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

Nicholas Brown

  • GPs could face quinolone antibiotics prescribing restrictions from next year

    Nicholas Brown's comment 27 Nov 2018 1:27pm

    agree with many of these comments- and easily available OTC in Asia if there concerns about drug resistance.Very useful drugs when used sensibly.

  • Should GPs be registered as specialists?

    Nicholas Brown's comment 23 Jul 2018 10:29am

    the whole training and career structure of general practice needs a reassessment- the basic job of general practice- which for many seems to be the aspiration, clearly is no more a specialty than core medical or surgical training, but there are lots of specialty areas within in general practice which require recognition-
    health care organisational planning and commissioning
    public health in primary care,
    complex care including area such as unscheduled care, management of long term conditions, and complex whole person care, particularly of the elderly or terminally ill
    - and now increasingly,
    leadership in service provision- an area which used to be in the job description of every partner.
    it is time that these 'specialist' areas are properly recognised, given visible status and therefore provide the career aspiration clarity that enthusiastic young gp trainees require. The Royal college should take this initiative which could require major organisation change and make it a more inclusive representative authority.

  • Is it time to upgrade our status from GPs to consultant family physicians?

    Nicholas Brown's comment 25 Jun 2018 9:41am

    I agree but having asked this very question at the RCGP annual conference a few years ago , it seems the RCGP cant change its name ( Royal warrant, statute and so on) and therefore cant lead this transformation.- par for the course. My job- as a commissioner, trainer and leader of a team is very much that as a Primary Care Consultant rather than a General Practitioner

  • #IamHadiza: The full story of the legal case that shook medicine

    Nicholas Brown's comment 02 Mar 2018 10:14am

    this is a clear example of how doctors are being exposed by the manpower and organisational failings of the NHS, and when something goes wrong, institutions go for these vulnerable individuals , who are already aware of, and feel guilt about the sub standard care that they have provided, for whatever reason. It is time that institutions, the government, the Public and the Press come clean about the precarious state of the NHS rather than blaming the medical profession, either as individuals, or groups. We need to ask why 50% of bright and enthusiastic Medical students failed to continue into higher professional training in the NHS.
    It is time for the profession to unite- as they seem to have done behind this particular Doctor- I suspect that many of us have personally been close to this unfortunate scenario at some stage in our career.

  • GP leaders fly out to tempt medical students studying in Bulgaria back to UK

    Nicholas Brown's comment 16 Nov 2017 11:51am

    this is all very well but I think it is an outrage ( and embarrassment) that we have an accepted political policy of desperately trying to entice doctors to the UK, who have been trained at the expense of governments of less well off countries, with populations with much greater heath needs (but presumeably less wants) than our own. I think that confirms that we are becoming a third world country dependant on overseas aid and charity.

  • When you really need it Ms May, I hope the NHS is still there

    Nicholas Brown's comment 04 May 2017 11:48pm

    As both a health provider- a GP, and a consumer,- with a critically ill relative, I take issue with one Particular statement by Dr Finnikins , that the Prime Minister should have access to an NHS like today in her hour of future need. I hope that any future health services will be significantly better. It needs to be more responsive to patient choice , needs to value its workforce and trainees, be less obsessed with tick box bureaucracy and needs to have much more effective local leadership which is liberated from centralisation, with more local accountability. The politicians can do us a favour by distancing themselves from the day to day workings of our health service.

  • Three-year GP training is long enough already

    Nicholas Brown's comment 08 Mar 2017 10:57am

    The MRCGP exam is a well planned exam that determines whether a trainee has the knowledge , attitudes and consultation skills to be able to practice safely as a newly appointed (salaried or locum) GP and I agree entirely with Dr Merrifield. What it does not do is prepare or inspire GPs for partnership- and perhaps that is one of the reasons why newly trained GPs are not considering this option, and it does not prepare GPs for the wide range of scenaria and portfolio career options which are available. The question is whether this is best done as part of basic training or as continuing medical education and it makes some sense -both practical and financial that it is the latter.Early appraisal therefore should have a strong focus on career development. Either way this variety of career pathways and skills requires a modular approach so that trainees/ junior GPs can access relevant training which they are interested in and will enhance their personal career choices.

  • Thousands of practices unaware they could be 'in breach of data rules'

    Nicholas Brown's comment 07 Mar 2017 4:24pm

    so who is at fault here ?- thousands of GPs, the law or TP? the idea of each practice having to have a Caldecott guardian who is the protector of patient electronic records is out of date and needs a radical review.

  • GPs to be paid £150 to diagnose and treat dementia

    Nicholas Brown's comment 06 Jan 2017 11:52am

    Big deal- we have been doing this in Wiltshire now for nearly 3 years- it works really well and GPs are ideally positioned to diagnose and treat dementia- the only problem is in Wiltshire we don't get paid this much !!

