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Independents' Day

Jonathan heatley

  • CQC suspends 14,000-patient GP practice over patient safety concerns

    Jonathan heatley's comment 10 May 2018 2:32pm

    Whenever I hear about CQC failing a practice it always talks about process and protocol and not about clinical care. practices I know of were failed for back office functions as these are easy to grade by box ticking. so for instance not having a reference for mambers of staff who had been working there for over 20 years caused a fail. Not having photos of staff in their file a fail. Washing window curtains once a year instead of twice caused a fail as did the doctors drinking tea in the consulting room.
    When general practice is struggling this kind of petty and vindictive nit picking is exactly the WRONG way to vet and check services. Anyone working for CQC should hang their heads in shame.

  • Why it’s time to re-think guidance on 28-day prescriptions

    Jonathan heatley's comment 14 Mar 2018 7:45pm

    If its been acceptable to give 6 months of the contraceptive pill and HRT why are we so exercised about longer scripts for stable conditions like BP, lipids and thyroid. For many years I have been giving 6 monthly scripts for these conditions when stable and patients are very grateful. All these medications cost less than £2 a month so the maximum waste would be £12 which is trivial compared to appointments and surgery time saved. Be brave and trust your patients!

  • We’ve become just another practice closure statistic

    Jonathan heatley's comment 12 Mar 2018 12:32pm

    So sorry to hear this, I guess this is the final blow after years of stress and struggle.
    I am curious- do you work under new management or do you leave and they recruit from fresh. I guess the former as there simply aren't the dedicated GPs like yourselves out there. It would be very interesting to hear how it goes as there are many of us in a similare position......

  • NHS could claim half a billion pounds back, if Pfizer pregabalin appeal fails

    Jonathan heatley's comment 01 Mar 2018 5:19pm

    pregabalin was a hugely expensive version of an old tried and tested drug - low dose amitriptyline.
    Using the latter would have saved billions over the last 20 years.
    Amitriptyline 10mg 1-2 hours before bed has to be the most useful sleeping tablet of all time....

  • Guideline of the month - managing adult pruritus without rash

    Jonathan heatley's comment 01 Mar 2018 5:12pm

    this makes it sound easy but pruritus of old age is a nightmare to manage as nothing much works. Having a guideline is not going to alter that one bit. I suspect the consultants have done this in the hope of preventing referrals. Unfortunately referrals are usually necessary to prove to the patient that the GP is not 'holding out' on their misery and no one has any easy answers. I used to prescribe a combo of emulsifying ointment dermovate and coal tar solution (3%) which was given me by the late queens dermatologist and this worked better than anything else. but because it has coal tar in it which gives rats cancer it has to be made up by men in protective suits and costs over £250 for 300gm so is no longer usable. There would be a good business if someone can provide this on a named patient basis at a reasonable cost.....

  • Researchers urge Government to rethink GP access strategy

    Jonathan heatley's comment 21 Feb 2018 9:17pm

    the amount of prebookable appointments available in extended access hubs are pitifully few and won't make a wothwhile dent in the workload for general practice despite taking up a lot of money. They simply double up on OOH and pinch the few GPs prepared to work unsociable hours further damaging OOH. Its so much easier to see 5 prebooked simple cases an hour than trying to cope with chaotic and highly stressful OOH work where most patients have been waiting many hours in distress....I fear we will face a collapse of OOH cover and it will be hastened by extended access.....

  • Experts call for more evidence to back up move to new GP care models

    Jonathan heatley's comment 21 Feb 2018 9:08pm

    well said Joe Macgilligan. There is a move to mega practices and the patients don't like large anonymous groupings. The modern NHS is so complex they need a friendly personal GP to help them navigate their way though all the fragmented services. Community services are a prime example. please could we have district nurses who are attached to the surgeries so that everyone can work as a team?
    We would lose most of our autonomy if we became salaried employees of such large groups and would live to regret it. Perhaps however part time GPs would not miss the autonomy as much as those for whom being a full time GP is a vocation in the traditional manner. Maybe it will all have to change as the full timers aged 50+ all retire and are replaced by part time GPs??

  • Walk-in service scrapped as GPs are asked to refer to 'overflow hub'

    Jonathan heatley's comment 21 Feb 2018 8:53pm

    they are fragmenting care, doubling up on precarious OOH services by pinching those GPs prepared to work outside normal hours and raising locum costs for hard pressed GP surgeries. What idiot thought this up ? Oh yeah I remember now a certain Mr Hunt.
    The issue no one is addressing with 'noctors' whether in surgeries or OOH is that it leaves the poor GPs with an exhausting clinic full of complex difficult patients - the sort that sap morale. I believe we can only stay sane by seeing the dross (quickly) as well as the complex. Am I alone in thinking this?

