This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

Insert pseudonym here

  • High-profile GPs lose seats in Conservative landslide

    Insert pseudonym here's comment 13 Dec 2019 1:44pm

    We should be happy. The 40 new Hospitals will be staffed by the 5000 new GPs arriving by New Years Eve suitably aided by the Brexit Unicorns suitably nourished from eating chlorinated chicken. It's a Christmas Miracle. God bless BJ.

  • GPs expected to vaccinate schoolchildren as flu programme is delayed

    Insert pseudonym here's comment 07 Nov 2019 4:11pm

    Sounds like some rapid commissioning needs doing to get this agreed upon. PHE could contract directly with Feds or PCNs. Until then it's non-contractual and responsibility sits with PHE and it will be "thanks but no thanks, bit busy vaccinating those I am commissioned to vaccinate". If practices are stupid enough to roll over and do this without an agreement then we can't really blame PHE for trying it on....

  • RCGP warns GPs against interpreting genetic tests from commercial companies

    Insert pseudonym here's comment 18 Oct 2019 9:59am

    Interpretation of any result medico-legally sits with the requestor. In this case the patient! No different to secondary care dumping interpretation of requests they've ordered on us: "Thanks but no thanks".

  • PM aide's advisory role with Babylon 'raises conflict of interest questions'

    Insert pseudonym here's comment 11 Oct 2019 7:47pm

    The problem probably isn't how long the piece of work was, more how much money was handed over! MPs have to report such external interests, unfortunately not so "advisors" or those pulling the puppet strings. Then again, I doubt Cummings is the most active of the pro-Babylon lobby.

  • Same-day pharmacy appointments could help tackle GP pressures, says RCGP

    Insert pseudonym here's comment 24 Jul 2019 12:19pm

    Just another sticking plaster for the lack of doctors. I think the impact these schemes have is often less than expected. It removes a small percentage of easy to handle appts and just leaves the complex, lengthy appts being squeezed into long clinics full of 10 minute appointments that end up taking about 30! The two main issues (lack of doctors and increasingly elderly frail complex patients) are totally ignored.

  • NHS to investigate GP ‘fraud’ in retaining ghost patients

    Insert pseudonym here's comment 12 Jun 2019 2:58pm

    I wondered how they were going to fund the extra money attached to the new contract......

  • GPs to call for ‘immediate’ withdrawal of new contract at BMA annual conference

    Insert pseudonym here's comment 06 Jun 2019 11:38am

    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 at Hand set to apply to be single network in 'destabilising' move

    Insert pseudonym here's comment 02 May 2019 1:12pm

    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.

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

    Insert pseudonym here's comment 14 Mar 2019 11:14am

    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.

  • How GPs have been left dealing with the pensions pot fiasco

    Insert pseudonym here's comment 03 Jan 2019 10:51am

    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.

  • Leaked NHS memo warns pensions errors may affect 'large proportion of GPs'

    Insert pseudonym here's comment 18 Oct 2018 10:40am

    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.

  • Government to partner with Amazon's Alexa to offer NHS health advice

    Insert pseudonym here's comment 20 Jul 2018 10:50am

    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.

  • Removing earwax is down to GP practices, says new NICE guideline

    Insert pseudonym here's comment 21 Jun 2018 10:51am

    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.

  • GPs to be protected from secondary care workload dump

    Insert pseudonym here's comment 29 Jul 2016 8:55am

    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!

  • GPs told to ignore NICE statin prescribing guidance in cost-cutting drive

    Insert pseudonym here's comment 02 Jun 2016 10:58am

    What's the NNT with statins at 10% ?

  • PM asks GPs to 'halve' inappropriate antibiotic prescribing

    Insert pseudonym here's comment 01 Jun 2016 8:48am

    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.

  • NICE recommends introduction of 10% statin threshold into QOF despite GP opposition

    Insert pseudonym here's comment 02 Jun 2015 11:58am

    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....