" This is not a sensible way to support clinicians to reduce antibiotic prescribing safely. "
Absolutely. None of us doubt it needs to be addressed but this will actually make that "antibiotics not needed here" conversation fraught with suspicion. It is counterproductive. This needs to be a shared decision and we need time to do it properly
Lansley TALKED about the importance of primary care, so does Hunt (when he's not busy denigrating our "clocking off at 7 PM " culture). But their actions speak for louder than their words...
Hunt demonstrated as culture secretary his total lack of integrity or probity- he is absolutely not to be trusted
Aghast to find my own CCG wishes to take on contracting for GPs and implement 7 day working in the process- feels like a betrayal. Here's my arguments against:
1. Lack of evidence
Margaret McCartney the GP on BBC's R4 Inside Health was clear that she was unable to find any evidence that the 7 day pilots worked. Three were cited on the programme, two failed and one succeeded and this was about whether they were utilised. The other two closed down due to lack of patients.
The evidence for a reduction in A&E attendances was not there, in fact the presenter on Inside health said the pilots seemed to have discovered a whole new untapped need, and Richard Vautrey from the BMA called it 'building an extra lane on the motorway'.
Even the one that succeeded in finding this untapped need will be trimmed next year when the pilot ends, so may not continue to succeed.
Even the successful one will cost the CCG money when the pilot ends - £1.5m a year. Has there been any demonstration of the savings Sunday opening should bring?
What are we gong to STOP doing when we work on Sundays? Was there any guarantee that we will reduce weekday appointments? We absolutely cannot take on more hours
has anyone thought about the receptionists and nurses who are going to have to go along with having their weekends disrupted? Shouldn't they have a say?
What's the hurry? I reckon we would be one of the very early adopters, the effect on recruitment of us expecting Sudnay working when other areas didn't, I suspect would be dire.
6. Negotiating tactics
The BMA and RCGP have both come out this week saying, effectively, this is not a done deal, we need a lot more assurances. Our CCG, by going early are undermining this position.
Your are shooting at the wrong target- the real overprescribing is of codeine gabapentin and benzo s
What is the GMCs view of the 'merits' of suing a doctor for late diagnosis of dementia?
Making a diagnosis like dementia is fraught, like making a diagnosis of alcoholism - often people may be aware things are not going well but they don't want to know what it is or they're not ready to hear it. There is a skill in finding out how much people want to know and giving information in a way people can handle, like telling anyone they have a terminal illness. This sort of blunderbuss being held to out heads makes an already very delicate conversation ten times harder and drives a wedge into our relationships on which good consultations depend
Jeremy Hunt's 'movement to redress the balance' must be at about the same as that of a sheet of glass flowing....
I will retire as soon as I can afford to in the meantime I would appreciate being swamped with loads of stupid work - drug shortages unplanned as missions initiatives dementia screening, and large bits of policy which affect my patients issued without warning to ask I'm talking about the drug driving laws I expect to be inundated with requests for information and letters of confirmation that the patients are taking the prescribed drugs that have been found in their system yet we had absolutely no notification from DH
I did my 10 years alternate weekends on call as a junior GP partner - never again. gPs are humans too though big pay figure may make us seem like monsters to the lower paid - we still need to sleep relax play sports socialise and see our families, no money is worth missing all that for and just feeds the rise in demand. No wonder 4 out of the last 10 GPs I've appraised are taking early retirement. Did anyone stop to look at the feasibility of this idea before throwing huge sums of money at it? Or didn't it matter, seeing as it's only a meaningless election prop?
Dr Gancz is to be thanked for bringing this issue to media attention. Not only care-data itself but the frankly dismissive way in which concerns have been handled.
