Thanks for the additional comments of support from you all and anon2017 for the impact. There is an additional impact for single handers, that the GMS contract is terminated. In Kent no contracts have been awarded to single handed practices since 2003, mine was the one but last in 2001. The application form for performers list is 32 pages and includes requirement to have a DBS subscription and a language test (after 25 years of working as a GP and producing numerous audio recordings on the practice website and two videos on youtube)
I have not had the inclination to review all that went on since 2007, when I was first reported to NCAS by NHS England and the multiple investigations since 2011 when the local RO office told me she would make life so difficult until I complied with every demand from NHS England.
I have slept without waking at 3am in a cold sweat for the last month, and thinking of all the obstacles pointed out by anon2017 and the thought of being a salaried or locum in the current NHS primary care, no inclination to work, every inclination to draw my pension this year. It seems a shame, to abandon a job I think I am good at, and see the NHS deteriorate, to stand by while patients suffer, but I don't think I can take any more.
Good luck to you all, you will need it.
The primary care funding is inequitable, Welsh practices receive 12% less global sum than an identical English practice. NI and Scotland were given a different indicator in the formula so the funding cannot be directly compared.
For clarification: I made a video of my presentation to the CQC in March 2016. I published this on youtube in November 2016 after the CQC rated the practice inadequate.
I had also audio recorded the rest of the day because of bitter experience with NCAS and NHS England taught me there are elements that cannot be trusted.
Requests for recording meetings and procedures were always turned down, followed by false minutes and reports. Audio recordings cured my disability of ‘mishearing’ and ‘misunderstanding’ the contents of meetings and assessments. Against my own beliefs I had to make the decision in 2014 that I could not continue to place my trust in unscrupulous elements in the NHS and record meetings without asking for permission.
The video recorder used to tape my presentation to the CQC was in a cupboard to try and get above the audience, not hidden but also not in plain view. The same place as the 2017 presentation. There is no law against taping your own presentation in your own building. In the MPTS building a few weeks ago I did not notice for 8 days there were smoke glass domes in the corridors, presumably making covert video recordings of me without anyone asking or pointing them out. The photo's published in the daily mail were taken covertly as I was crossing the street. No problem.
I underwent an assessment by the GMC in 2015, and the GMC covertly audio recorded the visitors (including two doctors) and my staff giving ‘third party interviews’ in our surgery, maybe they also covertly audio recorded other parts of the assessment, I do not know. So there is no problem with covertly audio recording meetings, even if you are in someone else's property.
In 2016 the CQC failed to admit (both in email and on the 2016 video) that the inspection was targeted. After the publication of the CQC report I made a SAR request for the CQC information and received 75 heavily redacted documents, confirming amongst other things that the inspection was targeted and instigated by NHS England. I published these on the website in January 2017 as additional evidence to challenge the inadequate rating of the practice, and expose some of the practices of the CQC. I had given the 75 files nicknames to keep them apart, which were then included in the icons on the webpage (boohoo, now this is censoring, etc).
I think the tribunal’s finding is that I should not have published the evidence challenging the inadequate rating of the CQC in 2016 with my comments attached, so I am planning to republish after reviewing the comments and file names.
During the 2016 inspection my manager came to my room in tears 10 minutes after the arrival of the lead inspector, as she told her that we were in breach and not licensed to provide contraceptive services straight after walking in. This was retracted later in the day. We have heard of many other practices where staff were in tears during CQC ‘visits’ and many practices where the findings and ratings do not seem to correspond. There is no consistency in the approach, and with the Chief briefing publicly against small practices, publicly justifying using gender discrimination against small practices I felt I had to take a stand.
This came at the end of a 10 year period of repeated investigations and referrals by the local NHS England team, and without the audio recordings I made to challenge the 2014 NCAS inspection we would have been closed four years ago. It came at the end of three years of emails to CQC to try and improve their use of public data in their ‘intelligent monitoring’ reports published on the internet. I was at the end of my tether and decided to fight back against what I perceived as another unjustified inspection and another unjustified report, it happened to be the CQC coming back to inspect us for the second time, a second targeted inspection as we were in the first 500 practices after the CQC were appointed as regulator in 2013.
I did not intend to target individuals, I do believe that representatives of organisations should accept responsibility for the organisation, just like I take responsibility for the practice and like I expect my staff to accept responsibility for any policies they enforce, or otherwise challenge me on any policies, which should be possible in an organisation (this has happened many times, and I have changed many policies thanks to input from my staff). We put our staff on the letterhead and on the website, it strikes me as odd that the CQC wants to keep staff anonymous and not accountable, I would not feel comfortable with that.
To clarify matters I would be happy for the CQC to publish the unredacted 75 files they supplied to me so that we can all be clear about the procedures and justification of our 2016 inadequate rating. Maybe the magazines/press could request these if the CQC does not want to supply them to me.
Compare patient satisfaction between Mapperley park and Bellevue practice in Birmingham.
Maybe the BMA Wales could address the 12% funding deficit of Welsh GMS practices when compared to identical English practices?
Not a surprise that (1) managed practices cost more and (2) that in Wales GMS is even cheaper as the practices are underfunded by 12% compared to identical English practices.
Clarify, you are not charging for access, but to recover your copying costs, so your invoice should reflect this.
Since 2012 we are not dealing with solicitors, we deal with patient direct, so all records are collect from base.
GDPR states you cannot charge for access (the £10 access fee) and it states you have to give information that you have in writing you should supply in writing (i.e. not verbally only) but it does not specify you have to give it printed (emails and files are written), and it does not oblige you to deliver it by golden coach to Timbuktu either.
