P George Paige
Midlands Doc - they also need to still be at the coalface for 5 sessions a week minimum.
The Legislation is there, it is one of the schedules in the Drug Tarriff, anyone remember the black listing of Distalgesic, Valium, Xanax, a multitude of cough linctuses and numerous other "useless" drugs the NHS thought we should not prescribe - all they have to do is add to the list. (it might need hundreds of brands of Paracetamol etc - but that's what the admindroids are good at!)
"Professor Marshall said the new system would be 'a high-trust, profession-led, quality improvement scheme"
That's what was said about QOF in 2004! Look how it turned out.
"I LOVE the idea of 111 having to book into a triage slot, but:
1. Can we trust 111 not to take the attitude of 'we are the triage service so we shouldn't be booking a triage, we should be sending them to see the clinician face to face'?"
In OOHrs we already have this - the usual dross. However "the Rule" is that if 111 have clinically triaged a patient we have to accept that triage and are not allowed to re-triage!
Heaven help the practices.
The Perfect Storm strikes, Pay, conditions, indemnity, work rate, responsibility for Nurses.
Even some providers are finding problems and pulling out. The CCGs are going to have to be very inventive and dig deep into their pockets if they do not want A&E to carry the (more expensive) burden.
knowledge is Porridge
Have you looked at Anywhere from Vision? iPhone, Android, pads, windows 10, windows surface, desktop.
I have just seen this child who may have asthma, At 8 years old she cannot blow into a peak flow meter, She is blue and struggling for breath. I think I can hear a slight wheeze in her chest but it is so quiet (I cannot hear any breath sounds clearly. Her pulse is 180, she has subcostal, tracheal and rib recession.
Normally I would give her nebulised salbutamol and steroids but she has not diagnosis of asthma so could you please see her and arrange spirometry and FeNO tests. (preferably before she expires)
I am glad we all trust politicians to tell the truth and stick to their promises. No more worries. (cynic mode off)
My concern is that - as noted many times above - this is preparing for a salaried service. but I am afraid that all this DIRECT reimbursement (rather than putting it in the global sum) will draw HMRC's attention and they start dealing with us (partners) as salaried with a loss of flexibility in claims and expenses. That would push even more to jump to full salaried for the extra protection of hours and workload.
The problem locally is the the Dementia diagnosis is the gateway to social services, benefits, carers etc and SS do not accept a normal GPs diagnosis so you have to go on extra training to be able to diagnose it so that it is acceptable to SS. But it also allows the GP to take over the prescribing of the Rx. Without the "proper" diagnosis no Rx & no SS support. Mad!
Can I have some codeine, pregablain & lorazepam please?
Thank you very much.
what the F*** does this mean?
'To gain clarity on the pathway to financial sustainability as a system brought about through demand management; active cost management and increased productivity; aligning resources and incentives with collective decision making; developing new contracting and payment models; service and pathway transformation resulting in improved value; together with a new model of out-of-hospital care enabling the resizing of acute hospital services.'
and if they don't get their amoxil from the GP they go to the Walk in centre, 111, Out of hours, A&E, or anywhere else they can get them .
Interesting article & response from Dr Chand. What worries me about the physicians associates, nurses, nurse practitioners & pharmacists is the responsibility. Who will be the fall guy if a complaint comes in - will it be the individual or the employing partner who is in the firing line?
I am confused. GP records are confidential. How can TPP send "each GP partner in SystmOne practices had been sent lists of around 20 patients who had received incorrect risk scores and needed a review." Surely this means that they can access the detailed, identified records. Who else can access the records?
7.31 - I agree - nurses are cheaper per hour but take longer to see and treat, and refer more - the experience of Walk in centres seems to support this. Nurses rarely have a 2nd gear to see more to clear a backlog or increased demand when there is a local or national panic (flu, meningitis, septicaemia, Zika, ebola etc etc)
"|Gerard Bulger | GP Partner|04 Apr 2016 1:17pm
Until any patient can be seen that day in their practice, this problem will get worse. What is not understood that GPs will not need to work much harder to achieve this. Offering one or two more slots a day, and being flexible when there is flu or pre-holiday inspection syndrome about. Patients should be able to book months in advance. All it is needed it to clear the waiting list, that will be a bit of work, then prevent it arising again. The demand is NOT infinite. There are only that many patients on our lists. Make sure there are 5.5x list size slots available over the year."
This works in the short term, but as people get used to being able to make an appointment at the drop of a pin their "need" increases and even more appointments are needed. the consultation rate used to be 3.5/1000 in the late 80's now it is 5.5, or 6.5 in our practice and the expectations and absence of self care both increase.
|Anonymous | Other healthcare professional|18 Mar 2016 7:02pm
Remember - whoever you are - you are a healthcare professional and will soon be working 7 days at plain time if JH wins this round. The next round will be other healthcare professionals. he cannot have a 7 day "normal" service without nurses, Physios, OTs, porters, secretaries, OPD Nurses, radiographers, etc etc etc.
I am surprised that none of the above comments have noted that the average APMS is only £143.84, the Average GMS £137.05. this difference is being shouted from the tree tops and PMS is being squeezed.
What about the APMS "friends" taking home profits of £50/patient above GMS!
Surely this is an inevitable progression from computer generated Med3's. There are probably plans for us to send them electronically to the DWP as we do with electronic prescriptions. Then the DWP will have patient identifiable data electronically as the PPA has for prescriptions. - Add the two together, add care.data and summary care record - What have you got?,
Put the NHS Number in the mix and Hospital records open out.
Cross reference DOB & address (on the med3) & social service records - where does it end??