  • Medical school applications fall by 4% for 2017

    Nicholas Brown's comment 28 Oct 2016 11:58am

    unfortunately if current GPs discourage medical students, then there will be no doctors to look after them in their old age- a degree in Medical sciences is still a great launch pad to many careers inside and outside the NHS- as my medical student son, who has seen it all first hand, informed me

  • DH unable to guarantee 76% CQC fee hike will be fully reimbursed

    Nicholas Brown's comment 20 Oct 2016 6:46pm

    How about this- I have just logged onto the CGC 2017 consultation document to register my thoughts on this important subject to find that the on line link sent me to the 2015/6 consultation template, where I was informed that the closing date of end Jan 2016 was past- therefore can anyone tell me who regulates the CQC as I would like to complain about this woeful administrative incompetence

  • DH unable to guarantee 76% CQC fee hike will be fully reimbursed

    Nicholas Brown's comment 20 Oct 2016 2:56pm

    we have just been inspected at significant personal and organisational cost in terms of money, time and stress . we are a single site practice of 16000 so if- as anticipated, we receive another visit in 5 years- then that cycle of inspection will be £30,000 before we even consider the cost above - this is an outrage.

  • DH unable to guarantee 76% CQC fee hike will be fully reimbursed

    Nicholas Brown's comment 20 Oct 2016 2:48pm

    this is an outrage- we have recently had a CQC inspection at a huge personal and organisational cost- both financial, time and stress and given that we anticipate being re-inspected in 5 years- the cycle admin cost of this for our large practice will be £30,000 !!! How can that possibly be justified ?

  • I'm with Ian. There are reasons to be cheerful

    Nicholas Brown's comment 08 Aug 2016 3:55pm

    GP partnership is a full time job with the stress and rewards that are associated with that responsibility. It is clear that many GPs no longer want that stress but they also cannot expect that reward and they should be willing to accept salaries more akin to those of our very hard working and capable nurse practitioners.
    Shaba- I respect your views and work ethic, but I am not surprised to hear that you found it impossible to shoe-horn GP partnership into your busy portfolio career- so please don't completely write off GP partnership, and please don't imply that I am being exploited by the Government and cannot say no just because of my self employed status- GP principals- abandon that independence at your own risk- but if you see GP as less of a vocation, and more of portfolio/part-time Job, then GP partnership is not for you.

  • How the GP Forward View has split opinion

    Nicholas Brown's comment 27 Apr 2016 5:48pm

    The' forward view of general practice' is that it will be GP-led rather than GP-delivered and like the nursing profession, senior clinicians will relinquish their hard earned, decisive and efficient clinical skills to an army of telephonists, computer programs and fast tracked 'clinicians' and become managers, CCGcommissioners, appraisers and CQC Inspectors. The out of hours services have already piloted this model and it is blatantly inefficient, expensive and unsustainable.. This is not a forward view that gets my support, as a future patient, rather than a future doctor.

  • LMCs consider radical motions calling for industrial action at GP crisis summit

    Nicholas Brown's comment 16 Dec 2015 9:22am

    Prof Steve Field- ex president of RCGP tells us that the GP profession has failed in its responsibility to maintain standards.The Public accounts Committee has stated that The CQC is behind where it should be as a regulater. Both of these failures seem to lie firmly within the responsibility of Prof Field. The BMA persuaded many gps to strike for a day a few years ago which was a pointless and harmful action but i really dont see why the Profession should accept the CQC in its present form- PARTICULARLY AS WE ARE PERSONALLY FORCED TO PAY FOR IT ! If we want to take action then surely a national refusal to cooperate with CQC would be a good start...we cant all be closed down, no matter how bad a job so many of us GPs are supposedly doing.

  • Professor Steve Field says GPs have 'failed as a profession'

    Nicholas Brown's comment 14 Dec 2015 11:00am

    Unfortunately there are a number of reasons why General practice is no longer a popular career choice amongst young doctors and the 2003 and subsequent contact changes and Steve field and his CQC are two of them. Failing practices are running into difficulty primarily due to doctor shortages and that is not the fault of the Profession, but the fault of the increasingly difficult system in which we are struggling to work. My current ST3 has said that working in General Practice has been the most difficult job she has ever done.Steve Field is unfortunately making this more difficult rather than less difficult and as more and more gps leave the profession to retire, work abroad- or choose soft and well remunerated options such as being a CQC inspector- like the man himself, this will only get worse. Professor Fields latest out burst to the Mail is not a surprise- i didnt like his attitude from the first time I heard him present at the NHS Alliance 2 years ago.