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Gold, incentives and meh

Jmd

Jmd

  • ​GPs asked to provide Brexit plan and practice lead in case of no-deal

    Jmd's comment 11 Mar 2019 11:30am

    totally agree with Truth Finder

  • Digital GP consultations make spotting signs of sepsis 'a challenge', says PHE

    Jmd's comment 11 Mar 2019 11:28am

    The digital consultation is completely a futile process.
    Issues:
    1. how do you obtain vital signs
    2. how can you illicit signs
    3. how reliable is it to consult a child over teh phone, can one rely on parental history!
    4. the time taken for digital consultation is no less than seeing F2F a patient
    5. Ultimately the holy grail- do safety netting and pass the buck back to the patient and the usual GP!!

    Technology is not all and be all . We need to think what we are doing and what the real savings are.

  • NICE set to lower hypertension treatment thresholds for CVD patients

    Jmd's comment 08 Mar 2019 10:29am

    I feel any new workload generated by any national or local body needs to be resourced. The NHSE cannot continue to demand more work from GPs without resources. The money they predict will be save by these schemes should be ploughed back as resources to meet the new demands.

  • Digital GP providers will 'help expand GP workforce', says Government

    Jmd's comment 08 Jan 2019 4:59pm

    Technology is good, but this is ridiculous.Digital/skype consulting does not save time. It creates more problems and issues( cf Kings Fund Document)
    To carry out digital consolations, requires diligence and more detailed history taking and this invariably take 8 mts or so, then we are left without diagnostic parameters;e.g, O2/bp,pulse,RR etc.
    We need to be careful and all these ‘’flip by wire needs evidence based analysis’’
    I wonder if there is cynical agenda behind all this !!!!

  • Rise in patients leaving IAPT treatment early prompts GP concern

    Jmd's comment 05 Nov 2018 10:40am

    This is not surprising!
    Has anyone looked into the funding agreed for Mental Health is actually going into Mental health or is teh money being used to balance books.
    GPs should write to DOH/NHS England and make it clear that once referred to IAPT then the responsibility of outcomes will be the responsibility of the CCG or the contracted organisation.It is too convenient to dump things on PS.
    There has been cases when IAPT rings GPs to say patient is suicidal, can the GP take on this assessment.NO!, the responsibilities lies with IAPT and they need to liaise with MHT teams to have the patient assessed.
    These political sound bites of more resources to MH is a
    baloney!

  • RCGP chair: ‘GPs on the frontline just can’t afford the investment in technology’

    Jmd's comment 05 Oct 2018 10:32am

    The college and BMA should be promoting equitable earnings throughout the country based on deprivation, adult population and vulnerable patients.
    The earnings vary a great deal and in some cases GP partners are earning less then their counterparts but doing the same work if not more.
    The salaried system will iron out these inequalities and may enthuse some ..!

  • RCGP chair: ‘GPs on the frontline just can’t afford the investment in technology’

    Jmd's comment 05 Oct 2018 10:28am

    I completely get the point.
    However, to resolve these issues and those in the future, we just need to have an overview of GPractice. My personal view is the system should be salaried run owned by local Trust akin hospitals and in this way GP will be left to see patients.Under the current model, most partners appears to be involved in activities away from patient care.

  • GP partnership model: what isn't working and why change is needed

    Jmd's comment 24 Sep 2018 10:48am

    Partnership models needs an overhaul. The primary care should be run under an umbrella of a trust and practices run on the same model as secondary care. There needs to be an overview of all primary care practices. CCG are ineffective, there is top down model and it had failed in its fundamental duties…’’run by grassroots needs''

  • Capita regrets taking on unprofitable primary care support contract

    Jmd's comment 24 Sep 2018 10:43am

    if capita new why did they bid with disingenuous figures. They take on the contract and then shed crocodile tears with an intent for more public money to be cured into their coffers to make the system work.
    There should be a ‘stress test’’ applied at the bidding stages by NHS England to see if the contract canoe delivered down the line without ‘cock ups’’and with out more money plugged into the system to make wrong right.
    I would like to know who is paying for the pensions fiasco, I assume the tax payer.

