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

Gary

  • GPs secure locum cover for colleagues gradually returning from sick leave

    Gary's comment 20 Apr 2018 6:35pm

    What if your partner/salaried colleague is one of the 5000 promised by the Government. A non-existent GP who has taken permanent leave. Effectively the same practical situation.

  • BMA: GPs 'likely' responsible for care of psychiatric inpatients in their area

    Gary's comment 10 Apr 2018 7:06pm

    I’ll be waiting for the local DGH to call me to do a home visit. Ridiculous story. It was April 1st last week.

  • Government must protect GPs against new data protection legislation, say LMCs

    Gary's comment 13 Mar 2018 7:11pm

    I’ve always thought that I owned the IT infrastructure ( with 100% reimbursement) however the CCG tell me that the NHSE own it. The NHSE also has determined who joins my list, as I have no veto. In essence then the NHSE owns the list and the IT systems. There is probably a case to say that NHSE is the data controller. The distinction is between data controller or data processor. Here is the distinction defined legally:
    Under the current EU Data Protection Directive:

    only the controller is held liable for data protection compliance, not the processor
    any processing must be: (a) governed by a written contract; (b) carried out in accordance with the controller’s instructions; and (c) subject to appropriate security measures
    in order to protect itself against unnecessary compliance risks, generally, a controller will seek to pass its responsibilities to the processor via the data processing agreement
    regardless of the existence of any data processing agreement, controllers remain legally responsible for any breaches caused by the actions of their data processors

    I think that pretty well sums it up. We are the processors, not the controllers.

  • General practice given just 4% of NHS winter bailout money

    Gary's comment 20 Feb 2018 3:32pm

    Well we all know what to do now don’t we? Let the patient follow the money.

  • GPs set to gain access to 30-second fingertip AF testing device

    Gary's comment 18 Feb 2018 7:24pm

    Lots of these type of things available on eBay and without the need for a smartphone. Smells of big pharma marketing push to flog more NOACs

  • Anticoagulants may increase risk of stroke for CKD patients, study warns

    Gary's comment 16 Feb 2018 11:34am

    If you look at the graph in this paper, specifically for all cause mortality, you might get a shock! It’s in figure 1
    http://www.bmj.com/content/356/bmj.j510

  • Bawa-Garba: timeline of a case that has rocked medicine

    Gary's comment 28 Jan 2018 5:40pm

    All doctors urgently need to redefine what they regard as ‘a safe workload’.
    We all know that the NHS will ground to a halt when we do this, as it means we will not accept workloads that cause us stress.
    So be it.
    We have received the message, load and very clear.
    And I would like to get something straight here- are we actually witnessing all this over the fact that a doctor is being held to blame over a dose of enalapril administered by someone else, a relative, when it wasn’t for administration on the kardex?
    And what about the portgugese agency nurse Isabel Amaro

  • GMC successful in High Court bid to strike off junior doctor

    Gary's comment 25 Jan 2018 6:46pm

    Disgusting story, makes me very sad. Makes a total mockery all that we do.
    If this doctor is at fault then so is the Trust that placed her in this position of hopeless workload. I trust the GMC will take the trust’s responsible adults to the cleaners as well. Fat hope of that.

  • GP trainee claims he was reprimanded after highlighting A&E safety concerns

    Gary's comment 17 Jan 2018 11:56pm

    Bizarre behaviour. It seems reasonable but then on reflection you see that here is a very junior dr , a junior employee, offering opinions and relating them to everyone via a very public medium. Perhaps he doesn’t understand what pressure is, and the pressure he was working under was quite reasonable. As I recall A+E always had its moments. Who knows. My advice to him is to wind it in a bit

  • GPs told to order two different types of flu vaccines amid efficacy fears

    Gary's comment 07 Jan 2018 10:23pm

    Crazy set up. Children’s vacs are free to GPs and we simply order them in. obviously the only reason the NHSE doesn’t do this is because they are in thrall to the big pharma chains and have done some deal where there is an “understanding” that they won’t favour one over another by ordering en-bloc.
    just make a block deal with the suppliers and let us GPs or pharmacists get as much as we need. If demand is poor then we just bin the excess. If we need more we just order more. Does Nhse really think that we GPs can really predict demand, in a changing marketplace with competitor pharmacists, a whole year in advance?

