This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

A faulty production line

Alex T-S

  • The King of Complaints

    Alex T-S's comment 07 Aug 2019 5:03pm

    My record is 66 pages and 3 appendices but you have outdone me. I doff my cap, sir!

  • Kindly do your own bloody work

    Alex T-S's comment 05 Apr 2017 6:15pm

    I had a BUPA "health screen" sent in recently with 7 "GP action points" on it. Needless to say it went into my "routine appt" (i.e. 4 week wait) pile. The terrible thing was that point 4 ("likely BCC on back") looked very much like 2 x malignant melanomas to me (and the dermatologist I referred to via the 2WR agreed). This sort of dumping is exceedingly dangerous!

    I have considered changing my letter sign-off to "community house officer" but don't feel that accurately reflects the level of non-esteem I'm held in by certain hospital staff.

  • Mr Hunt! I know where your 5,000 extra GPs are

    Alex T-S's comment 22 Feb 2017 3:08pm

    Flat6 - I would agree about a "separation of the powers" in politics but policy direction is something else entirely - you really do need somebody who knows what's happening "on the ground" to shape that. After all, the PCT days with little clinical input weren't that rosy, were they? The difference is that the CCGs now have much greater power with NHSE having offloaded most of their responsibilities to those same CCGs - if there's no GP input do you trust an NHS manager to be making decisions about your future?

    I would argue that if you're not part of the solution, you're part of the problem, and simply moaning without coming up with anything better isn't really being part of the solution, is it? Mass resignation or refusal to comply with the pointless nonsense we are "required" to do may be another route to change, but unfortunately this tends to result in casualties (us and our patients, cf the junior doctors' strikes). I would argue that it is less disruptive/harmful to change things from within than without. It may often seem like wading through treacle but it avoids unintended misfortune in angry revolt (Brexit, anyone?.....)

  • Mr Hunt! I know where your 5,000 extra GPs are

    Alex T-S's comment 22 Feb 2017 1:00pm

    My parents always taught me that if you don't like something, don't whinge about it, do something about it. Since the whole NHS seems to be going to hell in a hand cart should I sit on the sidelines wailing & nashing my teeth? No - I decided to use my "day off" (which as we all know doesn't really exist) to do a day at the CCG trying to steer the somewhat ruderless supertanker in a direction that might benefit our patients and the clinicians of the NHS. Does this make me a Morlock? I rather thought I was one of the oppressed coal-face workers who might have risen up to try to influence things for the better! I actually spend most of my time trying to thwart plans for labyrinthine over-regulation to ensure we can just get on with our clinical jobs whilst ensuring a sustainale future. Don't fall into the trap of "divide & rule" - there are still some well-intentioned people out there!
    PS - I still see just as many patients at the practice as my colleagues.

  • GPs’ diagnostic skills could be obsolete within 20 years, says Hunt

    Alex T-S's comment 06 Oct 2015 3:57pm

    Open the surgery doors please Hal........

  • GP to sort? I don’t think so

    Alex T-S's comment 01 Jul 2014 4:58pm

    Patient admitted with LRTI under respiratory physicians and found to have a suspicious lung lesion on CXR. Discharge summary states, you guessed it, "GP to refer to respiratory team under 2WR". You couldn't make it up.......

  • CCGs should be able to take action against underperforming GPs, claims report

    Alex T-S's comment 25 Feb 2014 11:06am

    Our contracts are with NHSE, not the CCGs so don't try to dump more work back by trying to make GPs police their own contracts via the CCGs thank you!

  • Local enhanced services worth millions to be opened up to competition from April

    Alex T-S's comment 03 Jan 2014 10:00am

    Further privatisation via the back door. This time General Practice. And the truly shocking thing - we've fallen straight into the government's trap and are doing it to ourselves!(we are the CCGs after all).

    Next step: Put out GMS/PMS contracts to AQP on a (likey) 3 yearly basis (yes, I know we can't do this to ourselves via the CCGs but NHSE sure can......)

    See how the NHS is deconstructed steadily but surely and through a process of "divide and rule" we're all complicit.

  • Offer more same-day phone consultations for urgent patients to reduce burden on 'creaking' A&E, GPs told

    Alex T-S's comment 13 Nov 2013 9:46am

    Hang on, Ive got another idea - more telephone consultations from hospital consultants. After all, I've only got a 3 week wait for a routine appointment with me whilst a hospital OPA is averaging 3 months at present.............
    I think the local cardilogists would be delighted for any of their patients to ring them at any time for "a bit of a chat".
    Just applying the same logic...........

