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Gold, incentives and meh

LateralThink

  • GPs required to take pictures of lesions before skin cancer referrals

    LateralThink's comment 08 Apr 2019 10:23am

    Good idea, provided it is properly resourced, funded and training is given. But who does the work for the GPs while this is being put in place and when it is in use?

    Is there a word we could invent to describe 'GP mission creep', I wonder?

  • GP indemnity claims to be under ‘discretion’ of the health secretary

    LateralThink's comment 20 Mar 2019 11:42am

    The bottom line is that the NHS is likely to look at the total cost of a claim, and whether it is cheaper to 'please guilty and pay the fine' or to fight the case. The difficulty from this is that if the NHS chooses not to fight a case, the accuser will be likely to say 'see, I told you Dr X was in the wrong', and now the NHS has agreed. This may then be reported in the local press (indeed, probably will).

    The net result from this will be that we will probably be protected against big claims that clearly aren't our fault, but not necessarily against smaller claims -- and yet a profusion of successful small claims might then be used as evidence against us at the GMC.

    If this is the case, then it will be important for the NHS to communicate with the GMC to ensure that the GMC cannot automatically use 'information' like this to investigate GPs any further, as otherwise we will all be highly vulnerable to a concerted attack from a small group of aggrieved patients who are 'trying to make a point'.

  • GP federations will not count as primary care networks 'in most cases'

    LateralThink's comment 21 Feb 2019 4:46pm

    Let's re-re-re-re-re-organise... again.That should occupy whatever minutes of free time we still have left. And then we can re-re-re-re-re-re-reorganise a further time in 18 months (just when we've got into the hang of dealing with the current re-re-re-re-re-organisation).
    Don't managers realise that the cost of reorganisation isn't just the time that it takes to move things around, but the time taken to get accustomed to working with it, to plug the gaps, to find the advantages, to remember where the weak points are? It's like changing to a different computer system: it takes 18 months before productivity is back to where it was before the change.

    What an utter, shambolic, totally unnecessary waste of time.

  • CQC tells patients to complain about GP care to improve services

    LateralThink's comment 19 Feb 2019 1:51pm

    Funnily enough, I hear about lots of complaints about CQC in general -- but I don't think CQC are actually listening to them. Funny that. A good example of 'do as I say, not as I do', don't you think?

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

    LateralThink's comment 21 Jan 2019 12:40pm

    The worst thing about Matt Hancock's vision is that it rather implies that he doesn't have much of a decent understanding of the medical IT system as it really is. As the article quite correctly states, the real problem isn't with the GP systems (though as always there are improvements which could be made), but with what they are connected to (or not connected to as the case may be).

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

    LateralThink's comment 21 Jan 2019 12:37pm

    Note to the sub-editors.... 'SNOMED' and 'SystmOne'

  • CCGs told they must set up primary care networks by end of June

    LateralThink's comment 15 Jan 2019 5:51pm

    Great idea to spend lots of much-needed NHS money on lots of not-needed things.

  • Mr Hancock, there’s a simpler solution to this IT mess

    LateralThink's comment 07 Jan 2019 2:31pm

    SystmOne already HAS a hospital-based solution.

  • MPTS extends suspension for Dr Hadiza Bawa-Garba by six months

    LateralThink's comment 20 Dec 2018 5:26pm

    Utterly disgusting.

  • NHS unaware of fate of 100 newly-qualified GPs at threat of deportation

    LateralThink's comment 11 Dec 2018 12:02pm

    As usual, the NHS shows that it couldn't care less about its staff. Maybe it needs to remember that the truest guide to your real opinion is found by seeing what you do, rather than what you say.

  • GPs advised to order next year's flu vaccine before NHS finalises programme

    LateralThink's comment 23 Nov 2018 11:21am

    Potentially a catastrophe in the making. What happens if NHSE suddenly decides that a difference vaccine is needed -- and refuses to reimburse the one that's actually been ordered? It strikes me that this is the NHS at its disorganised best: with, of course, the GPs as the fall guys, stuck in the middle.
    May I point out to those in NHSE that 'leadership' means 'deciding firmly what to do, and supporting the troops up to the hilt while they do it' (and also taking the flak/cost/reputational hit if it all goes wrong).