  • Single-hander crowned GP of the year after turning 'red-rated' practice around

    Gary's comment 01 Dec 2017 11:53am

    Well done Karen. As a single handed GP myself I can appreciate what you have done. From your website I see that patients only have to wait 2 days to be seen, excellent!

  • GPs should use spirometry and FeNO tests to diagnose asthma, says NICE

    Gary's comment 30 Nov 2017 5:15pm

    It's not a big issue. If we need a better diagnostic method and feno is it then that's that. Just a quick letter to refer. Can't see the problem.

  • Best be blunt about Brexit

    Gary's comment 25 Nov 2017 0:55am

    New drug trial : 34 million patients, 52 % success rate. P value practically undetectable. Without a doubt a winner. When will these remainers stop moaning that they were robbed.
    And no money was promised. It wasn't an election and there were no candidates, so there's no one to blame. Except those who voted. Back to moaning again.

  • GP numbers decrease by more than 1,000 over past year

    Gary's comment 21 Nov 2017 9:38pm

    The success story of this is quite simple. Locum numbers have increased by just under 50% in the last year. 692 to 1029. Whereas in the previous year sept 15 to 16 they increased only 20% from 567 to 692. This looks like it will take-off. Hazard a guess at where they'll be in 12months, 2000?

  • GP leaders vote down proposal for struggling practices to go private

    Gary's comment 11 Nov 2017 11:42am

    I pay the £38 a month only on the basis that I get the BMJ and that should I need some legal industrial representation then I could access the BMAs resources. They don't represent me politically and they should remember that. They are my union and I expect them to ballot me and represent my views in political discussions.

  • 'Uber-style' private GP company crowdfunds to boost recruitment

    Gary's comment 08 Nov 2017 9:49pm

    Diazepam, tramadol anyone?
    No notes stored and you can hop from one GP to another, as often as you like.
    Oh dear!

  • GPs have ‘chosen’ 10-minute consultations, claims NHS England lead

    Gary's comment 23 Oct 2017 6:47pm

    Hi Macdonalds
    There is a nice paper on what patients consult on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750725/
    Which has some interesting findings - namely a mean number of problems of 2.6 with a quarter of consultations being for 4 or more problems. This finding was not related to this specific study, as it quotes many other studies from across the globe where it has been found that GPs universally see multiple problems.
    It seems that the consultations where only one problem was raised were mostly for acute problems.
    Interesting.

  • GPs have ‘chosen’ 10-minute consultations, claims NHS England lead

    Gary's comment 22 Oct 2017 8:16pm

    As a single handed GP I have never seen the point of restricting patients to a single problem. Why should I? they will only book in to see me tomorrow.
    Single problem consultations are a game playing strategy that GPs use where there is a high probability that another GP will see the patient when they rebook. Although it goes against the grain I have to agree with Dr Varnam, it is a disrespectful practice.

  • NHS spends £21m on consultancy advice on how to cut costs

    Gary's comment 30 Aug 2017 8:29pm

    My daughter used to work at Deloitte. Fresh out of university her time was billed out at £930 a day. What a waste of money

  • GPs to be asked to 'peer review' all referrals

    Gary's comment 29 Aug 2017 5:22pm

    Obviously it has to be internal as no one in their right mind would veto another GPs referral , the indemnity issue is immense.
    So this really a workload shift, and as such needs to be paid for.
    I am quite happy to refer 20 patients and then spend an hour consulting/considering whether they should be sent in the first place. I would expect the full 20 to be referred eventually, whilst picking up a cheque for £250 in the process.
    Of course, if the CCG wants to see a reduction in referral activity I will simply volunteer a cool 30 patients for consideration to the vetting procedure, and end up with 25 being referred in the end. And picking up a cheque for £375 in the process, for the 1.5 hrs it takes me.
    Of course the CCG might not want to pay private rates, so I might tell them to do it themselves.
    Fun and games set by non doctors.