I've long believed that we should be charging foreign visitors for using the NHS. The problem is that the current rules are so complicated that it is well nigh impossible to administer them in busy GP's surgeries, A & E departments & outpatient clinics, unless like some of the Central London hospitals, you have so many foreign visitors that you can employ staff whose main ob is to see that they are billed appropriately & that those bills are paid.
We will never get on top of this problem until the DOH simplifis the rules.
The Government talks as if the only priority is relieving pressure on A & E departments. What about the pressures on general practice, particularly as we are facing yet another recruitment crisis?
Good to see that the spirit of King Canute is alive & well & living in Whitehall
Why are General Practice & A & E in a state of crisis? Because patients can access them directly free at the point of use without any consideration of the costs involved. Now the DoH wants to do the same to Oncology while NHS finances are stretched to the limit. Think again Mr Stevens.
In West Kent where I work, the problem with 111 is not so much inappropriate referrals, although there are some, but the inability of 111 to accurately assess what is urgent & what is not. On the 2 occasions over Christmas & New Year when I did triaging for our OOH provider, less than half of the calls marked as urgent actually were. The result was that these non-emergencies leap-frogged the non-urgent cases, who were kept waiting for many hours. One can hardly blame them for giving up waiting & going to A & E instead.
Now we know why the DoH & CCGs are so keen to see practices forming federations.
We already have a looming recruitment crisis in general practice. Seven day opening for routine care can only make it worse.
While I accept the need to provide GP cover 24/7 for urgent problems, I see no good reason why we should be doing routine work at week-ends. When lawyers, accountants, teachers & civil servants start doing routine work (by which I don't mean catching up on paper-work) at week-ends, I might be prepared to reconsider.
Delays, abandoned calls and an 11-hour wait for a call-back: Leaked document reveals the extent of NHS 111 performance issues
The idea behind 111 was not bad. Unfortunately it got highjacked by the DoH into a cost saving exercise & they now have a lot of egg on their faces.
What this fiasco demonstrates is what a good job OOH providers & the GPs who work for them have been doing hitherto. Having two different organisations responsible for providing OOH cover is a recipe for misunderstandings & mistakes. Patient safety has been compromised. The DoH should admit they have got it wrong & hand back to OOH providers the responsibility for triaging OOH requests.