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CAMHS won't see you now


  • LMC advises GP practices not to sign network contract

    Andy's comment 10 Jan 2020 0:27am

    This specification is lunacy, clearly dreamed up by a team that has no connection with the pressures of having to actually deliver and pay for it.

    NHSE, you can play fantasy primary care all you like, but when practices collapse, partners go bust and patients have no GP, or practices simply refuse to sign-up to the PCN DES, you will have achieved absolutely nothing positive whatsoever.

  • Pulse 2019 review: GP workload laid bare

    Andy's comment 29 Dec 2019 11:16pm

    The government is simply not willing to pay enough for primary care to be delivered by GPs.

    For our own sanity, we must deliver the service that we are paid to deliver, which will mean using cheaper, more diversified workforces.

    If the consequence of this is a worsening of safety and delayed diagnoses in some cases, then that sadly that is the service that has been commissioned. If the public want better then they will just have to vote for it.

  • GP leaders demand end to seven-day routine access scheme

    Andy's comment 26 Nov 2019 0:46am

    I fear I may be posting heretical comments for this site, but please read on.

    The additional weekend sessions are funded in addition to weekday workload and I believe they do reduce weekday activity.

    As someone who does these shifts, I also find they provide a welcome change in diversity from weekday clinics, which tend to be biased towards the elderly and the unemployed, and a valuable opportunity to provide health checks and much needed lifestyle guidance to our middle aged, working population who otherwise struggle to get in. Surprisingly, we get very few DNAs.

    For now, I think weekend shifts are good thing for the practice and good for our patients. If in future the additional funding falls away, I will probably change my mind.

  • CCG bans patients from leaving hospital-managed GP practice amid exodus

    Andy's comment 17 Jan 2019 2:53pm

    Yes, I thought so.

    The same group of four practices lauded as a case study for merging same-day services in the NHS GP Forward View of April 2016.

  • GP practices face annual pension contribution rise of around £50,000

    Andy's comment 21 Dec 2018 1:15am

    If this goes ahead and is not funded it will mean pay cuts for all salaried staff. LMCs will need to work with localities to ensure that the cuts are applied universally.

    Hospitals will presumably just cut services to patients and dump more workload on us.

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

    Andy's comment 23 Nov 2018 8:52pm

    Sally 3:37pm - I'll second that. We will be waiting for NHS England's final guidance.

  • NHS England 'ahead of target' on GP funding rise plans with £580m boost

    Andy's comment 21 Sep 2018 0:33am

    How many reader's practices are only viable because of private profits from add-on services, such as dispensing, surgery and research?

    Those of us in this situation are in-effect running private enterprises in our own time for the purpose of subsidising (what is supposed to be) public funded healthcare.

    Would our local corner-shops agree to push their private profits into subsidising the NHS? (I doubt it.)

    Ask ourselves then, is it time to stop propping up the system and instead deliver, honestly to our patients, what the Secretary of State for Health actually chooses to fund?

  • More than two thirds of GPs work less than full time, says official data

    Andy's comment 20 Sep 2018 11:10am

    How were the NHS digital figures calculated? Are the figures based on sessions or actual hours worked?

  • Appeals court rules in favour of Bawa-Garba appeal

    Andy's comment 13 Aug 2018 4:15pm

    "This was a case of the tragic death of a child, and the consequent criminal conviction of a doctor … We are sorry for the anguish and uncertainty these proceedings have had on Jack’s family …" - yet more emotive language from the boss of the GMC.

    The GMC needs to be clear whether it is a professional organisation that protects the public by supporting fitness to practice decisions based upon facts and fair risk assessments, or a political organisation with the power to punish individual doctors on the basis of popular opinion.

    Charlie Massey may "fully accept the Court of Appeal’s judgment", but he cannot stop himself from playing politics with peoples’ lives.

    In 2016, 1300 doctors signed a statement of no confidence in Charlie Massey. Surely it is now time for him to go.

  • Lord Darzi: All GP partners should be offered salaried NHS employment

    Andy's comment 19 Jun 2018 11:03am

    I listened to John Humphrys' interview with Lord Darzi last week and found myself in disagreement with almost everything he said.