  • Virtual consultations can be used in '85% of cases' says Babylon's top GP

    Jmd's comment 29 Aug 2018 11:09am

    Real concerns.
    85% - where is the validation, the pilot study for outcomes?
    I feel Dr B has wearing a cap of a business model( profiteering) and medicine and health is not.
    The time it takes to have a phone or video consultation is no less then F2F where a Dr can assess and carry out vital examination of all parameters needed.
    How are you going to assess sepsis, unwell child on a phone or video etc.
    It appears that Babylon will cream off easy pickings and leave the harsh reality of medicine to GPs. This culture by Babylon will encourage the ‘worried well’’ and reinforce it further.
    Why not invest this money locally and let the local GPs decide on a model. This will encourage a degree of continuity and also local GPs will be aware of the socio economic of their patients.
    I am also afraid that there will be more referrals to 2ndry care as no Dr in Babylon will risk their careers for missing an important diagnosis.
    What may be fruitful is for GPs to plan on a model of working shift work with extra resource for patient contact.This will cater for late and early consultations thus removing the need of the private sector.
    Under Babylon system, how are they going to distinguish patients entitled to NHS provision- we will be opening flood gates for tourism health!

  • GMC to ask why BME doctors face more complaints than white colleagues

    Jmd's comment 23 Apr 2018 12:49pm

    This is nothing new. It is the public perception of foreign looking doctors albeit trained in UK, a racial bias. I have seen where BME Drs had been singled out despite issues with all doctors if the practice and there are cases where family complained but no further action taken by the family despite of seriousness of the case...,forget about institutional racism, there general racism though practiced subtly....I wonder if all complaints reaching the GP practice are centrally lodged (away from the insensitive GMC) locally and reviewed by say the LMC committee nod may find the content of the complaint will be if equal meAsure between the indigenous vs BME

  • Thousands more 'fit notes' issued - but one in five GPs say their advice is ignored

    Jmd's comment 01 Mar 2018 11:38am

    The fit note needs to taken away from GPS. There should be an independent body the pt need to attend if they require a fit note, takes away the bias in Dr-pt relationship . It will be worth looking at the Dutch model

  • Lack of evidence for GP video consultations, finds study

    Jmd's comment 01 Mar 2018 11:32am

    Baffling how any telephone or online consultant ion can be sage...how can one diagnose sepsis without examination of the vital signs?
    Personally, I think for a good safe on line or phone consultation needs 10 mts or so, this is how long it takes for F2F....a much safer and patient orientatedservice

  • ‘Targets to reduce referrals are morally abhorrent’

    Jmd's comment 28 Feb 2018 12:43pm

    Interesting proposition,but morally and ethically abhorrent. Shame on you CCGs.
    Quite rightly these CCGs should be reported to GMC, as amply demonstrated by thei4 recent action on patien5 safety!
    If the Nice and the government are trying to promote early detection, let alone cancer but any chronic disease, will mean more referrals not less.
    Nice in its own wisdom promotes guidelines that do initiate more referrals.
    TIME TO DISBAND CCG...utter waste of time!

  • We must not be afraid to overhaul the general practice model

    Jmd's comment 22 Feb 2018 11:04am

    The article certainly have started the debate!

  • 'The GMC treats BME doctors differently and harshly'

    Jmd's comment 12 Feb 2018 5:52pm

    There are other senior eminent Drs who have had complaints against them registered with GMC..and none are erased!!!!!
    Where is the justice?
    Or
    is the GMC practicing a 2 tier system……..

  • GMC says it is 'not discriminatory' following Dr Bawa-Garba case

    Jmd's comment 12 Feb 2018 5:43pm

    Spot on cobblers.
    Has anyone under FOI act requested data from GMC on % of BME vs Indigenous doctors on complaints to GMC for FTP and the number of erasure!

