Kafka-esque. 'You are unfit to practice... because we chose to suspend you. You will therefore be penalised further.'
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?
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'.
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.
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?
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).
Note to the sub-editors.... 'SNOMED' and 'SystmOne'
Great idea to spend lots of much-needed NHS money on lots of not-needed things.
SystmOne already HAS a hospital-based solution.
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.
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).
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.
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.
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?
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.
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.
Remember Einstein's dictum: not everything that can be measured matters; and not everything that matters can be measured.
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.
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.