  • We need to stop prescribing antidepressants in primary care

    Jonathan heatley's comment 03 Jun 2017 1:53pm

    There is a large group of unhappy patients who don't have real depression but just a very bad time. I find that if I give them amitriptylene 10mg so that they can sleep well they get over their issues and doing so allows them to become more resilient. I try to restrict SSRIs to the genuinely depressed. Patients who take them for years are surely showing that they have neurotic depression.....

  • All GPs will go salaried to the detriment of patients, predicts senior GP leader

    Jonathan heatley's comment 18 May 2017 3:57pm

    let me stick my neck out and say I love being a partner in a medium sized partnership covering 15000 patients. We control our own environment and are happy and supportive to each other. We are proof that the traditional model works and would be sad to see the flexibility lost. Our registrars see how we work and are fired up and keen to work similarly. Some of us need to get the word out there that it is a workable model and worth joining.....

  • Dr Chaand Nagpaul: 'GPs must resurrect our Darwinian survival instinct'

    Jonathan heatley's comment 18 May 2017 3:47pm

    I hear today that the conservatives plan to bring forward their committment to making us provide 12/7 cover. This either adds 40 % to our working time or doubles up the OOH provision and so is unworkable. The hidden agenda seems to be to kill off individual group practice and force us all into large groupings which won't deliver the personal service that patients so value. This needs clarification.

  • Tories bring forward deadline for universal seven-day GP access to 2019

    Jonathan heatley's comment 18 May 2017 12:50pm

    This is so anti the traditional GP surgery. This has evolved over the last 60 years and is effective cheap and patients love it. Why oh why are they so hell bent on destroying it. I love my job but they are determined to destroy it.

  • GPs, it is time to face the elephant in the room

    Jonathan heatley's comment 09 Mar 2017 9:30am

    the elephant in the room is the increasing prevalence of part time GP working. Some put this down to the high numbers of female GPs who need to split their time between children and work but an increasing number of male doctors are also going part time. this plays havoc with continuity of care and does not help the doctors own confidence which only builds with a lot of experience. Medium sized practices with full time partners are surviving very well and will still be here when all these other desperate measures have been tried and discarded. Hang on in there!

  • NHS chiefs urged to rethink flagship diabetes prevention scheme to boost uptake

    Jonathan heatley's comment 08 Mar 2017 10:10am

    this perfectly backs up every GPs realisation that about one in five newly suspected type 2 diabetics will do the dramatic weight loss and exercise and cure themselves. the rest for whatever reason aren't able to do this; and efforts to galvanise them won't have much effect. Is there not a risk of 'moral hazard' whereby they know they don't have to do anything because there are lots of keen diabetes experts keen to ameliorate every symptom they get offering everything from cialis daily to bariatric surgery. Just look at the rising proportion of the NHS budget devoted to type 2 diabetes....

  • Practices across entire town close lists as fears grow general practice will 'go under'

    Jonathan heatley's comment 09 Dec 2016 6:27pm

    And I expect they are suffering from the CQC, like the rest of us with nit picking vindictive inspections that take hundreds of hours to prepare for, cost tens of thousands of pounds and destroy morale. Please o please could the RCGP defend those of us still struggling from all these onslaughts.

  • GPs are the deplorables of medicine

    Jonathan heatley's comment 09 Dec 2016 6:21pm

    great stuff! I like it. Could you tear a chunk out of CQC for all our sakes?

  • ​GPs' actions 'responsible for increasing patient demands', claims BJGP piece

    Jonathan heatley's comment 02 Aug 2016 7:10pm

    He is a brave voice in the wilderness of protocol driven primary care. I fully support his views and am dismayed by some of the antagonistic comments. I think a lot of us GPs who are now over 50 would recognise exactly what he is saying. Its almost becoming a generational difference with older full timers prepared to take a lot more risk on their shoulders and younger less confident part time GPs playing safe with high investigation and referral rates

  • ​GPs' actions 'responsible for increasing patient demands', claims BJGP piece

    Jonathan heatley's comment 02 Aug 2016 7:10pm

    He is a brave voice in the wilderness of protocol driven primary care. I fully support his views and am dismayed by some of the antagonistic comments. I think a lot of us GPs who are now over 50 would recognise exactly what he is saying. Its almost becoming a generational difference with older full timers prepared to take a lot more risk on their shoulders and younger less confident part time GPs playing safe with high investigation and referral rates

  • Why I ditched partnership for a salaried GP post

    Jonathan heatley's comment 30 Jun 2016 9:50am

    I am a partner and I love it. there are plenty of happy functional practices out there but they keep quiet. A lot of the pleasure is in running your own business and keeping the paper work to a minimum. There is such a thing as trust and when you have a good team this is what glues you together and its a far better way to work than the salaried, protocol-driven new model that seems to be creeping in. We need to protect this partnership model that has evolved over the last 75 years.

  • Situation vacant: the GP shortage in numbers

    Jonathan heatley's comment 02 Jun 2016 10:12am

    ha ha I like that last comment!