This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

CAMHS won't see you now



Retired. Done. Dusted. Too bloody dangerous to practice medicine safely now. You hear that GMC?

  • NHS hospital trust says GPs will manage patients it has told doctors to discharge early

    Cobblers's comment 17 Jan 2020 6:13pm

    "It may mean that GPs will have to prioritise managing these sicker patients potentially involving work beyond their scope over patients they routinely manage and have been trained to see."

    No. Readmit.

  • Working Life: Working in trans health

    Cobblers's comment 09 Jan 2020 5:13pm

    SB 4:13pm

    Unlikely. I counted homosexuals as friends then and still do now.

    Are you not in the least troubled by what are irreversible actions in a very vulnerable population?

    Primum nil nocere is our dictum is it not? This is harm. Even if a vocal group are baying for treatment do we give it if it is harm?

    Let alone balance the funding needs of the whole population?

    I don't have an answer but what we do need is a grown up discussion generally how we afford any treatment on the NHS.

  • Working Life: Working in trans health

    Cobblers's comment 09 Jan 2020 3:23pm

    Dr Simon Braybrook Chair SE Wales RCGP Faculty.

    Heavy weight establishment piles into support a, no doubt, well meaning doctor.

    Are you going to be around, either of you, when the chickens come home to roost as DecorumEst has suggested?

    In 10-20 years time those who have had their genitalia refashioned regret their actions and decide to unload legally?

    "Well m'lud it was the zeitgeist. It seemed like a good thing to do".

    Good luck with that.

  • GPs lodge formal objection to housing as developer plans 300 new homes

    Cobblers's comment 07 Jan 2020 7:12pm

    Save your breath lads (and ladies). After suitable emoluments have exchanged hands and the odd funny handshake it'll get passed.

    They will talk the talk only. HMG have set stringent housing targets which they have to meet.

    All you can do is close lists or RLE.

  • Millions of patients wait more than three weeks for GP appointment

    Cobblers's comment 06 Jan 2020 11:53am

    'There are limits beyond which GPs can no longer guarantee safe care to patients and the potential for error or misdiagnosis increases.’

    I think we are at that limit. The media are becoming aware of near miss incidents or deaths.

    If GPs started opening private centres and charging they would be surprised at the demand.

  • GPs to visit care home patients fortnightly under network requirements

    Cobblers's comment 02 Jan 2020 2:27pm

    I was looking for the straw that broke the camel's back in all of this and I think I've found it.

    Bringing back OOH care to the PCNs aka GPs after 20/21.

    That'll break the bloody camel.

  • Pulse 2019 review: GP practices face ambulance delays

    Cobblers's comment 31 Dec 2019 11:45am

    DrRubbishBin 30 Dec 2019 7:49pm

    Ping! Light bulb moment.

    Pay As You Go App? Suggestions?




    GoDuff (Obs Probs)

    Migps (Men In Green Pyjamas)

  • Pulse 2019 review: GP practices face ambulance delays

    Cobblers's comment 30 Dec 2019 2:22pm

    This has long been the case in SE Kent. SEKAS would 'delay' attendances to surgeries and a GP call from a patient's home. Inevitably this brought the response that the patient or a relative would be asked by the GP to call and, if asked, to state no doctor in attendance.

    I even recall surgery staff 'pretending' to be the patient's friend when calling an ambulance.

    J*** effing C***** why can I get a take away in 10 minutes and an ambo in 60 (if I am lucky) minutes? WHY?

    COI I left mainline practice in July 2016.

  • Bah humbug - The Pulse annual awards

    Cobblers's comment 19 Dec 2019 3:53pm

    PULSE! Hank Beerstecher was a Sittingbourne GP.

    If he ever went to Folkestone it was to find a crapper place than Sittingbourne.

    COI Born in Folkestone.

  • Nine in ten GPs work extra hours every week as a third cut clinical time

    Cobblers's comment 18 Dec 2019 10:43pm

    30% of GPs handing contracts back would break GP.

  • Nine in ten GPs work extra hours every week as a third cut clinical time

    Cobblers's comment 18 Dec 2019 6:45pm

    Agree with comment from The cavalry isn't coming Dec 2019 4:51pm;

    "Something is very wrong somewhere"

    I earned just over £160k in 2006, PMS contract, but single handed practice, list size some 1900.

