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Independents' Day

Andrew F

  • GP bureaucracy that was ‘poor use of time’ should not be reinstated, says NHSE

    Andrew F's comment 22 Jun 2020 2:13pm

    Ha ha ha - so we're to have stakeholder engagement meetings, fill in surveys and no doubt open up discussions about how to cut needless bureaucracy.

    If only the time devoted to coronavirus planning meetings and workload surveys would reduce a little, there might just be time to fit that in.

  • GPs should contact all shielded patients as a 'follow-up' to letter, says NHS

    Andrew F's comment 26 Apr 2020 8:33pm

    Last week's centrally provided lists of vulnerable people (to be approved by us for shielding letters) included several healthy children deemed to have severe COPD or organ transplants and elderly patients deemed to have diabetes and other major diagnoses, which they simply didn't have. We saved the patients' upset, our time and the NHS's embarrassment by not contacting any of them.

    I suggest NHSE leave the rest of this to us, thank you.

  • ‘Reassuring’ evidence on surgical masks for GPs but only in use with other PPE

    Andrew F's comment 29 Mar 2020 11:24pm

    I will not be seeing patients myself or let my staff see patients with symptoms suggestive of COVID-19 without appropriate PPE. There is no benefit to anyone in martyrdom.

    If the proper PPE kit is being reserved for secondary care then so should be the patients.

  • Matt Hancock: 'We will retrain doctors to operate ventilators'

    Andrew F's comment 17 Mar 2020 8:27pm

    I can be pretty cynical myself, but negativity in this forum is saddening.

    These are unprecedented times and needs must.

    Yes, more people will die with minimally-trained ventilator operating teams than might in the hands of skilled anaesthetists, but more people will die than usual regardless.

    One only has to look at pictures and stories from Wuhan to appreciate the level of commitment that will be required. Unlike Wuhan, we will not have the benefit of tens of thousands of doctors being available to ship-in from other provinces.

    Dare I say it, well done Matt Hancock for taking this seriously!

  • Continuity of care has worsened 'due to part-time GPs', says NHS England chief

    Andrew F's comment 09 Mar 2020 11:06am

    It has also worsened due to the proliferation of super-practices at which patients "never get to see the same GP twice" - a change that has been driven intentionally by economics and policy.

    There are two achievable solutions:

    1. Change policy and funding to recognise the value of smaller practices at which staff know their patients and continuity of care is intrinsic.

    2. Put more money in the core contract so we can hire more GPs, lengthen appointments and shorten clinics, to allow more admin time. This will make the workload sustainable, at which point GPs may work more days in the week.

    Both of these are in the gift of NHSE.

  • Hancock wants ‘value for money’ from PCNs in GP contract negotiations

    Andrew F's comment 28 Jan 2020 4:02pm

    PCNs a great success - seriously? We were strongly encouraged to sign up for them and we did. If that in itself is a great success then congratulate yourself Mr Hancock.

    But it would be far better to judge their success on what happens from now on...

  • Hancock wants ‘value for money’ from PCNs in GP contract negotiations

    Andrew F's comment 28 Jan 2020 3:59pm

    With a core GMS payment of barely £90 per weighted patient per year, the government can hardly complain about getting "value for money" from primary care. Frankly, most people spend far more on their dog!




  • LMC advises GP practices not to sign network contract

    Andrew F'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

    Andrew F'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

    Andrew F'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

    Andrew F'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

    Andrew F'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

    Andrew F'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

    Andrew F'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

    Andrew F'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

    Andrew F'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

    Andrew F'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 https://t.co/927zClwOPG @ 5:51).

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

    Andrew F'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

    Andrew F'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'

    Andrew F'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.