Didn`t we see this coming years ago? - the demise of local organisations (ie Partnerships) and the formation of large and economical (?) "business units" has been a pattern in Government since the 1980`s. The problem is that elsewhere in public service as well as in Secondary Care this has been shown not to work. All Primary Care has to do is sit back, do what we are told and wait for it to fall apart so that we can form local Partnerships again and wait for the next cycle of ineffective change We all know that politicians never learn from history.
It is very important to also make clear that the complaint (in primary care as well as elsewhere in the NHS) must be answered by a person designated as the Responsible Person (ie someone very senior who oversees the complaints process). There may also be a Complaints Manager who can be designated to answer the complaint as well as managing the investigation and response (Sections 4 and 14 of the 2009 Regulations). An individual GP in a practice writing and signing/sending a response to a complaint other than through these two specified persons is not within the Regulations. The intention of the Regulation is to ensure that no complaint remains hidden from the practice Partners/managers and any disciplinary/regulatory issues are concealed as well as enable the practice to discuss and identify trends and take remedial action.
Well... NHS Manager suffers severe case of `foot-in-mouth" disease. NHS Manager tries to get appointment with GP to have foot extracted only to find there is now a GPs foot embedded in the opposite end of the digestive tract. NHS Manager goes to A&E because there are too few GPs left only to find all the Junior Drs there have emigrated to Australia. NHS Manager blames everyone else apart from NHS Managers and politicians who are pulling the purse strings for putting foot in mouth in the first place. You really couldn`t make this sort of fairy tale up could you ???
The issue of interpreters is a minefield for 3 reasons... Using other patients could put you in breach of confidentiality. Using a relative in some cultures might result in you getting what the relative wants you to be told rather than what the patient said if what is being consulted about happens to be a problem for them. Finally the professional interpreters should be translating accurately but others might not. On top of all of this it is another hidden cost for the NHS.
Strange that a few days before a government-commissioned report recommends scaling back CQC inspections the Chancellor has asked CQC to model funding reductions of 25% and 40% ! Is this what they mean by "joined up government" or is it "insider trading". It also makes the fundamental mistake of failing to realise that GPs are more likely leaving because of government policy and funding cutbacks.
It strikes me that A&E attendances will rise significantly as the result of GPs seeking medical assistance to have the brush removed?
The reasons that CQC have rated this practice "inadequate" will be on their website for all to see. My own experience of CQC is that inspections are scrupulously fair and not intended to be heavy-handed so the reasons for the rating I would expect to be genuine and substantial. It does seem to me that the way GP is developing is towards larger multi-partner practices or federations who have the critical mass to ensure they are safe, effective,responsive, caring and well-led.
20+ years ago when I was working in another major public service I was subject to "performance Indicators" which started out as "input" measures, moved over 5 or 6 years to "outcome" measures and which are now entrenched `obligations`. Why should anyone in the NHS think that this identical progression is any sort of a surprise? Does no-one learn from history?
The best take-up of flu vaccinations in recent years have been those occasions when the Government of the day pressed the panic button over bird/swine etc flu. I am sure the badly-informed `popular` media would be happy to oblige with hysteria should someone in Whitehall suggest a link with some other headline illness and raise a panic this year???
Perhaps the MP could use astrology to predict if he is going to be re-elected in May? Save us the job of voting for Monster Raving Loonies....
In the event this does boost numbers surely it will only serve to increase the numbers of salaried GPs as opposed to Partners? Who would want to take on the grief of being a Partner under successive governments when they could do their hours and go home with the salary as opposed to having to run a business that they were never trained for, cover every emergency that happens because "its` their business after all" and take all the financial pressures that the NHS will impose? Politicians want to off-load the responsibility for Primary Care to some large conglomerate who will employ salaried staff and gobble up the Partnerships. Why else would they create CCGs who were set to fail from the outset?
In what is increasingly a `sellers market` for Locums it is hard to exclude anyone who might be available on a day unless they are serial `offenders` for cancellations. Likewise I would never cancel a locum without sufficient time for them to find alternative employment. Having a Partner `0n call` for such an occasion should be part of contingency planning and while I have sympathy for the single-handed practice, doesn`t it just add to the argument that a bigger practice is always better for patients and gives flexibility in managing the human resources?
In line with all the previous strange decisions of Politicians in the UK it now seems that the more patients you allow to die before their time the more money your CCG will get. Is this a peverse way to kill two birds with one stone (sorry!) and reduce the growing cost of State Pensions while still being able to say they are funding the NHS adequately?
To change is not a requirement but neither is survival mandatory. The day of small practices with little room for flexibility and limited staffing (both clinical and admin) is surely over and as the world changes then practices will need to adapt. Couldn`t anyone see this coming 10 years ago?? It wasn`t party political - just political.
Surely the critical issue here is not who undertakes the care in pregnancy buy rather have they got a robust Service Level Agreement that actually delivers quality care and quality information back to the GPs? Experience of NHS commissioning has seen SLAs that you could drive a coach and horses through and providers delivering what they wanted not what was needed. If a qualified provider knows what is needed and is contractually bound to deliver and the commissioners know what they want and have been clear and precise about it then all should be well? Shouldn`t it??