Sorry don't the army have guns and tanks designed for war.
And our resilience will be be based on an e-module.
I vote to join the army.
On a serious note, if this is the serious message from the GMC the counterpoint to this will be medicine practiced by risk assessment. Hello US healthcare,
I'm happy to practice defensively, might have an effect on admissions and OPD clinics, but its OK there's plenty of capacity there !
I second Una coales
I have no understanding on why this survey has any relevance.
Some people moan, what's new.
not another link to the xmas BMJ, surely you can't have this many comedy article links
i think the xmas bmj is there for a reason, why is pulse regurgitating the comedy, doesn't work here.
I read the pulse to feel depressed and low, not for a smile.
but its the core of academic GP's and Public health dr's who are pushing this.
recognising work to be done should be accepted once evidence is established not using primary care to run the experiment!
the rcgp..incompetent and divisive ...never
can't believe people think darzi was in any way coherent.
He was pulled apart from the beginning, remember allyson pollock taking apart his report as soon as it was published.
Solving these issues is relatively easy but we have to recognize what we're aiming for. politicians are held back by their own dogma.. they really don't care about anything outside the electoral cycle
the CQC do need to justify their existence
There are some politicians who are openly talking about reducing the role of CQC already and tthe CQC will need to show it is collecting doing 'metrics' because that Is what counts!
I'd like to say shocking but its not is it?
If GMS funding really is not sufficient then the tendering process involved in APMS will show that
Its already been demonstrated time and time again how non-viable APMS is. However the reason it is being pushed is for ideological reasons and pure dogma from the right wing political class.
The facts that fewer people are entering the market for APMS unless it is funded at 4-6 times GMS rates tells us everything.
The GPC need to follow this through - it may fail as it will depend on interpretation of law - but then it does crystallize the issues for the politicians
Anonymous | 15 August 2014 1:51pm
What you is true for some areas, some abuse of position has occurred. But this is not the complete picture.
There are plenty of real and fruitful opportunities still out there
I think as a young partner ( despite old profile) it feels as if there is a panic which will lead to self fulfilling disaster in the NHS.
From my perspective, I work in a lovely areas of the East mids and have great job satisfaction. I did take over my father's practice so did not have to buy in. We work hard, have great job satisfaction and good incomes. Even anyone buying in would earn more then a full time locum.
However we are fortunate that the 2 newest partners have taken over from retiring parents.
What has happened locally is that neighbouring practices cannot recruit because of the panic and they are losing patients to us. That is causing us significant issues, we employed sev salaried GP's but it became too much trouble to bother because of a jobsworth attitude and we now manage with NP's.
We've even been approached to take over the running of the other practices which we have declined.
I don't believe the big players are interested, they've have their fingers burnt too many times(failed walk in centres). But there will be niche for partnerships if we take it on.
The neighboring practices are very good but report the same issues with a lack of professionalism with newer Salaried GP's. Because it takes time to learn how read accounts new GP's off VTS have no idea how to analyse accounts and cannot see a good thing when it is in front of them.
I know there is historical abuse from partners towards salarieds but these were often large inner city practices, and I do feel they may have long term premises issues if they are in converted Semi detached houses.
However for those who are interested, want good relationships with patients there must be a lot of practices like ours. I think there are small inner city practices which will be destroyed by the current government but not everyone is the same boat.
There is a lot of reason to be suspicious and pessimistic but there are thriving practices who believe partnership is the best balance. Yes it is under deliberate attack . But as sev other commentators are saying it looks like we'll end up with sev big and medium sized players and lots of lower paid staff - be they dr's or nurses.
The question is where do you want to be?
Harry Longman | Other healthcare professional | 04 August 2014 6:22pm
The core failing with your data is that it is a database collecting data which will be selective -i.e not prospective datasets designed in a trial setting with strictly defined parameters.
The data you have will have limited validity, but if you have confidence in it - publish and allow it to be scrutinized.
You shouldn't confuse cynicism with critique. The problem with peer reviewed research is that it breaks through dogma. In an area where there many vested interests pushing telephone consults or skype consults ( without any published evidence supporting it).
Some things in medicine are really simple, safe productive consulting should be face to face largely. when Skype introduces 4k resolution 3d cameras with real time physiological monitoring I may reconsider !
Harry Longman | Other healthcare professional | 04 August 2014
I appreciate you have declared your financial interests as you run a company promoting phone triage.
One of the nice things about medicine is the use of evidence in a trial settling and the power it has to show real clinical benefit. Access to your database of information with respect has absolutely no relevance at all. If you had any confidence in telephone triage then publish all your data, commit to trials.
Your anecdotal reply to the evidence does sound desperate. Like so many fads in medicine they arrive with great fanfare and disappear as the evidence mounts. It is tough for your company.
I know several practice s who are now starting to drop the mainly telephone triage, as it has been disastrous and interestingly tallies with the findings of this study.
However the good news for you is that governments and NHS England have never let evidence get in the way of their dogma!
I am very sympathetic to the dr's and partners is these practices. But many will be poorly run, probably with excellent doctors but not run efficiently.
Time to let poor practices(in business terms) fail, let a crisis develop and then have a proper long term solution
wow, well said
I do fear for careers though. I always wanted to in partnership. There are good ones out there which are doing ok, but it can be difficult to tell.
All that is left for the rest of us is salaried slavery or being a larry the locum!
Anonymous | Sessional/Locum GP | 06 July 2014 11:15pm
Very funny - did someone touch a raw nerve? You did take the bait!
As someone who has done the CSA and MRCP your comments do come across as naive though.
The AKT is hardly a test of anything, and the CSA only tests one standard form of gp model of communication.
It is a limited exam and the RCGP would do well to learn from more serious college exams such as the MRCP and MRCS. The CSA is a test of acting skills not of medical skills.
I also think the CSA is a politically correct exam.
Although in the current environment - not sure where GP's are meant to go with our careers, locums and salaried positions may not be ideal but good viable partnerships are increasingly rare.
We're becoming a training practice, I think you still need to be with the RCGP for that.