    His views come across as anachronistic and out-of-touch with reality as those of the rest the Blair regime of which he was a part.

    When he declared that he was a "doctor not a politician" I nearly choked (BBC podcast @ 5:51).

  • The areas where general practice is on the brink of collapse

    Andy's comment 31 May 2018 8:54pm

    If our Secretary of State for Health genuinely valued patient care, he would direct whatever funds he could squeeze from the Treasury into general practice.

    If he pushed a couple of billion pounds our way, say £30 per patient via the global sum (not through some vague "primary care", "working at scale" pot with strings attached), we could hire and retain more GPs, patient satisfaction would improve and the rest of the NHS struggles could be eased through our ability to better manage our patients.

    He might even look caring and win a few votes!

  • Thousands more 'fit notes' issued - but one in five GPs say their advice is ignored

    Andy's comment 09 Feb 2018 4:39pm

    Most of the patients requesting sick notes around here (or "fit notes" of course, in doublespeak) seem to be the unemployed seeking ESA.

    The employed patients often have zero hours contracts and don't get paid when they are off sick so they don't want a Med 3.

  • DH and GP leaders 'to review partnership model'

    Andy's comment 07 Feb 2018 6:23pm

    I distinctly remember hearing Mr Hunt say (at his first RCGP conference attendance) that he recognised the small business / independent partnership model of general practice had brought successful innovation to healthcare and he would not favour its destruction - so I hope he is true to his word.

  • DH and GP leaders 'to review partnership model'

    Andy's comment 07 Feb 2018 6:16pm

    Re Shaba Nabi 6:01pm:

    1. A contract which reflects activity - yes
    2. State indemnity - yes
    3. Freedom to treat their own patients privately - yes

  • Health Education England to consider extra year of GP training

    Andy's comment 13 Dec 2017 12:56pm

    Sorry, I am confused. I cannot see how an extra year of training will help the workload crisis.

    Is extended training intended to benefit the trainee with more confidence, the public with safer doctors, the NHS with presumably cheaper trainees than qualified GPs, or large training practices by staffing them with externally funded GP trainees? Because as a "First 5" GP, I struggle to see how extending training will help the workload or increase recruitment.

  • Patients are more satisfied with practices owned by GP partners, finds study

    Andy's comment 03 Nov 2017 6:45pm

    What a reassuring statistic for those of us in GMS practices who care about patient care.

    Sadly I do not think the results will effect any deviation in Tory policy for primary care, not because Mr Hunt "cannot grasp statistics", but because the Tory priority is not patient care.

  • GPs to test patients' blood before prescribing antibiotics in pilot scheme

    Andy's comment 02 Nov 2017 10:44am

    This scheme concerns me. Used perfectly it will be helpful, but used in place of clinical judgement it has the potential to cause serious harm. As Anon-locum 10:33 has written - what about CRP lag?

    I cannot forget the case of a teenager who I treated for septic shock due to a lower respiratory tract infection. His CRP was just 15.

    How many courses of antibiotics do we have to save to justify one person dead due to untreated sepsis?

  • Revealed: NHS's plans to bar patients from attending A&E without a referral

    Andy's comment 19 Oct 2017 11:37pm

    This is a very bad idea.

    Destroying the reassurance that we get from knowing that in a crisis, whatever time of day, whatever state of physical or mental health we are in, help can be available just by getting ourselves to the A&E front door, would be political suicide.

    What is required is that emergency departments continue to develop their systems for redirecting patients who turn up but are not in a crisis.

  • Revealed: NHS's plans to bar patients from attending A&E without a referral

    Andy's comment 19 Oct 2017 9:44pm

    Peculiar that Mr Hunt would propose a "talk before you walk" system.

    I thought he had shown by example that one should straight to ED:

    November 2014, "Jeremy Hunt took children to A&E rather than wait for GP", available:

  • Government to introduce 'state-backed' indemnity scheme for GPs

    Andy's comment 12 Oct 2017 10:10am

    Let me guess - the scheme will only be available to larger providers / MCPs / federations and will initially cost on average £8000 per GP per year - which will be deducted at source from your monthly statement.