  • Offer more same-day phone consultations for urgent patients to reduce burden on 'creaking' A&E, GPs told

    Alex T-S's comment 13 Nov 2013 8:47am

    Due to being rather shortsighted some years ago my patients already have "open access" to phone calls with myself. My predecessor refused to speak to anyone on the telephone saying that if they needed an appointment they had to see him face to face. The net result was that a lot of people just couldn't be bothered and their self-limiting problems resolved themselves. I thought this was slightly mean so agreed to call anyone back who wanted to talk to me. Unfortunately the initial 5 calls per day has grown into an unstoppable monster - at least 20 calls a day that often take me well past 8pm (record = 10:30pm to complete all contacts). These are often pointless conversations with the worried well (tagline jingle "If you're sat around at home, talk to your GP on the telephone on 0898....." etc) which take time away from those who really need it.
    Bottom line - the easier it is to access a free service, the less it will be held in regard.

  • BMA calls for practices to work together to extend GP access in blueprint on future of general practice

    Alex T-S's comment 07 Nov 2013 2:35pm

    Anonymous 11:43 - I think you're very optimistic. I think we're about to be rolled over and have our prostates tickled!

  • Merging into the detritus

    Alex T-S's comment 26 Jul 2013 6:36pm

    Hit the nail on the head again! It has struck me that we seem to be developing a collective case of Stockholm syndrome - a traumatic bonding with our evil overlords after years of abuse.

    Now, I really must get back to writing a 3 page EMIS template documenting my correct auscultation of the chest.......

  • Dr Mary Church: 'Ministers want us to out-of-hours back so they don't get the blame for it'

    Alex T-S's comment 14 Jun 2013 7:04pm

    Agree with all of the above - look what happened to the dentists and people's dental health as a result.

    My suspicion is that the DoH wants us all to quit because then they won't be saddled with any pension costs. Who will provide primary care then? Virgin, Tescos etc who may well offer to employ us back at lousy rates. Whatever happens this needs to be played very carefully. Having already accepted the poisoned chalice of commissioning we should not get suckered by "phase 2 " of the evil master-plan to deconstruct the NHS and remove any power from our profession.

  • The Department of Health is responsible for out-of-hours care, not GPs

    Alex T-S's comment 21 May 2013 8:44pm

    Anonymous 3:47pm - you are not called twice a year for a clinician-centred tick-box exercise, you are called twice a year for a DoH-centred tick-box exercise. Believe me, nothing is more depressing for us than having to sit in a room with a patient asking increasingly irrelevant questions that insults both their and my intelligence. Unfortunately, if this does not happen, the practice does not earn any income and will cease to exist (and don't think it's because we're taking all the profits despite what the Daily Mail tells you (who do you think controls their agenda?)).

    An excellent article!

  • There's no way GPs would take back out-of-hours work

    Alex T-S's comment 15 May 2013 10:13am

    Dr. Copperfield - I could not have said it better myself! I have seen this plan unfolding for some time.
    David Bush - the reason we have been firmly handed the poison chalice of commissioning is all part of this plan - when there is the inevitable excrement-fan interfacing in NHS funding, who will be to blame? Not Mr Hunt or anyone at the DoH! No, the people who brought down the NHS (suddenly retrospectively viewed through rose-tinted glasses) will be those fat, lazy, overpaid GPs that couldn't even be bothered to get out of bed to see your toothache at 3 a.m......

    Once again I will plug my e-petition to get rid of Hunt and at least get someone to listen at:

  • A curious case of vanishing sick notes

    Alex T-S's comment 01 May 2013 12:10pm

    Ah yes, I can easily remember the last time in my surgery I said "Oh yes Mr. X, I appear to have carelessly mislaid your highly confidential paperwork that will have a direct influence on your ability to eat, pay your bills and keep a roof over your head. I suggest you contact the agency who sent it to me and get them to complete it all again and send it to me as I really can't be bothered to sort out my own mistakes" and then did exactly the same thing thousands of times per year.


    I guess that may be because we are "ideally placed" to sort out everybody else's cock-ups but live in fear of being sued/struck off if we make even the tiniest error.

  • RCGP chair challenges Hunt for using GPs as 'scapegoat' over A&E failings

    Alex T-S's comment 26 Apr 2013 10:01am

    Once again I would ask anyone reading this to sign my e-petition regarding Jeremy Hunt at:

    And please pass the message on - we cannot tolerate this fool for any longer!

  • Hunt blames GPs for a rise in patients presenting at A&E

    Alex T-S's comment 16 Apr 2013 7:53pm

    David Bush - I could not agree more wholeheartedly. I am so incredibly disheartened by Jeremy Hunt's abject lack of understanding of his portfolio that I have set up an e-petition on the government website here:

    I would urge anyone interested in seeing this buffoon go to please sign it.

    (And I'm quite happy for the GMC to see my online opinion represent the view of the medical profession to boot!)