Indeeed. And on a local level it should be a QOF requirement for each practice should keep a register of all the registers it keeps.
Will be interesting to see what happens.
There seems to be a contradiction between two of the NHSE's aspirations for GP at the moment:
to make access more convenient by directly booking GP appointments
to direct pts to non-GP clinicians where possible, which requires triage (IE requires that GP appointments are not directly booked)
I don't know if this contradiction has been explicitly acknowledged - perhaps it has...
It is hard to see how this "responsibility" could work in practice, given Copernicus's point that we are not generally notified of admissions.
I suppose it is relevant on the occasions that a GP is making the admission.
One would have to consider the opportunity cost of the primary care clinician input needed to improve control:
Is intensifying risk factor reduction for a large number of patients currently the most productive use of primary care clinician time?
Or are other clinical priorities more important?
Also, as usual, only relative risks quoted, making any judgement on the significance of the issue impossible.
Are you saying that overmedicalisation is less prevalent in private healthcare systems?
Is there any evidence for that?
We have this requirement already in my CCG; dermatoscopes have been provided for us. I can't say it has caused many problems to my knowledge.
Life expectancy is a prediction, but it's hard to keep that in mind when it's being treated as actual fact or data.
To know whether this change is meaningful or not one would have to know a lot more about how the prediction is made.
Maybe the statisticians have just altered some assumptions.
"But most of all, we need longer consultations."
That assumes that GPs are the right people to do the work of discussing risks and benefits. But I had an hour-long meeting with a financial advisor yesterday and it occurred to me that the conversation we had was the same sort of conversation about long term priorities, risks and benefits.
Maybe this is indeed the proper role of the GP, but:
1. We can't spend an hour making a personalised preventative plan for each patient. There is no version of the NHS in which that is going to be an option.
2. If a personalised plan is needed (and that's a big "if"), is a medical degree needed to provide it?
I find the "mandatory training", which is nothing to do with appraisal and revalidation, to be more annoying. (I think the push for mandatory training comes from the CQC.)
I agree entirely with your logic but not your statistics: life expectancy for a UK man age 75 is 12 years, not 4.
It's not really clear whether non-attendence for smear is a significant problem, given that I understand that cervical screening has not been shown to improve all cause mortality.
(see, for instance, https://www.karger.com/Article/FullText/365059)
Perhaps the women who do not attend are making a reasonable choice?
If anyone has found data showing reduced all-cause mortality, please do post below!
We all die of something; a very elderly patient who is less likely to die from cardiovascular disease is therefore more likely to die from cancer, dementia etc. Are we sure that is what our patients want?
"Necessary would be defined as it being in the patient’s best interest, particularly if there are concerns that the patient would not access the recommended treatment"
Presumably this means continue to prescribe OTC meds for patients who say they can't afford the recommended treatment?
When I work for OOH services, access to SCR is fairly patchy - one service I work for can't access SCR at all.
Surprised that SCR is apparently now outdated even while it is yet to be fully implemented!
Here's one of the CPR studies:
Survival to hospital discharge was 72%!
I'd like to see a realistic presentation of CPR outcomes.
I seem to recall a study showing over a 60% chance of full recovery for patients having CPR on a TV show.
Have the medical defence firms got a position on this?
Since 2ww guidance is currently
"refer 2ww for woman with discrete lump over the age of 30",
it is hard to see what GPs might do differently in view of this finding.
Missed appointments give an opportunity to check results, letters, emails etc. If our attendance rate increased, we'd need to shorten our surgeries to compensate!
The NSC is a rare bastion of good sense... and therefore is routinely disregarded.