I think to those of us who look at what UK primary care has achieved these are really sad moments.
I would love the ethos and hard work of the UK GP to be supported and nurtured, instead of being destroyed as it has been. I just do not know how you will save this.
I still see viable pockets around, there are thriving practices and maybe we need to create viable areas and non viable areas. maybe thats how HMG will wake up?
this is where the RCGP has failed, unfortuately this job was too much for maureen baker, we need a fighter for general practice.
regulation for some selected groups is always the question. a local health spa near us which provides nursing care and cosmetic beauty treatments has recently told us they don't need CQC registration. Imagine their competitiive advantage over most health care sites.
They actually want CQC registration but CQC are not interested!
next you'll be saying families are a good basis for a stable society ...you old traditionalist!
concentrate QOF on areas where there is evidence or where there is substantial potential benefit
Fund it properly
I didn't mean to cause offence to locums.
But although it is patently true that the standard GP contract is grossly underfunded, the role of locums is mixed.
Yes you need a certain number as they allow some flexibility. But all the young GP's I have seen are taking locum posts, and when they do take on any middle management type roles they cannot cope, because they have not developed the skills.
From a clinical point of view unless they are a long term locum I see 60% of their consults as pointless because they will not know the background of the patient or the future plans.
Partnerships are the only way the NHS will survive(in an economically viable way) - we need to be pushing for this more then trying to fragment what is left
surely the problems with locums is that they are generally poor, not because they may not be good doctors but what makes a good gp is the ability to have continuity of care.
the risk to locums comes from physician assts - not becasue they have to same skill set but because they can do enough to highlight and streamline cases available to real GP's.
working for the mail...thats surely too low for a doctor to stoop to.
It must be awful to work for NHSE. There must be some people who work there who are trying to do their best.
But to be stuck in such as evil organisation must be soul destroying. I really hope if there are honourable people left within NHSE they speak out sooner rather then later when saving the NHS will be too late
Anonymous | GP Partner | 29 October 2014 12:55pm
Interesting, can you cite where that information is published? would be appreciated
Shaba Nabi | GP Partner
I think its naive not to recognise the impact of part time work on medicine.No-one is suggesting it is the sole problem. But it is a very major factor.
It applies to both primary and secondary care and the fact we have almost given up on continuity of care as a concept shows what impact it has had.
Although it was traditionally female drs who worked part time, increasingly male doctors are doing so - to avoid being the sole full timer in their clinical setting.
Rather then being overly sensitive to this I think recognition is the first step. There are solutions but they will be uncomfortable ones.
When the RCP talked about this a few years ago - there was such a backlash. Our own college refuses to acknowledge it. We have to have some honesty here.
I think there are too many people with 'chips' on their shoulder about this.
The academic side of GP is fairly new. Also the RCGP with the CSA has concentrated on consultation skills and communications skills theory - much of which is pseudoscientific in terms of its 'evidence base'.
Until we get to grips witht he hard science aspects of the profession - it will be considered peripheral. Other royal colleges struggle to get a vlice at medical school but they occupy a different space and their research often is outside bio medicine - ie. the radiologists and anaesthetists.
We should be taking over the theraputics aspect of research - its our bread and butter. sure keep the soft skills stuff but recpgnise how weak an area it is .
some one else referred to this
but I am shocked the closures are even in leafy london
A true hero in an age of so many false ones.
We're already raised several glasses to you
I have heard dr Baker speak on several occasions and it seems interesting that she is happy to ignore the negative impact of part time work but open to everything else!
I think RCGP chair may have been too much for her, whatever you may say about clair Gerada she was very able in the role and got the balance right in being a leader and being able to deal with media and strategy. professor field was ok without any flare
interesting analysis, but nothing you've said actually solves then problem.
considering the problem is a simple one: it is not economically worthwhile being a salaried GP or a partner. Hence locum or emigrate.
Solutions either deal with this problem or pretend it does not exist. politicians seem to struggle with simple solutions.
Forcing doctors to work by draconian means appears silly, the proctivity of GP's is far above any other area of medicine in the UK. surely utilising this would be useful
Again only a complete idiot would think of allowing social care budgets to get merged with health care or even consider allowing councils to have a meaningful voice. Oh wait a sec!
Again GP's must not look at this as an honest dialogue.
This is a either lazy science or something more sinister( i.e GP's being set up to be blamed and then used as an excuse for other 'reform').
A public health offical on radio 4 this morning talking abt inc antibioitc prescribing between 2010 and 2013. No mention if this was an increase per 1000 patients or just raw figures. She appeared happy to talk about 'levers' to change behaviour.
Typical BBC but there was no analysis, no questions about why - how much is primary or secondary care initiated? How has complaints and defence fees had an impact? How many people are self prescribing from antibiotics bought in from elsewhere?
after all any honest conversation about antibiotics would raise above issues.
Unless you see this for what it is - part of a campaign of hostility then you Gp land will be destroyed further.
Quite easy to fight back though, LMC to ask sec care to do their own antibiotic prescribing? maybe time to ask pt to opt out using patient records for 'personal safety reasons!'
Those of you who have had any real business experience need to learn where the niche markets are.
there are thriving practices ( financially) with very stable set ups. GP's actually still have incredible power to be able to do this if they wish. There are savvy characters out there doing this - this does not mean large federation practices but merely recognizing your own niche and improving it.
The solution in most areas would be for GP partners to work in viable hotspots and allow NHSE to pick up the rest of the workload.
All the medical profession have good reasons to be negative with the media assault you're under. But you can change things and find a safe and stable way of working
It strikes me that the reason General practice is in trouble is because you guys are your own worse enemy. Soft weak GPC, woolly headed GP's such as this writer and what is frightening is that he's a director of the GPVTS!
If you don't recognize that you're in the middle of political media war you will be destroyed as a profession. We will all suffer if that happens.