Jones the Tie
cynical middle-aged bugger in West Midlands. Qualified Birmingham 1994.
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
Big and Small ...I love you ! Bang on , completely endorse what you state
Not a massive sample though really eh... 3000 folk out of 65 million... it might be a 'bit prone' to sampling error I reckon if you try and generalize anything from a sample of only 0.004% of the target population..just saying...
Crikey ...anybody want my partnership? If you really want to put your house on the line in NHS Primary care land and accept all the responsibilities therein for no real increase in remuneration please let me know. I couldn't give a stuff if you are a GP or a nurse or a practice manager or HCA or physio I'd have NO PROBLEM accepting you as a partner as long as you don't mind buying in and committing to the risks involved for no more than you are currently getting now and if you want to improve a service with expenditure but within a falling budget accept that means you taking a personal pay cut for the privilege... There's the nub in my practice see..Why the effing Nora would anybody want to be a partner in the current climate?? I think this article shows no real understanding of what Partnership means. In my practice where I have one partner, me and 4 salaried GPs, 2 nurse prescribers, 3 nurses health care assistant and awesome practice manager, reception team etc etc I happily take all their ideas and innovations and leadership ideas re running the practice and providing innovative services. I often have to moderate their enthusiastic ideas with the stark reality of what can be afforded..being a 'partner' does not offer the heirarchical archetype this article suggests and I think somebody may well need to think a bit more about it as I think they may be misunderstanding or feeling their role is undervalued which is more about the organisation/ethos of a practice than the partnership principle of which poor sod is left carrying the can when it all goes belly up.
Pharmaco-vigilance is something that we should all practice. Unfortunately this is one of those things that takes time and knowledge for which NO ACCOUNT is taken during our working day. If one looks at the main culprit drugs it is the usual suspects, nsaids, chemo agents etc. More complex drug to drug interactions take time and knowledge to prevent. I have lost count of the number of times I have had to point out to consultants in secondary and tertiary care that their prescription is potentially harmful. The responses I get are rude to say the least. We ALL need to improve our prescribing but I think MR H will find that just 'monitoring admissions' will not help. Often drug interactions and ADRs are complex and it takes time to stop patients suffering potentially avoidable type A ADRs. I don't think any of the 'sneering secondary care ' professionals will have ever tried to police hundreds of complex scripts week after week and organise complex recall and monitoring systems that need to take in to account the ability to provide the service. I suspect they think just writing in a letter stating what should happen with monitoring miraculously makes it occur. It doesn't . It takes time and expertise and a pragmatic and rational approach. No matter how good we make systems drugs will still cause harm. Full stop. What Mr Hunt needs to do is realize that the service he has got is what he pays for. Staff and expertise are expensive but he should realize that what the NHS is suffering from is chronic low morale, underfunding compared to other similar nations, under-staffing and a lack of coherent planning. I have NO allocated time to check repeat prescribing in my day and cover for colleagues when they are on leave. If I had dedicated time it would need resourcing properly. That would be your job Mr Hunt.. help us health professionals and prescribers have enough time to be able to safely carry out the tasks we all know about..and no professor Lord Tertiary neurologist Badcrumble I won't issue a script for propranolol for 'benign tremor' to a brittle asthmatic at your say so...it's a bloody good job I know my patients and check these things which you don't and now I've got to tell the patient why I won't prescribe it as ' that professor said you'd do me a prescription' ..well Mr Shaky in the grand words of Doc Martin ' I have an aversion to killing my patients' rant over
I'm close to throwing the towel in. Those left trying to keep the ship afloat as it sinks are being left hanging out to dry when things go wrong with the sinking ship. When will the public realize we are human and when we have all had enough of working in this horror show and call it a day there will be no-one left to help them in their hour of need? How will the GMC and HMG respond to that situation? I am sooo glad neither of my children show any inclination to take up this profession as I think they see what it is doing to their Dad. Long hours, endless stress , responsibility for situations utterly out of your control, constantly being asked to do more for less, an NHS that thinks we are just bits of equipment, made to feel guilty for the parlous state of our sinking ship...can't say I blame them. Message to this poor doctor who has been struck off..'every cloud as a silver lining'
too little too late?
does 'suspend QoF until the end of March 2018' mean they will give ALL practices 100% QoF monies this year ( 2017/18) or does this just mean they will wait 'til the end of March and when practices haven't tackled QoF hit them with a stick as new QoF year only begins on April 1st 2018..as ever Devil is in the detail