the uk population has risen by 1million over this two year time period.
NHS choices quotes a figure of 0.58 FTEs per 1000 patients. That's 580 FTEs to be added to this figure of 439 fewer GPs.
This is catastrophic. Practically 3% over 2 years, taking rise in population into account.
Being a locum is a no brainier, as the differential between partnership and no partner is zero, or negative. Remember that the NHS only provides a list of patients for partnerships. That's all. They don't provide a surgery ( think land architects builders mortgage) or staff or furniture or equipment. And they don't provide intelligence and management and problem solving. It takes 5-10 years to get a practice up and running, and until that happens your practice will underperform financially.
Locum s fail to realise this , they often think that the office they are sitting in comes at zero cost. It doesn't.
Until differentials are recognised it would be madness for any new GP to consider paying for a practice so that others could benefit. Where is the point in that? Liability yes. In which other business does the franchise owner allow employees to work less than they do and yet earn more money?
So who is going to take out a 30 year rental agreement? Not any GPs of course. Only the NHS/CCGs or such commissioning body. Hence we have the demise of general practice in its independent format.
Of course , if there was a commitment to ensure GMS then GPs could simply walk away from working in one of these buildings and set up a converted bungalow- like 30 years ago. I predict that if this goes ahead it will be linked to the promise that GPs will never be allowed to " walk away" and set up independently again.
According to Wikipedia Jeremy hunt "After university Hunt worked for two years as a management consultant at OC&C Strategy Consultants, and then became an English language teacher in Japan."
Good for Japan then
The point is I think that the RCGP is an organisation that is funded by the poor mugs who take their exam. An exam that has been made longer and harder to pass as the years go by. We are being asked to not put off trainees who haven't yet parted with their money.
Personally I can't understand why the head of an exam factory thinks she can speak for GPs as a whole, where is her mandate?
I can't really understand why doctors use the placebo word as some kind of demonic incantation. They probably haven't read any scientific study about how it works - for instance Benedetti's book on placebo effects.
St. Paul was cheap I think because it offered only concurrent cover, meaning that once you retired you had to keep up payments in case someone claimed retrospectively
Any branded generics cost the NHS more due to the indirect guaranteed reimbursement made to pharmacies in the medicine margin framework. the cheapest way (for the NHS) is always generic; for CCGs the cheapest is branded generics (when it comes to pregabalin), . CCGs conveniently forget that the NHS pays pharmacies the guaranteed profit in the margin framework top up .
Did it in Norfolk 5 years ago after a 6 week national media campaign - not a cheap option! 1 trainee already on the local scheme turned up.. obviously somebody has not done their homework.
I think Norman was far more effective as an opposition spokesman when he was in power
So 19% of GPs are 55 and will retire within 5 years. Last quarter saw 0.9% drop in GP numbers. Get used to it. There will be a regular drop of 1% GP workforce every quarter for the next 5 years. No - make that the next 10 years, as of course all those 50-55 will be coming through next. Of course it could be a lot worse should all those
Is that 45% of GP partners? I.e. Those contracted
I wonder when HMG will allow the sale of goodwill? Presumably when Virgin asks them to
Steve- doctor specialising in consultation skills perhaps. Though this is easily misunderstood as anyone can take a history. And your point about "not life threatening" is unfortunate.
Take the simple sore throat. Common knowledge is that a monkey could do that. But it's all about the black swan event. Over the years I have recognised tonsillar cancers, epiglottitis in a 60 year old(intubated), addisonian crisis ( was hypothermic), a fatal lymphoma, as I recall. Every GP has their own war stories here. Add in the ubiquitous quincies, oral thrush and neutropenic patients, oh and the scarlet fever occasionally and you have a diagnostic slippery slope. Yet we get through these in a few minutes apiece.
So - people will always see us diagnosing non life threatening diseases whereas what we do is diagnose everyone who has anything. More to the point we do this best in our own surgeries where we work with patients we have prior knowledge of. Bayesian!
I don't think Steve is being patronising. He says we manage Undifferentiated demand - we take all comers and we can handle that. The reason is we are good at general medicine in a way that hospital specialists aren't. We are so general we can accommodate all branches of medicine( gynae psychiatry etc). To put it bluntly there are no doctors working in hospitals who can do that. We deliver highly abstract diagnoses rather than specific ones as we work with simple tools, very quickly. We understand when the medical model doesn't apply- somatisation- and we specialise in that - as we see it all the time across the board.
The problem is that when they use us in casualty we have an image problem. We are the triage, the junior taking the walk ins and the bouncers. Any junior doctor viewing how we are utilised will soon get the idea that we are the "sore throat" doctor. And that I'm afraid is why we should avoid working there.
A GP out-of-hours service may be relocated to a nearby GP Surgery to ‘alleviate pressure’ under CCG plans.
NHS Cambridgeshire and Peterborough CCG has proposed to move the service currently based at Addenbrooke’s Hospital to Chesterton Medical Centre in Cambridge
It says this could mean less GP home visits.
So - who is responsible for the follow up? A split GP service but I suspect all the work will devolve to the daytime weekday GP. This isn't a 7 day GP service. it is still a weekday daytime GP service with a large dollop of showboating. NHS playing games again and fiddling whilst Rome burns