    Every year from 2006 - 2016 the annual amount dropped. It ended up at just below £90k with list size 2000. Workload had soared.

    I got out in 2016.

    What other profession would take that sort of reduction in money with increasing workload?

  • Nine in ten GPs work extra hours every week as a third cut clinical time

    Cobblers's comment 18 Dec 2019 12:11pm

    We are our own worst enemies here. I worked as a locum and submitted my Ts&Cs to practices and stuck to them.

    I got a phone call one early afternoon after a session saying I had left work undone. The PM seemed baffled when I pointed out that my hours were 0900-1200 and that I had left at 1210hrs. "But what about the repeats" she wailed.

    I was not free that afternoon to 'pop over' and even if I did I would have charged. In the end I did the repeats within the contracted times the following day.

    Mind set change required by staff doctors and patients.

  • What is the future of the GP home visit?

    Cobblers's comment 17 Dec 2019 11:39am

    HFY 9:25am Yes I understand that but it was a scenario that actually occurred was it not?

    In my early days I met this mind set too. An old biddy who was negotiating with me as to the time I would call as she had two 'appointments' with a gap in between for me at home.

    Needless to say she came to the surgery somewhat grumpy.

    We are singing from the same hymn sheet. :-)

    Charging is one option. No home visits would be better.

  • What is the future of the GP home visit?

    Cobblers's comment 16 Dec 2019 8:37pm

    8:25pm why does your MiL feel she 'deserves' a house call? Yet those same days she gets that privilege she goes to a luncheon or gets her hair done.

    A quiet word in her shell like is needed. Or maybe a word in the shell like of the cardie GP? Or both.

  • What is the future of the GP home visit?

    Cobblers's comment 16 Dec 2019 8:33pm

    Errrr. The North Staffs Guidelines were being used by the OOH Co-ops and the Co-ops were disbanded some 15 years ago.

    This latest version is Revision 5, (01.11.19) and 2012 presumably was Revision 4.

    Come on Pulse basic fact checking.

  • We GPs need to embrace new ways of managing our stress

    Cobblers's comment 14 Dec 2019 12:50pm

    Sorry Tom there is nothing 'inherently' stressful in work as a GP.

    It varies according to the zeitgeist. In the 80s I found OOH stressful, workload was easy. In the 90s it was burgeoning management roles in the Co-op and Fundholding, the noughties brought increasing workload at the practice and the new contrick, more of the same in the teens.

    The workload is now beyond parody. The overburden (GMC, CQC, Daily (Hate) Mail to name a few) is killing practice.

    You need a plan and RLE (Retire, Locum, Emigrate) has long been the go to. Psychology can help but only to unclutter the mind and find your way forward.

  • The value of general practice

    Cobblers's comment 12 Dec 2019 5:39pm

    Shaba, I refer you to my last sentence at 11 Dec 2019 11:17am.

  • GMC stops offering non-evidenced private screening to staff

    Cobblers's comment 12 Dec 2019 5:34pm

    So the apparatchiks of the GMC have had a 'benefit' removed. If I were one of them I would so quantify what that was worth to each and bang it on my next wage claim in addition to the yearly uplift.

    COI just fomenting discord within the ranks. With any luck the b@stards will go on strike.

  • The RCGP must adopt a neutral position on the assisted dying debate

    Cobblers's comment 12 Dec 2019 1:01pm

    Soren kierkegaard | Locum GP10 Dec 2019 7:23pm.

    Pseudonym a case of nominative determinism?

    Søren Kierkegaard was a Danish theologian, poet, social critic and religious author.

    Hmmm. Maybe a COI addendum SK? Such as "probable Christian" whose philosophy would espouse allowing people to die like a dog, no, worse than a dog, as, at least the vet would put the dog to sleep.

    Having a neutral stance would allow the RCGP to disavow either side of the argument and should be the default position.

  • The value of general practice

    Cobblers's comment 11 Dec 2019 11:17am

    Sigh. No I don't think so.

    Perhaps a few months as a full time GP in a busy practice might disabuse you of your, no doubt well intentioned, ideas?

    "Academic GP" is a cop out for "I don't really see the unwashed".

    Why do I feel that I have just kicked a puppy?