Isn't it amazing how, given a problem within the NHS, the authorities take every possible action except the one actually necessary to deal with the situation?
'Secretary of State to be made personally responsible at law for any failures within the NHS' might do a little more good, don't you think?
The Emperor Nero comes graphically to mind...
With a bit of luck they will delay this for so long that the money will only be released the day after the last practice has folded... thus saving all that money which would otherwise have been wasted.
To me, 'removing medication errors' starts with having a decent system, with minimal copying (=minimal transcription errors).
We need a national medication database for each patient, from which everyone works, whether in hospital, primary care, private medicine, community, OPD, wards... so there is an immediate understanding of what the patient is taking. (A single database doesn't mean a single software program to run it, BTW).
Then we need a total absence of silly rules ('you can't put CDs on repeat dispensing' -- which I suspect was why Repeat dispensing never took off that well at the beginning).
Then we need prescriptions which are written to cover clinical needs, not financial ones. All that faffing around to repeat prescriptions every month for longterm medication such as levothyroxine is simple wasting time and increasing the possibility of transcription and transmission errors (electronic and physical).
Finally, we need time to make the decisions: and it's got to be unhurried and not pressurised. Tired, overwhelmed staff will make mistakes: it's not their fault as much as the system which creates that tiredness and that sense of being overwhelmed.
... and ONLY at that point should anyone start to investigate the competencies of the prescribers themselves (though will all the above in place, I suspect that the level of mistakes would already have dropped precipitously.)
Great... provided the rules are changed so that as a GP I can fast-track into being a brain surgeon. No? I need fuller training to be a brain surgeon? Really?
Then why cut down the time needed to learn to be a GP -- probably the hardest job in medicine to do well?
You really couldn't make it up, could you?
Many congratulations to the coroner for expressing such a sensitive, forthright and brave response.
Seems to me that it's a case of 'if the NHS provides the money it unblocks the log-jam.'
Fine. Just what GPs have been saying for years. Now do it nationwide.
Very important to ensure indemnity for locums and especially for those with portfolio careers.
The totally disproportionate size of the penalty and the fact that it is also a criminal matter speaks volumes about the utter incompetence, cluelessness and insensitivity of certain of those 'managers' (sic) who run the NHS.
May I also remind people of the fact that if you are given a criminal record it will affect your GMC registration; your ability to work abroad; even your ability to emigrate, etc.
The whole plan is total overkill, made worse because (1)the object of the exercise isn't really what general practice is directly about (2) those 'managers' in the NHS 'organising' (sic) this need to put their own house in order first.
This will only work if the risk is taken by the NHS, not by individuals or individual practices.
Why don't we formally instigate an NHS policy of 'cutting money for anyone who actually does things' -- thus leaving more for all the talking shops, committees, new layers of management, new investigatory powers, new consultation processes...
You mean it's cock-up, not conspiracy?
I agree entirely with Cobblers. Data breaches are serious, and should be treated seriously and impartially, whoever or whatever was responsible, without fear or favour.
I am always concerned, as a matter of principle, about banning things, because later longer-term investigations often seem to turn up things that work better than we thought, or in a different area. Banning substances stops doctors being scientists and investigating correlations that they have 'just noticed'. When I first started practising, amitriptyline wasn't used for pain: now it is.
Similarly, we all know of patients who don't respond well to certain medicines - they need alternatives that at first may seem less useful (Co-proxamol, for example). To have someone centrally banning medicines is surely not a helpful way to go, because it cuts off any ability of doctors to tailor their prescriptions to the needs of the actual patient in front of them.
I have consistently said that if we don't flex our industrial muscles and be prepared to go on strike, general practice will collapse as so many good GPs can't take any more, despair and leave... and then there will be no primary care in the NHS anyway -- permanently. So what's better - a temporary hiatus while we have a rumpus, or a permanent shut-down?
The paramount rule of first aid is 'first, keep yourself safe'.
So, first, keep yourself safe by not working in legally suspect conditions. There's no point in you becoming a casualty too.
I am concerned that 'twenty struggling practices' will soon turn into 'one struggling mega-practice'.
The BMA has consistently failed to recommend, implement or investigate the private provision of NHS primary care services - and I suspect this is going to come back to bite it. It may even (paradoxically) make it more likely that primary care will be taken over by the big commercial firms, simply because it has failed to think through what a Plan B might look like.