  • DH and GP leaders 'to review partnership model'

    Jmd's comment 12 Feb 2018 5:34pm

    I have read all comments and the main piece.
    We need to look afresh at the GP model.The current model is from the 60s and things have evolved- medicine and management.
    I fail to understand of the 3 tier system inn GP
    1. GP partners and more of the taking on CCG or other non patient contact roles.
    2. Salaried doctors— these are “exploited’, asked to perform partners’ role minus the profit share!
    3. Locums- there need to be an incentive for conversion of this group- they are becoming deskilled in chronic disease management and equally may be falling back on new local guidelines for effective management of patients.
    4.Partnerships are also profiting from increased valuation of the premises to which the pubic had contributed.The GPs should not benefit form tax payers contributions.
    5. ether is no need for GP based dispensing practice, in this day and age- a fast delivery is available on line. The resources can be redirected into patient care. This also causes disquiet among non dispensing practice.
    A debate needs to be initiated—>I certainly can start one from here on…
    6. We need a central state of the art premises which are locality based, not the numerous practices in a locality as current.

    Personally, the partnership model needs to be reviewed - the patients / staff of the practice should all have a vested interest in the practice by being allowed to hold unit shares in the practice( non- profit).
    There needs to be a mechanism by which the tax payer do not lose out on their investments into premises when a partner retires and the valuation of the premises had soared!
    Secondary care NHS model needs to be adopted in some ways…can i suggest that GP are re-labelled as primary care consultants and the salaries approximate to hospital consultants.( note to be a consultant you need at least 8yrs of training)
    The locums can continue as a personal choice but be regarded as staff grade doctors or associates and be remunerated as such—the will bring more GP into a permanent role providing continuity of care.

    Lets look at new way of working and channel our energy into this rather than being negative all the time.I do not think public will sympathise with us if be continue to moan with out making necessary changes.​

  • DH and GP leaders 'to review partnership model'

    Jmd's comment 12 Feb 2018 12:53pm

    I have read all comments and the main piece.
    We need to look afresh at the GP model.The current model is from the 60s and things have evolved- medicine and management.
    I fail to understand of the 3 tier system inn GP
    1. GP partners and more of the taking on CCG or other non patient contact roles.
    2. Salaried doctors— these are “exploited’, asked to perform partners’ role minus the profit share!
    3. Locums- there need to be an incentive for conversion of this group- they are becoming deskilled in chronic disease management and equally may be falling back on new local guidelines for effective management of patients.
    4.Partnerships are also profiting from increased valuation of the premises to which the pubic had contributed.The GPs should not benefit form tax payers contributions.
    5. ether is no need for GP based dispensing practice, in this day and age- a fast delivery is available on line. The resources can be redirected into patient care. This also causes disquiet among non dispensing practice.
    A debate needs to be initiated—I certainly can start one from here on…
    6. We need a central state of the art premises which are locality based, not the numerous practices in a locality as current.

    Personally, the partnership model needs to be reviewed - the patients / staff of the practice should all have a vested interest in the practice by being allowed to hold unit shares in the practice( non- profit).
    There needs to be a mechanism by which the tax payer do not lose out on their investments into premises when a partner retires and the valuation of the premises had soared!
    Secondary care NHS model needs to be adopted in some ways…can i suggest that GP are re-labelled as primary care consultants and the salaries approximate to hospital consultants.( note to be a consultant you need at least 8yrs of training)
    The locums can continue as a personal choice but be regarded as staff grade doctors or associates and be remunerated as such—the will bring more GP into a permanent role providing continuity of care.

    Lets look at new way of working and channel our energy into this rather than being negative all the time.I do not think public will sympathise with us if be continue to moan with out making necessary changes.

  • NHS forced to admit sepsis guidance is 'difficult' as GPs switch off alerts

    Jmd's comment 30 Oct 2017 12:47pm

    I am baffled why the IT providers do not write an algorithm which behaves like an alert and cannot be turned off. The GP is obliged to fill in the appropriate data and look at its conclusion before being able to file the notes. I use EMIS and i am always alerted to use the template and it also allows me to print out PIL on sepsis which I discuss and give to the patient. There is no excuse not to practice good medicine.