03 Sep 2019 7:30pm

    Well done to Pulse for instigating some much-needed field testing - responding to concerns of clinicians and others.

    NHSE have signally failed to do so.

    Facts on the ground do not support current NHSE/DHSC policy.

  • GPs should not prescribe antibiotics for impetigo, says NICE

    Nick Mann's comment 15 Aug 2019 1:02pm

    Facial impetigo is likely to represent URT carriage of pathogenic Staph/Strep.
    Topical treatment of any kind does nothing to address this.
    The patient remains a risk to themselves and to any contacts.
    Cases of neumonia, sepsis and scarlet fever have increased. Who is researching the impact/harms of not treating?
    Too many agenda guidelines based on too little medical evidence.

  • 'Large' amount of unallocated GP pension cash still sat in NHS account

    Nick Mann's comment 17 Jul 2019 8:19pm

    It took nearly a year of badgering Capita to get them to send out the type 2 pension forms for the practice. The forms, for 2017, were made available only a few months ago. Last year's awaited...

    I found out about a year ago that my TRS hadn't been updated for three years, so nil paid into my (and almost certainly, many others') pension. Are they hoping we'll forget.

    Stealing people's pensions seems to be ok these days, as does the reflex of blaming 'user error'.

    NHSE's lack of action or interest is tacit approval.

    Bring pensions in-house, now.

  • GPs in England receive over 250,000 inappropriate NHS 111 referrals per month

    Nick Mann's comment 16 Jul 2019 7:39pm

    My experience echoes these and many others'.

    111 is crap and dangerous. But NHSE and Babylon don't care.

    "NHS England said NHS Pathways - the triage software used by NHS 111 - is regularly independently reviewed" - NOT ACCORDING TO CORONERS' REPORTS.

  • NHS England: PCNs must succeed or face 'being salaried to other NHS providers'

    Nick Mann's comment 01 Jul 2019 8:08pm

    I agree completely with Michelle Drage.
    NHSE know exactly what they're saying - the intention has always been to shaft the awkward independent Partnership model, to provide a malleable, downskilled, obedient and poorly paid workforce, working for healthcorps.
    Simon Stevens always was the Letwin privateers' pet poodle, destined to do just this.

  • NHS to investigate GP ‘fraud’ in retaining ghost patients

    Nick Mann's comment 12 Jun 2019 7:55pm

    NHSE will probably spend more money than they will recoup, but at least they won't have missed the opportunity to slur GPs.

    But Capita...

  • Health secretary given right to suspend GPs' pensions before conviction

    Nick Mann's comment 17 Apr 2019 2:43pm

    Sounds like theft to me. Are we indentured to SoS?

    What a meagre excuse for this bunch of morally destitute cowboys to go to war again with a profession. Others have remarked on the sinister and purposeful nature of this; hostile environment - asserting control by making us scared and cowed.

    Does Simon Stevens have anything to say on our behalf?

    I would request that BMA take QC's legal advice.

  • GP numbers will fall 7,000 short within five years despite increasing trainees

    Nick Mann's comment 21 Mar 2019 1:19pm

    The (unmeasurable) unmet medical needs of the population will grow, while patients bounce around the system from noctor to noctor.
    Poor, verging on pathetic, response from the three thinktanks.

    No exploration or analysis of what it means when medical care denied becomes 'social' care offered.

    Where is the demand for an Inquiry into the unprecedented, damaging and culpable failure of workforce planning arising directly from changes due to the H&SC Act 2012?

    Well said, Prof Stokes-Lampard.
    UK GPs are the reason why the NHS has proved to be so cost-efficient and cost-effective for the last 70yrs. That is all about to change. There is no reason whatsoever that this could not have been anticipated and planned for.

    Some of those badly-needed GPs have run away to the private sector and portfolio jobs. Perhaps they could be enticed back, but not to this performance-managed NHSE flea circus.

    Doctors' professionalism has been inexorably eroded by NHSE while they've down-sized the NHS and its offer, deliberately creating silo-driven postcode lotteries while endorsing increasingly spurious denial of evidence-based medical care across the country. See: teachers/barristers/police....

  • GPC to push for ‘radical overhaul’ of 'outdated' GP training

    Nick Mann's comment 19 Mar 2019 6:34pm

    I agree with Drs Silman and Sanders. Cross-discipline training contributes enormously to our clinical and nuanced understanding of specialties.
    It helps to build our knowledge and skills as specialised generalists. We are first and foremost doctors. I still relate back to my hospital learning, every single day.