Great article thank you. I have been trying to explain to my patients and family and almost always met with initial total disbelief that this is actually happening. Good to see the RCGP list of demands today http://www.rcgp.org.uk/news/2014/february/rcgp-calls-for-reassurances-before-controversial-data-scheme-goes-ahead.aspx and the possibility that tide may be turning…. http://www.telegraph.co.uk/health/healthnews/10646151/Patients-should-be-warned-before-NHS-shares-medical-records-doctors-say.html
Please keep reporting on this it badly needs straightening out
The investigation should focus on where there is LOW opt-out rate - where it will smack suspiciously of s deliberate campaign to prevent informing the public - witness the taking down of medconfidentail.org site tonight :(
High opt out means well-informed public - after all it's THEIR choice ? …..Or isn't it?
1. Information contained in patient records to date was given in strict confidence at a time prior to the possibility of data sharing. NHS mandatory training on Information Governance states that consent must be sought EACH TIME information is proposed to be shared, therefore, how can automatic sharing of these past records without actively seeking current verbal or written consent be legal under the data protection act?
2. Given both the issue mentioned above, (that the information given by patients in the past was given in good faith that it would never be shared), and the very sensitive nature of such information, why do patients have to opt OUT of data sharing - surely this should be something they would have a right to expect to have to opt INTO?
3. Households have started to receive this leaflet: http://www.england.nhs.uk/wp-content/uploads/2014/01/cd-leaflet-01-14.pdf entitled: "Better information means better care"
a) Why was the method for opting out not made clear in the leaflet?
b) Why does the leaflet instead encourage patients to seek advice from their GPs on opting out - surely this is a complete waste of both GP and patient time ?
c). Furthermore in the light of such advice and also in the light of their role as data controller, why were GPs not themselves individually informed of how they should advise the patient?
4. Why are we taking the risk of harming patients by making them afraid to talk to their doctor? NHS England's own risk assessment on the move states "The extraction of personal confidential data from providers without consent carries the risk that patients may lose trust in the confidential nature of the health service….[because] patients will not receive optimal healthcare if they withhold information from the clinicians that are treating them".
5. If a patient changes their mind at a later date and wishes to opt out, is it true that it will be too late, and the data will already have been shared with no possibility of stopping it's onward sharing in the future?
6. Secretary of State for Health Dr Poulter has said if a breach occurs, the guilty party may be fined by the Information Commissioner and it is “open for an individual to seek redress through the civil courts”. Please explain what mechanisms HSCIC has put in place to track and inform patients of precisely who has their data and to notify them individually when their confidentiality has been breached. Without this, surely there is no possibility of redress?
(reference: Mr Godsiff: To ask the Secretary of State for Health what his Department's policy is on providing compensation to people whose medical confidentiality has been breached by (a) the care.data programme and (b)his Department's other programmes. 
Dr Poulter: The Health and Social Care Information Centre (HSCIC) has been established to be the secure environment in which personal confidential data is held and analysed. The HSCIC is legally bound to maintain confidentially and to ensure confidential information is held securely. This would include data collected as part of the care.data programme or other programmes managed by the HSCIC on behalf of the Department.
Breach of confidentiality by the HSCIC would attract a fine of up to £500,000 from the Data Protection regulator, the Information Commissioner and leave it open for an individual to seek redress through the civil courts. 15 Jan 2014 : Column 591W)
I live in the North and we have all got the leaflets this week. They are glossy, flimsy things. I've heard several friends say how they thought it was one of those advertising things that falls out of the newspaper or that they nearly threw it away. i rang the helpline and was informed the leaflets are being distributed 'area by area' and we have 4 weeks to respond from the date of the receipt they know when each area got the leaflets. The really scandalous thing is that they do not tell you how to opt out, they say contact your GP - and I as a GP have NOT been informed of what we should tell our patients! I know for a fact many surgeries are getting this wrong,and telling patients to opt out of the summary care record, which is a different thing to care.data. This is how to opt out: https://dl.dropboxusercontent.com/u/14156524/caredata_trifold.pdf
and this is what should be being dropped through our letterboxes at the same time as those uninformative leaflets!