  • GPs urged to administer more than 2m flu jabs to over-65s in two weeks

    LateralThink's comment 22 Nov 2018 3:34pm

    I always get worried when I see the two words 'ambitious targets'. It usually means either that the managers have created totally impossible ones; or are using perfectly reasonable objectives but with an impossibly short timescale, usually because of a foul-up on the managerial side.
    It's time we called out those who behave in this way, and get people to understand that any use of the word 'ambitious' in these circumstances will be treated with the contempt it deserves.

  • Hancock: UK building ‘refrigeration capacity’ in case of Brexit drug shortages

    LateralThink's comment 08 Nov 2018 4:46pm

    Project fear on steroids, obviously.
    So tell me -- why does everyone run around panicking at the thought of a no-deal Brexit, and that we will all starve/have huge customs delays? We all managed before 1973! We will clearly all make the necessary arrangements. Because, quite simply, if the UK can't import easily from the EU, what will we do - sit down in the middle of the road and scream? What will actually happen is that if there is any delay to the supply chain from the EU, it will be made very clear to the EU that if this situation continues, we will be buying from elsewhere, they will lose their market, and if the EU tries to be awkward, they may well lose us permanently.
    The other thing that the EU needs to remember is that 17.4 million of us (including our families) will have a choice: if the EU acts awkward, will we actually want to buy from it any more? We could have an excellent boycott of German, French and Slovakian cars, French and German wines, and most importantly, holidays. That might just concentrate EU minds a bit.

  • NHS Digital paid management consultants £1.2m for advice on GP IT overhaul

    LateralThink's comment 30 Oct 2018 12:14pm

    This isn't just a simple financial kick in the teeth, it's a complete dereliction of duty and a rubbishing of all the considerable, detailed, and longstanding IT expertise available on primary care. Bear in mind if you will that of all the areas of medicine, primary care is by far the best in its use of IT - in come cases by about 15 years. So where was the consultation with the leading representatives of primary care, and primary care informaticians? Was there any at all? With the BMA, with the User Groups, with the PHCSUG, with the Faculty of Clinical Informatics, with the CCIO and CIO networks?

  • Pregabalin and gabapentin to be controlled as class C drugs from April

    LateralThink's comment 16 Oct 2018 6:00pm

    Utterly daft to require a wet signature. The more that the prescribing process is fragmented, the less patients will use it and the more prone to error and manipulation it will become. Remember KISS - "Keep It Simple, Stupid". The more complex the prescribing system, the more that is likely to go wrong, get forgotten, or get bypassed.

  • GPs could be asked to do C-sections under proposals to retain maternity unit

    LateralThink's comment 28 Sep 2018 9:08pm

    The real measure of expertise in any given subject isn't whether you can do the procedure properly, but whether you can reliably extricate yourself and your patient from every one of the standard potential snags and pitfalls that may befall you. If you can't deal with the standard complications, you shouldn't even be attempting the procedure on your own.

  • CQC inspection regime 'requires improvement', evaluation concludes

    LateralThink's comment 27 Sep 2018 10:00am

    Remember Einstein's dictum: not everything that can be measured matters; and not everything that matters can be measured.

  • Expanding GP at Hand app is a full frontal attack on general practice

    LateralThink's comment 20 Sep 2018 8:11am

    Why does everyone run around in circles here? It's not rocket science.

    The basic question is: how can government stabilise payments to GPs so that it is appropriately profitable for them to continue to provide services to patients who aren't suitable for telemedicine solutions?

    In essence it simply means a decent re-tweak of the Carr-Hill formula. My suggestion would be reduce the remuneration somewhat for patients who are being seen via telemedicine, because they are likely to be far less demanding on time, and increase the remuneration hugely for those who are still seen face to face. This would be fair and just all round, allowing the benefits of new technology to take place, suitably rewarding those who do the telemedicine while also appropriately remunerating those toil away seeing the much more intensively demanding clinical situations that remain.

  • Babylon app ‘takes pressure off’ GPs to help all patients, says health secretary

    LateralThink's comment 13 Sep 2018 3:25pm

    This will be fine... until the first legal cases for misdiagnosis, harm and even death come in. Will Matt Hancock be prepared to shoulder the responsibility then, I wonder? (And maybe the answer with be a sold 'Yes', so I'm not making allegations.) But he needs to realise that his statements need to be seen as accountable.

  • How to spot zebras - acoustic neuroma

    LateralThink's comment 12 Sep 2018 12:11pm

    Yes, agreed - good description, clear guidance.