Grant Jonathan Ingrams
Please can everyone complete the NHS England Survey explaining why this proposal is short sighted. PCNs were supposed to address the workload and capacity issues in general practice. The proposals will increase GP workload and cost GPs for the privilege (as we will pay 30% of the cost of all additional staff). Survey at:
The CCG is a membership organisations. The LMC should be organising a no confidence vote by constituent practices in the CCG, and oust the current leadership...
The report is rather suspect with a lot of caveats and guesses. I am puzzled that under the Patient Fraud (General Practice) heading it guesses £35million fraud, but then says this is mainly secondary care!! Not least bizarre, as anyone within England is entitled to free access to general practice.
Also using their own figures the £88million suggested fraud represents 0.07% of the estimated £1.29billion total fraud, or 0.05% of the annual £1.7billion spend on general practice. I would have thought most private companies would be extolling this insignificant level, and praising their contractors!!
'Give high dose statins'?? I think you mean given a licence to flog for a very healthy profit ...
So Professor Stokes-Lampard, what first attracted you to the multi-billionaire Sultan of Brunei???
Only passed as I wasn't there to propose it ;-) Sheep led to slaughter ....
Not often I am rendered speechless. Jaimie Kaffash - Could I please suggest an annual Health Service Management Ignoble award for the most stupid management idea, and nominate this for the first award
The article refers to ‘informal’ discussions about this. Could I reassure that there have been ‘formal’ discussions over many years that the BMA/GPC has been party to.
The issue is a legal requirement for GPs as data controllers to ensure that third party data is not shared. Ask the staff in your practice how dedactions they make for each record requested under a SAR to get a feel for the size of the problem.
Since at least 2010 we have been arguing that access to records must be preceded by improvements in clinical software to allow suppression of third party data easily when it is added to the record, that this work should be funded, and that access should be prospective only until and unless the significant cost of redaction of restrospective records is sorted out
Older GPs will remember that this was the approach successfully used for access to written records from November 1990
If the DH etc had followed our advice in 2010 we would be well on the path to implementation
Personally I am not worried about patients asking for explanations or spotting errors in their records as I feel this will improve healthcare and the doctor patient relationship
DOI ex chair and deputy chair of GPC IT subcommittee who was involved in the formal discussions
Only good news is that it will probably destroy the GP@Hand model of care ...
Vinci Ho. The controls started as the European Directive on Certain Aspects of the Organisation of Working Time. This evolved into the European Working Time Directive in 2003 (2003/88/EC). The latter was incorporated into UK law by the Working Time Regulations 2003. However this only applies to employees so does not apply to partners and locums (and anyone who is self directive of their working hours). The maximum of 48 hours (average over a 17 week period) can be legally opted out of by an employee (ie cannot be enforced). As usual there are exceptions, which until 2003 included Doctors in Training.
Just wanted to say as one of your representatives, that this is well known and understood … ;-)
However, the problem is often not so much with the total number of hours worked, but the intensity of work within those hours
I would suggest that Helen has not taken into account that these services are likely to be increasing activity within the same budget. GP-at-Hand wont care about this as they are cherry picking the most healthy people, but if rolled out across all practices it could cause significant additional workload for no additional funding and no additional health benefit. It is akin to what happened with the Darzi WICs. the Kings Fund report demonstrated that by making access even easier they created additional workload for no health benefits.
These services respond to patient demand and not need. This would be OK, if the public were willing to significantly increase the NHS budget to pay for it (well above the 3.5% offered as this is insufficient to keep the lights on in the long term).
In my last practice I constantly attempted this over many years for benzos 'z' dugs and opiates. Some real successes but am aware that many patients when it became challenging just moved to another surgery. Needs to be an area wide initiative.
oncehadavocation. Like your name but not your appraisal. The figures are not easily interpreted. We know that a growing number of GPs are part time (male and female) and if there is a high percentage of half time GPs working 30 hours each week this would also suggest a problem. In addition, in the highlands due to rurality the average list size is much less than in England. Finally there is a different between hours worked and work load. Over the past 25 years the number of hours that I am oncall has decreased but the number of hours I am face to face with patients and my work load intensity have increased significantly so that on a regular basis I feel I am providing an unsafe service.
Please note that I am a previous chair of GPC IT Subcommittee. I am not the current deputy chair, who is Dr Bea Bakshi. Therefore not my fault ;-)
Dr Grant Ingrams
Many patients just need to follow the JFEL diet.
It is bizarre that in an age where no clinician would consider not practicing evidence based medicine, colleagues working for CCGs are happy to implement non-evidence based management decisions. There has been much research published about referral management, and the Kings Fund has published some quite sensible advice. Referral management as described is costly, has limited (if any) long term benefits, and delays patient care. However there is evidence that audit and benchmarking does improve referrals...
Dear All. Choice is down to the practice. Any coercion should be reported to GPC and GPSoC. No manager ever takes into account the upheaval to practices if a move which continues for more than a year and the ongoing problems due to the inevitable data degradation
Last figures I saw was that it costs £130 to £160 per hour for a GP including oncosts - so practices which agree to take this on will be providing it at a loss - more fool them if they agree. 'Go do the maths'.
I wonder how much it has cost us to find out that indeed bears do defecate in woods.
More worryingly is that the govement is ploughing ahead using £6 per head of general practice money to keep these schemes going longterm, despite the evidence that it is purely about ideology and makes not one jot to capacity and quality of care.