I wondered how they were going to fund the extra money attached to the new contract......
Concerned grassroot member - I think some of that video drifts well into the tinfoil hat conspiracy theory territory. The new contract has downsides and the timescale is tricky but some of the "consequences" of the contract mentioned are highly speculative or just lacking evidence base. Great to see such enthusiasm and passion and willingness to speak out but scare-mongering isn't the same as informing people.
GP@ Hand is in no way a network. It's supposed to be a collection of practices in a geographic area who collaboratively organise local services. How can you have a network of one(!) particularly when they're serving patients up to 45 minutes away? It makes a joke of the whole premise of PCNs.
There are lots of risks with digital. A common suggestion is that our consultations will be quicker because online screening algorithms will provide us with the history from the patient prior to a consultation. Issue here is the algorithms aren't robust enough to be trusted. A babylon demo I attended asked patients if they had "a fever" and it was a binary yes or no choice. Where's the "don't know" option. What happens when patients don't know what precisely a fever is? They guess. What happens when patients enter incorrect information to game the system? And we're then supposed to rely on that history and therefore make our consultations shorter? Or perhaps we're supposed to go through the entire history again- in which case there's no time saved.... Some of the digital agenda smacks of desperation and leaves GPs walking a minefield. I keep on recalling the famous quote from Jurassic Park "Your scientists were so preoccupied with whether they could, they didn't stop to think if they should".... Some of digital is a combination of desperation and possibility rather than patient safety and proven effectiveness.
The whole thing is a disgrace. I have paid in to my pension for 24 years and counting- I have now been trying to find ANY figures (for any of this period) for my pension for over 18 months. Every time I ring they are "looking into it" or "recalculating" or "cannot process it currently". The last tax year I can find figures for Capita made a profit of 500 million. There is absolutely not way they should be allowed to spin profits whilst their unlucky "customers" get fined (through extra tax) due to Capita's incompetence. The thing that makes it even worse is NHSEs refusal to accept any kind of responsibility- if you try to complain to Capita they say "speak to NHSE- they commission the service", if you speak to NHSE they said "speak to Capita, they provide the service"...... I personally don't care if Capita regret taking on the contract- they did and they need to provide the service. They can't claim poverty (IE the amount they're charging being too low to do a proper job) when they're turning a 500 million profit annually with a nice little dividend for shareholders.
Capita can't provide me with any figures for any of the last 22 years I've been paying in. Whenever I contact them they're miraculously in the middle of a "recalculation which will take a month". Somewhat predictably when I ring after a month they're doing a new "calculation". This isn't discrepancies this is an abject failure by their part.
Oh that is too funny. My Amazon device can't even play the right song and even just last night it randomly woke up in the middle of a foreign language movie and started rambling on about something random as it had decided someone (in the tv program!) had asked it a question! At some point things like diagnostic AI bots (Babylon) and Alexa type AIs will be of use. Presently it's just hype and emperor's new clothes time and it's a shame the government wastes time and money on these schemes rather than sorting out the underlying issues.
I'm not sure I understand the gnashing of teeth here. NICE are recommending GPs do it, this puts the onus on CCGs to commission the service. When they do (and at a level of remuneration that makes it financially viable) I'll happily provide the service. Until they do I won't.
Whilst this may or may not be a "divide and conquer" prior to a contract change it is only possible because of the unacceptable dumping by our secondary care colleagues....
Re chasing results- if your local hospital has a GP Liaison officer then it's pretty simple to resolve- forward each letters on to them saying either they need to put you on the hospital payroll (standard GP locum hourly rate applicable) or they need to chase up their own results. I did this for about a week with the local hospital and the A+E department got the message and promptly developed a system to "chase" their own results. Hasn't happened since.
The worst case of dumping I have experienced was Barts Hospital who introduced a new appointment system which promptly destroyed their waiting lists. They wrote to us about every one of our patients who they believed was still waiting to be seen saying "Please contact the patient and see if they still need to be seen, if so e-mail us back at [whatever it was], if we do not hear from you we will assume the patient no longer wants to be seen". I sent them all back marked "DIY- unless we say otherwise the patient still needs to be seen- try ringing them and asking- your IT issues are not my responsibility". Clinical Governance officer also got a rocket!
What's the NNT with statins at 10% ?
I wonder what impact tighter controls will have when antibiotic usage is uncontrolled in many parts of the world and where 70% of all antibiotics used globally are put into animal feed to make bigger / cheaper meat. In the absence of medical advice in many parts of the developing world people will simply take a sub-therapeutic duration course of a number of antibiotics simultaneously- recipe for disaster. Whilst I dislike seeing patients given antibiotics to cover an unlikely bacterial component do we really think overly-cautious abx usage in the UK is really a major contributor to the global problem with resistance? Equally we should do something and realistically this is one avenue. Would be interested to know whether antibiotic usage in non-human animals is also being scrutinised. In my experience vetinary antibiotic usage is rampant.
The NNTs are available for the 10% cut-off and as soon as you explain them to patients they lose interest in being on a statin. So are we supposed to just mention the 10% risk and use it as a sword of Damocles to frighten people into starting a statin or have a rationale discussion about the benefits / risks even if this means they decide they do not want to go onto them..... Oh well, as long as we can exception report the majority who decline our kind offer....