Looking back at your work over the years, I can safely say that PULSE is in good hands. You have shown a genuine commitment to general practice and empathy with out plight. Above all, you have kept clear of snowflake politics. I'll start reading your periodical again. I wish you every success.
How many have come in from EU and non-EU?
I gave up reading the Guardian and listening to the BBC, but I'll continue with the "learning" section of this periodical, strictly.
Apropos, is Vince that elderly chap, the wannabe PM? (he's only short of 365 seats)
Divide and rule,
Those who OWN the premises think they are sitting pretty, watching unconcerned those whose premises are owned by the Government/DH/NHS Property Services. They don't realise that once the principle of reimbursement is compromised, THEY ARE NEXT.
Meanwhile, back at the serene atmosphere of Tavistock Square, our "leaders" are preparing their speeches "...humbled and honoured to receive my OBE, CBE, KBE..."
Vital date are missing from this article.
1. The Conservatives are planning to sell off NHS property by implementing the Naylor Review (March 2017).
2. The basic message of the Naylor Review is that some NHS assets should be sold in order to improve the rest.
3. Robert Naylor, former head of UCLH, was asked to “develop a new NHS estate strategy”. The “estate” is the land and buildings owned by the health service and it is worth tens of billions of pounds.
4. NHS Property Services, a company owned by DH, was created in order to implement this decision (Theresa May Spectator interview, 22 May 2017).
5. Part of the "estate" are the "premises" in this article.
It is now perfectly obvious that NHS PS are charging GPs exorbitant fees to force them out into cheaper accommodation, thus leaving the premises to property developers.
I presume our "leaders" are familiar with these facts.
It's amazing that doctors are attacking the Department of Health and let the real culprits off the hook. A grinning Jeremy Hunt has just scored a world record, FIVE years Health Secretary. He and his sidekicks, NHS England mandarins, are paid to privatise the NHS and they are earning their money. On the other hand, we pay BMA and LMCs (is it true? Londonwide hits £5,000,000 pa?) to protect it. They have failed spectacularly. And not only we carry on maintaining them in the style they are accustomed, but we also attack the DoH for doing their job.
There is only one way to save General Practice. Tell BMA and LMC: "Do your job properly or we stop paying you."
Plus DrDr's 100k makes a total DEFICIT of £260,000.
How, When and Who is going to clear it?
The current Governing Bodies and Trust managers who created this phenomenal deficit in the first place?
Interesting to know the management budgets of these organisations I did try to look them up, but failed. Perhaps Carolyn could investigate and tell us what the annual salaries of those managers and GPs are.
Lost as to what the fuss is all about. Triaging, patient management, patient flow and you name it have been around for ages. I was part of the scrutinising team of our old PCT and, as 11.03 observed, most letters were reasonable and well written. Nevertheless, the authors of a considerable number of referrals would have serious issues if the GMC got hold of them.
The experiment was successful in improving quality (referring GPs knew that a colleague would check and became more careful) and in reducing unnecessary referrals (thus saving money).
The sting in the tail was that a cash-starved local hospital was put at risk by seeing its revenue significantly reduced, powers from on high interceded and the service was terminated.
In conclusion: Is the local hospital financially robust to take the hit?
"The THUTH, the whole TRUTH and nothing but the TRUTH" is the basis of HONEST dealings.
If you did say: "if GPs do need to vent their frustrations, they should do so only when in the company of senior colleagues," then you expect GPs to withhold the truth from their juniors and in effect lure them into a fool's paradise.
Then, unfounded NEGATIVITY - a well established characteristic of several psychiatric conditions. I presume RCGP is currently preparing (with the help of PULSE-Learning) "Ten Tips to Conquer Negative Thinking" with a 3-hr CPD credit, which will help us enormously to hit impossible targets and meet meteoric indemnity fees.
I remain your ...etc etc
Apparently, the Government has allowed a staggering 88% of the population NOT to pay prescription charges:
They now regret their decision and they force us to retrieve the money for them, assisted by our elite colleagues sitting on CCG Governing Bodies.
Pending guidance from RCGP and BMA "leaders" I totally ignore the ban.
'I am truly humbled and honoured to be elected as..."(add appropriate appointment).
Wherefrom do they all copy/paste this insincere opening line?
Also to be repeated upon receiving the CBE, or is it KBE?
GP Partner/Principal21 Jul 2017 1:49pm.