So we now offer patients to come down with their camera, this was always an option under DPA, or offer to make copies for the copying charge.
It has not been tested in courts, and any complaint would have to go through ICO, who are snowed under and take a year to reply. Solicitors know this so will happily pay so far.
If you enter into a contract with solicitors a far way from home (same for mail order companies) and you have to recover costs, you have to travel to their local court, same vice versa. Any dispute with your patient can be dealt with in the local court for both parties.
I had a dispute over £50 and had to travel to Manchester for the case from Kent (2012, and then still lost as it is a civil case and it matters who sounds the most plausible not what is true.
This happens in every case where the accused has been kept from working by suspension, the minute the case is concluded the suspension continues as the accused has been off work too long (through suspension).
Even if the loss of income and pension could be claimed from the other party (GMC in this case) or the legal costs, it is in the end doctors paying for it through registration fees and not the people responsible.
It is a sick system.
OK, this link is to the GP patient survey, comparing Dr Madan to our 1,800 patient practice.
OK, this link is to the GP patient survey, comparing Dr Madan to our 1,800 patient practice.
I have been (audio) recording consultations since September 2014 and 99% of patients think this is a good idea.
They are part of the patient record with access rights.
If your consultation cannot stand the light of day, maybe you should be looking at your consultations.
If video or images are used for sexual gratification or comments, this is nothing to do with the consultation but it is simple sexual harassment, and should be dealt with as such.
The thin end of the wedge, none of the 4 procedures are performed in any case for the indications listed.
What should be made clear is whether the NHS constitution for a comprehensive service is being upheld?
There should be counterclaim for the £15,000 fine that you get for being not guilty, five years and hundreds of hours of distress, hundreds of thousands in lost income and pension, not even counting the legal costs borne by all the members of the defence organisations.
Ruined if guilty, ruined if innocent.
No different for all our multiple jeopardy with NHS, GMC, courts, ombudsman, all result in personal and financial fines irrespective of the outcome or whether the case was justified.
Dr Harris, thank you for the sympathy, I was under investigation by NHS England, the GMC, had voluntary udertakings with GMC and the CQC found my single handed practice inadequate all at the end of 10 years of repeated investigations.
111.crs.co.uk for some of the information.
I had been forced to tape the assessors and CQC inspectors and when the report came out I was forced to publish the evidence to refute the allegations and field press enquiries.
I am now under new investigation by the GMC for dishonesty, for making recordings and publishing these (on our website and on youtube) in defense to false allegations (the allegation that there is an unconsented audio recording is also false).
As a single hander I am already the lead GP in every department, the senior GP and career path reflections are a clear nonsense that I have to waste my time and my appraiser's time on, I was trying to limit the wasting of time.
maybe the reflections were irrelevant for the court, but how about the GMC?
To refute a false allegation I supplied my PDP folder (scrutinised by the MPS) to the GMC.
Exonerated from the allegation a few weeks later I the GMC demanded I re-identify a patient I had failed to obtain written consent for an excision of a sebaceous cyst.
I received an email yesterday that a rule 7 letter from the GMC is underway.
"Dr Beerstecher’s MAG file contains a large volume of supporting documents (some of which have been extracted by his representatives) and some of Dr Beerstecher’s reflections over the past year. Some of these statements are a cause for concern.
In the Achievements, challenges and aspirations section of the document (Section 12), Dr Beerstecher writes under the hearing ‘Achievements and challenges’;
“This is too depressing to discuss. There is a page on our website for the CQC report.”
And under ‘Aspirations’:
“No longer relevant, survival is the main goal for now. prepare for the legal case CQC some time in June I guess.retirement planning course?”
The file also refers to a Serious Event, in which Dr Beerstecher failed to obtain written consent from a patient to record the audio of their consultation. The patient is not named and it appears that no further action was taken in respect to this."
Maybe a dangerous precedent for GMC, that someone convicted can continue to practice?
Details should be clear from the appeal, good luck to Dr Bawa-Garba, on the face of it just one of those times the holes in the Swiss cheese line up to let a misfortune through. We've all been there.
Welsh general practice has been underfunded by 12% through a deceptive calculation of the Global Sum.
We informed the BMA wales and the Welsh devolved administration when we published the false accounting.
Gwion Rhys, Hendrik J Beerstecher and Claire L Morgan. Primary care capitation payments in the UK. An observational study. BMC Health Services Research 2010, 10:156.
Over 10 years ago we attended a virgin presentation when they were looking to dip into primary care.
Their model recognised no profit in primary care, but they were planning to have private community services and PAM (chiropody, opticians etc) and then 'work' the waiting room to have the punters part with their cash while waiting to be seen. Virgin does not run practices as far as I know.
The math is simple, I pay more for a locum than I earn, and work at least 50% more hours.
The GPC should work on all contractors (GMS PMS APMS) being paid the same money for the same services. This is not new, or rocket science.
Unfortunately I resigned from the BMA in 2004 over the new GMS contract (we all know how wonderful it is and how it has controlled workload and how we would finally be paid for the work we do) so I cannot resign again for the failure of 'our' 'union' to stand for our interest: same pay for same work.
Who has been running an APMS practice (Concordia) is our negotiators Chisholm and Fradd, neither having worked a single day under the wonderful nGMS negotiated for the rest of us.
I launched a similar request to NHSE a few weeks ago re:
(Sorry to editors - it is the competition magazine)
No surprise, you cannot run an employee service on GMS money, you cannot & should not force employees to work for free.
over 10 years ago: