The direction of travel is clear. Remaining partners will employ increasing number of salaried doctors, while they increase managerial roles and see less patients them selves.
It would be cheaper for the Government to move to salaried model and scrap the partnership model altogether.
I have no doubt that telehealth communication can be helpful. Especially for the worried well and busy professionals. What about the elderly who do not have computers , maybe hard of hearing, mentally ill. This would put a large part of the most disadvantaged in society at risk . They simply will not bother, they will present later in A&E ( If A&E allows) How many times does an unexpected diagnosis or concern turn up , an unexpected enlarged liver during an examination, a melanoma not expected. These may not happen often but are often very significant. The swollen ankles that are the first sign of anaemia or heart failure. This sort of thing cant be opportunistically diagnosed over the phone. If I was a young idealistic Doctor I would give GP a wide birth as I didnt sign up for call centre work.
GPs will be moved to large call centres to do video calls , practices will close, visits will be outsourced. Demand will increase for the worried well, the truly ill will suffer.
Instead of doing an immediate test the patient will told to make an appointment for their symptoms , further delay.
Video consultations may seem superficially like the answer to the stress on GP , but it will be the final nail.
At the moment most consultations are video or telephone. Up to 90%. Many practices will want to continue this after the Covid crisis is over. The problem of unmet need , no opportunistic screening, barriers to the elderly and mental health patients will be a problem . I would suggest that being a video consulting GP will be a soul less job . Increased medicolegal risk. Young doctors will be further discouraged . Such consultations will be dealt with in large call centres , local practices will close at ever faster rates. GP will be dissected up, Medicine management to pharmacies, palliative care to palliative care teams and so on,
No longer will GPs give continuity of care.
How terribly depressing.
As a GP local to Buxton I remember the old Devonshire hospital very well. Famous for its unsupported dome . Now part of Derby University.
The sad thing is that continuity of care makes for efficient consultations, reduces admissions and patients prefer it.
Like everything , not valued until it’s gone.
Yellow nail syndrome. I once saw a case of methaemoglobinaemia caused by blue stain from their pyjamas !
The motivation of two weekly visits to care homes is the hope that it will prevent 999 and admissions to A&E. It would make little difference. If you want to manage chronic conditions better , regular review is a good idea. However 2 weekly seeing patients for some arbitrary NHSE dictat is not helpful. Acute admissions may happen between visits anyway.
Interesting proposal. Certainly being called out of the surgery is stressful. I suppose larger practices have a GP on call doing triage and doing visits. In my rural practice we used to be the emergency service , Over the last 25 years the paramedic service replaced this role. We were never paid for rushing out we just did it and the patients were generally sensible. Inner city practice , nursing homes , entitled patients has been the death knell of this sort of service. Perhaps Practice networks may arrange this sort of cover. Retired rural GP
There was a paper in the BMJ about 20years ago . “ increasing inhaled steroids in exacerbations of childhood Asthma didn’t help”
This sounds like the 600 branch surgery is unviable or at least considered unviable. The arguments for closure are a convenient excuse.
The 2004 contract did away with the basic practice allowance which paid and incentivised the partnership model . The hamster wheel model of medicine whereby work harder and harder for the same money, add to that over regulation and you have suffocated and strangled GP . The BMA negotiated the 2004 contract and sold it to the profession as a triumph. It wasn’t .
I agree , the performers list is a nonsense
Imagine living in Berwick upon tweed or Carlisle , you can’t work if you travel a few miles into Scotland. What added value does it bring. If you stop GP but want to do something else like medicolegal or occ work you have to come off the performers list and find an alternative designated body, making coming back to GP a bureaucratic nightmare. It’s also another hurdle coming back from abroad and is helping to reduce GP numbers .
It is obvious / common sense that knowing your patients well improves efficiency and continuity.
On top of that patients want GP patients that offer personalised care . This is best delivered in small practices rather than the latest vogue for large mega practices . Fewer complaints.
As the data was previously sent, what has happened to it.
This is clearly unacceptable , the proposed time scale for doing it makes it even more so .
Interesting , but we’re all the subjects on a Mediterranean diet. Might not be relevant to U.K. NICE will probably be influenced by the study as may cut prescribing bill.
Will be interesting to read the BMJ
Even if the 85% is correct , which I doubt. This is self selecting population quite different in its characteristics to the ordinary GP population.
What is the secondary care specialist going to do PSA +- DRE .
If GPs haven’t got the skill to determine normality upon DRE they should refer and go to another CCG locality meeting.
The problem is the increasing number of men asking for a check up who are asymptomatic.
The significant false negative rate for PSA is a problem. By combining digital examination with PSA you can increase the sensitivity. You do need to explain that small cancers can still be missed . Recent change in LUTS May need referral.
Patients who can’t get to see a GP for several days, will vote with their feet. GPs are starting to have to operate in a market.
The government will see this as injecting competition .
“ Let’s make GP great again”
Pay partners a premium for being a partner.
Stop GPs going to CCG meetings and other pointless exercises.
Stop exploitation of salaried GPs. Some partners reduce patient contact go to meetings and pay salaried GPs less , win win all around for partners but not good for patients.
Encourage evidence babsed practice overseen by RCGP. RCGP stop politics.
Allow GPs to be trusted professionals.
Pay GPs to see patients.