I have had a varidesk which sits on top of my usual desk for the last 2 years. As someone who had a her first hip replacement at the tender age of 42 years sitting down for hours on end plays havoc with my hip flexors. Researching ways to keep the knife away from my other hip, I came across the standing desk. Research suggested that the standing desk made you more productive and reduced the risk of diabetes. I don't consult standing up, but when energy and concentration is flagging I can flick the handles and the desk goes up. I wouldn't want to be without it, but make you own minds up. So far I've postponed my other planned hip surgery but I would blame Pilates and the cross trainer for that too.
What a shame that so many GP colleagues are so cynical about the integration of pharmacists into our primary care team. Let's not get lost in this pointless discussion about flu jabs. We take the patients statements on face value, if they say they are a carer, we believe them. It is them committing fraud not us.
We are not in competition with each other. We offer complementary roles and the net output will be better for many of the patients if we work together. We have a list size of 6600 and have employed 2 full time pharmacists, having been completely unable to secure permanent General Practice help.
We have no regrets. The two experienced pharmacists are full of enthusiasm for their new roles and are helpful and approachable. They offer continuity of care, home visits, manage our mail manager and are training to do diabetes reviews and initiate insulin. They are doing medication reviews, organising blood tests and follow up. They do also advocate discontinuing medication where no longer needed. They are not prescribing, but will be training to do this. They are working with the local care homes to review the patients proactively and systematically. They have revised and updated our repeat prescribing policy. They are building relationships with our local dispensing pharmacists and improving systems and processes. Feedback from the patients has been universally positive. They do need regular help and support, much as a foundation Dr would do. I think it's also fair to say that they have found it much harder than they expected- dealing with such complexity and having to write it all down!
In contrast some of the locums we have used dictate their terms, squabble amongst themselves, won't be duty Dr, won't visit, won't check results and certainly won't review paperwork! I know who I would rather work with!
It would be great to benefit from the NHS England development, but we are benefiting allready from our new team mates and encourage other GPs to give them a try.
I think it's a fantastic idea and its a shame there are such a bunch of cynics out there. It is important that the patients get access to a health care professional that they can communicate easily with and who understands their condition.
Selected well, there will be no loss of quality for the patients and a full time pharmacist can offer almost twice as many appointments as a salaried Dr for the same money.
Let's get real. Even if the government agreed that we need at least another 5000 GPs, they are going to take 10 years to mature and are going to be hard to recruit. The workload crisis is now and we need help now. The current workload is unsustainable and leading to clinical errors, defensive practice and mental health problems.
Adding a full time permanent member of staff for continuity has great boons for both staff and patients. We have just recruited 2 full time pharmacists and they are extremely keen to make a difference and mindful that their brief is to make an impact on GP workload. It is obvious allready that this is a more complex area than we realised, but hopefully will mean that all those flawed systems will get sorted out properly and this time not with a sticking plaster.
Our pharmacists are reviewing mail manager, looking at some Docman and doing eclipse queries. They are not prescribing but will be doing medication reviews and training towards this. Patient feedback has been great and they are excellent ambassadors for our practice. It is great to have hard working team members asking to help, rather than locums whinging because they don't want to do home visits, can't look at results, won't be duty Dr and by the way need to go home at 5 pm.
We need to stop being so territorial and let some other well qualified professionals help us. By definition, they know their professional boundaries and are expected to ask us for help too. They will never replace us and I am sure they would not want to!
Dr Helen Terrell
Stockett Lane Surgery
Dr Helen Terrell
Stockett Lane Surgery
Please add my name to the petition
Dr Helen Terrell
Stockett Lane Surgery
3 Stockett Lane
Surely more bonkers that the NHS do not make
there own purpose built glucose monitors that
only their sticks will fit, - Nhs could then
control the price. We could then decline to prescribe
all the new ones! I've watched my Dad( in his 7os) try
to learn how to use his new one- osteoarthritic
fingers far too clumsy. Surely a patient group
with a decent OT could design a new one for the
NHS to patent?
I'm an optimist! Lets embrace the digital revolution and go for it.
Integrated care records are well overdue. I like the
card idea Simon.
It's time for the government to invest on decent kit
and make it happen. I don't know how much will
be saved financially but time definitely will be and time to care with compassion and communicate will be back.
Jeremy next time you want to commission a report
how about you ask Primary Care- I'm sure we will
be a bargain compared to PCW !!!
I am sure that the future is to integrate
all therapists under the NHS umbrella.
Surely it should be whatever helps?
I've seen a vast number of professional
therapists over the years and regularly use
relaxation and sleep hypnotherapy CDs.
I think the best thing is probably to try out
therapists for oneself. If gives you a chance
then to guage their professionalism.
I assume the pharmacists will be employing a
nurse to assist them and act as chaparone. I assume they will build
an extension to accommodate the couch and lighting needed. I assume that when someone costs this model
they will realise it doesn't quite add up!
Lets just sort out the communication, train more Drs
and integrate the records. It will be cheaper, but really we do need to get on with it.
Having recently been home from hospital these
results do not surprise me at all. I hope commissioners
embrace radical change including
pre op occupational therapy.
We can only realistically change the current situation by following patient journeys, adding up the cost and doing some systems mapping. I have no doubt that there are lots of unnecessary steps in each journey which could be avoided with better assessment and planning of need. With a move to a community model, finances will have to follow, but with less medication used and more appropriate therapy services hopefully the model could even be cheaper. Joint budgets between health and social care with real integration of records will make a huge difference to care and quality for our patients.
Congratulations to both of you. Thank you to Macmillan Cancer Support for understanding the potential
in GPs to improve and facilitate better systems
for our patients by giving us the skills to educate and train others.
I thought it was an interesting and inspiring lecture. There is little doubt that there is a great need for a generalist overview to help these patients who are clearly very vulnerable. A challenge in the time available, but engaging our excellent Practice Nurses is surely a no brainer.