A bit confusing
Does that apply also to:
Prisoners on Release
The Patient or his/her Partner is getting Pension Credit Guarantee Credit (PCGC)
Universal Credit (UC)
People Receiving Income-based Jobseeker’s Allowance
The Patient or his/her Partner is receiving Income Support (IS)
The patient or his/her Partner is entitled to, or named on, a valid NHS Tax Credit (TC) Exemption Certificate
Anyone on a low income can apply to get this certificate.
Patients who have a valid Maternity Exemption Certificate
a permanent fistula (for example, caecostomy, colostomy, laryngostomy or ileostomy) which needs continuous surgical dressing or an appliance
a form of hypoadrenalism (for example, Addison’s Disease) for which specific substitution therapy is essential
diabetes insipidus and other forms of hypopituitarism
diabetes mellitus, except where treatment is by diet alone
myxoedema (that is, hypothyroidism which needs thyroid hormone replacement)
epilepsy which needs continuous anticonvulsive therapy
a continuing physical disability which means you cannot go out without the help of another person
and the 88% of the population who do not pay prescription charges?
@ScottishGP | GP Partner/Principal17 Jul 2017 7:41pm
Absolutely right. When we wanted to move from Vision to Emis PCT/CCG objected. It emerged that local health authorities (by whatever name) decide not on performance of provider or wishes of GPs but on finances.
This article has opened a big can of worms.
This is about a photo I haven't seen, a meeting I haven't heard of and a topic I know nothing about. If the punchline is that RCGP should consider its membership's welfare more than its Board's, then, who said that romanticism is dead.
To hazard a guess, the topic was whether a KBE was more appropriate than the traditional CBE for our "leaders".
Both a safe pair of hands for the Medical Establishment, ticking the RCGP, LMC and BMA boxes.
Both qualifying for PULSE's pantheon of "influential GPs" and "inspirational leaders" and both eventually rewarded with a CBE or a KBE for "services to General Practice"
Quite depressing really for the rest of us, wretched mortals.
Look at the bright side. If all GPs become Trust's employees, there will be no need to have a CCG, saving millions for the NHS, or an LMC, saving hundreds of thousands for the GPs. Quite tempting really, if nothing else to bring back to the front line our remote "leaders" currently impersonating commissioners and guardians of the profession.
Nevertheless, not everybody is a loser:
Loaded with a good supply of Orlistat, sticking a nicotine patch and a good selection of Vapor Cigas and Vape Pens in the pocket, they start their daily round with a Big Mac, moving on to Starbucks for a Venti signature hot chocolate with whipped cream + whole milk and a carrot cake. Time for luncheon at the Bull and Mouth washed down with a couple a pints.
3.20pm, time for their health check at the GP surgery and their miraculous anti-cholesterol jab to cover them until time comes for bariatric surgery. Long Live the NHS, that meets the needs of everyone, FREE at the point of delivery.
Here it is for those not that long in the tooth:
* Dramatic drop of standards, thanks to brain drain and a RCGP that has forgotten Education and deals chiefly with Politics.
* Referrals and drug budgets zoom
* Desperate situations need desperate measure - NICE is born
* "Treat patients as individuals" is out and "One size fits all" is in - GUIDELINES are born
* Guidelines replace medical schools and they are here to stay, unless the process is reversed, but we are not holding our breath.
As for the noble idea of replacing Guidelines with Information, the question is: Who provides the information? Pulse and its medical adviser?
As clear as mud.
But let's accept that there has been a decrease in the number of FTE GPs. Could NHS Digital please help us to track down our missing colleagues, starting with:
How many are sitting comfortably at CCG governing body tables?
How many "represent" us at LMCs?
How many have become medical directors for Health Education England?
How many have joined DH & NHSE and their "agencies"?
How many choose to give pointless advice to patients (if you eat less) from Public Health England and H&W Boards platforms?
For more on "missing GPs' read the Peverley classic:
I see. It's the BMA's fault and nothing to do with the LMCs.
In which case why are GP FORCED BY LAW to maintain them?
Take London for example. They deduct at source £0.5384 per patient. For a Greater London population of 8,539,000 that gives them an annual income of £4,597,397. For this, London LMCs are telling practices that "they would secure the future of general practice in London through our work with all partners in the health and social care sector and beyond"
At least with the BMA, GPs can decide whether they wish to subscribe or not. With the LMCs, GPs have no choice.
Isn't it time PULSE contacts a survey among London GPs to see if they feel that they are getting value for money? Especially as they now propose to increase the levy to £0.5778 per patient, increasing their income to just under £5,000,000 per annum.
Maybe my figures are wrong, in which case, I would welcome a correction from London LMCs and happy to apologise.