Jones the Tie
cynical middle-aged bugger in West Midlands. Qualified Birmingham 1994.
Is that the Matt Hancock whose family run a software business?
oooh does HMG realize what would happen if GPs decided to work to these 'guidelines' for every problem presented? that would take at least 30mins plus for an average appointment. How about we say 'yes that's fine but now I can only see 15 patients MAXIMUM a day and then we're full and you'll have to go elsewhere. This is another example of pen-pushers and politicos having absolutely NO EFFING IDEA how efficient and safe the vast qty of GP appointments are and how we hold OURSELVES to high standards and try to do the best we can with what we have. Give me an hour with each patient and no reams of paper work and I'll follow every guideline you want but the outcomes and safety won't be any better for the population they'll be a damned sight worse as the laws of un-intended consequences quickly kick in. Where is the safety data for any 'guideline ' anyway. nobody seems to question that and as far as I am concerned a lot of guidelines are not evidence based but 'consensus' based which basically means folk who don't actually do the job sat around a table deciding what the folk that do should do...ahhghghhhhhh. I should be judged by the standards of my peers ie OTHER GPs who do the job NOT a bunch of various folk who are usually secondary care or industry folk sat around a table so until we get 'guidelines' produced by jobbing GPs whatever standard guidelines the ombudsman wants will be irrelevant oooh and by the way us coal face GPs usually haven't got the time to sit around tables coming up with guidelines as we are actually at the effing coal face trying to keep the NHS Titanic from sinking...there I've said it
ooh great non specific inflammatory markers mean myeloma only...FFS how about the Ivory Tower Bullshitters get out into the real world and try and manage clinical risk in short appointments about 3 problems ... utter shite...
that should say Scottish!! effing fat fingers
Scoottish GP- You star.. spot on and have made me giggle
serious point _ unusual for me ..locally the CMHT have allocated each practice a 'primary Care Mental healthcare Worker' who does 2 sessions a week in the practice and can often see and advise us directly about what the best service might be for that patient and actually treat them as well. They have great links and access to all the CMHT and third party resources and have become a very valued member of our team. This has enhanced our understanding of mental health issues and reduced referrals to consultant colleagues. the role is provided by CPN/Clin psychology trained staff and is utterly excellent. Nobody gets irritated by 'refusals' as we do that odd thing of 'talking' to each other. I realise we are very fortunate but surely this approach is much better for the punters that consultants reading letters at a distance and making 'suggestions' . How about that as a suggestion Francesca? We are ALL working with reduced capacity and increased demand I'm afraid and we are ALL underfunded both fiscally and in terms of clinical resource . Surely CMHTs across the country need to start looking at their excellent staff and using them more pro-actively. lots of 'referrals' don't need to go anywhere the consultant psychiatrist as there are other staff with extensive mental health abilities who can quite adequately perform this role freeing up the consultants to see the patients who do have significant issues which can not be helped by other means. ?? any use Francesca
there is NO WAY this needs to come any where near primary care. If HMG want to support this then by all means do so by subsidizing sales or whatever but NOT out of NHS budget and they do NOT need to involve GPs..or Pharmacists for that matter... I'm NOT going to spend ANY of the time I already have not quite enough of re-doing a prescription because some punter wanted bubble-gum flavour and not hideous Nicotine flavour or orange and mint or whatever etc etc. don't get me started on the anti-social bastards subjecting me to their clouds of bubble-gum stinking whiff whilst I am having a coffee or when I think their car is on fire because some Thomas-the-Tank engine Muppet is puffing away on a sesame and mango flavoured device whilst driving.... there I've said it
review yearly to assess? This author has little idea of the pressures on modern day General Practice in my opinion. Otherwise a reasonable article
very good article. I didn't know it was more common in rural areas. That's pretty important to me as I practice in the sticks where no sod lives as Del-boy would say :o)
just the job, key facts presented in a relevant manner and not overlong
bang on Pradeep!! It's like they ( HMG) think they can walk in to a Ferrari showroom chose a top of the range model with all the latest gizmos and gadgets and when it comes to paying say ' well I've only got £5K so you'll have to accept that but I still want the Ferrari' Then are flabbergasted when the garage tells them that's impossible... Muppets
what planet are these folk on?? 'refer within a month' and CMHT will phone them with some telephone help in 6 months time at best??? LOL who makes this stuff up, they clearly don't ask anyone on the NHS frontline!
but wo betide GPs if we bill local secondary care trusts (whose staff use our premises) for extremely reasonable service charges...
papering over the cracks with very, very, very thin paper.. No real attempt to address or understand why nobody wants to do this job anymore
Dr Get Real...so that would be CQC fee that appeared when this quango was set up then that we had to fund out of a limited budget and indemnity that all our hospital colleagues have funded for them IN FULL for their NHS work as part of NHS indemnity then would it?? How about just extending that indemnity to GPs working in an NHS capacity rather than paying a small amount to match the enormous increase in indemnity fees we are seeing?? I haven't seen any resilience money either so there you go how's that for a bit of balance ? What we need is more staff do meet the rising demand not 'schemes' to paper over the cracks
Kate, I too read your article in The Observer and now your blog post. I can totally identify with Richard. Medicine attracts caring , sensitive and intelligent souls which the GMC has very little understanding of. We care deeply about our performance and our patients and complaints can destroy us. The GMC has no understanding as far as I can see and their Draconian approach is likely to worsen outcomes for patients not protect them.
I am devastated to hear of your loss and gladdened to hear you trying to carry on as best you can. You need to be knighted as does Richard posthumously. Without folk such as you and Richard our NHS ceases to be and patients suffer. Just ask yourself 'What would Clem do?' when this soul destroying machine minces our compassionate colleagues. I'll sink a beer for Richard and your family at the weekend and my thoughts are with you. Thank you for bringing your tragic story to a wider audience.
Dr Andy Jones, GP, Hereford
mmm, jolly good if one is practicing medicine in an ivory tower but not quite so good if actually practicing at the coal face of NHS Primary care!
What would NICE like us to stop doing to achieve these goals? Do NICE actually know what is happening at the NHS coal face? I suspect they may thinks GPs have 45 mins with each patient??
sigh...ooh hang on how do I suck those eggs over there? I've no idea . I need some ivory tower rubbish to teach me... back on planet earth ..
JH's lost hamster..brilliant I'm going to use that analogy now as well!!
mental idea. numpties with little medical trianing following some ridiculous computer flow chart that ends up sending lots of folk needlessly to A+E already. Give them access to 30% of my appts so they can fill it with dross and add to the white noise my practice has become VERY adept at filtering... sod off idiots just fund primary care properly