Most care home elderly patient have complex medical histories and polypharmacy. There is a clear need for good medicines reviews as in many cases this does not occur on a routine basis and leads to problems[ no renal function checked on patients on ace inhibitors etc]. However, my experience is they take at least 20 minutes a patients if done properly, and the practice pharmacist I worked with requested an hour per patient. Good idea, but not sure how this gets fitted in with everything else!
To clarify, I accept that locum rates will go up and down with demand/supply and am happy to accept that and the variability of income that this leads to, or go and do something else if needed. There is plenty of work out there for GPs.
Like others, I found the working environment of GP partner role [ after several decades working at it} became unpleasant on many levels. Having tried to recruit younger GPs from the ST3 pool and got the same answer for several years[ thanks, but no thanks I prefer to do locums/bit of salaried/bit of occ health/bit of private/bit of aesthetics / I am developing an app and I like to have 6 long holidays a year], I could see the logic of their position and joined them. No regrets. Things are lean at the moment, but it nice to have a break from it episodically to recharge and do other things, before the very busy new normal resumes.
Surely it would be more efficient for patients with appropriate symptoms to report themselves to PHE.
You could do it via the new app.
Locum work will come back, as normal consulting will resume in July.
In fact, there is likely to be an increased demand to cope with the backlog.
We could see a big rise in locum pay rates, due to increased demand to address the backlog, and a reduced number of locums as some have moved onto other work due to the recent locum post shortage.
Given the current rate Covid prevalence in the general population all practice staff will need appropriate precautions and PPE for interactions when normal working resumes.
Alot of people with unstable medical conditions and possible cancer symptoms have defferred care because of the lockdown.
At some point this will backlog will need to be addressed.
Our current extended hours consultations are now 15 minutes. 12 pts in 3hrs- pay rate is good too.
Safer for pts and GP, and more professionally rewarding as have time to do things properly.
Its the way to go.
I work 1-2 days a week as a locum .
I did an evening surgery last night and saw 5 people with coughs and fevers who wanted to get checked, several coughed towards me. No protective clothing. Seems fairly high risk to me that GPs are going to get ill. Thinking of stopping locums for a bit until things are better organised.
Obviously financially favors locums over partners.
Is it any wonder that almost all newly qualified GPs are becoming portfolio/locum Gps?
Latterly,APMS contracts contracts were too much hassle and not economically viable for the corporates[ most are getting out or reducing] and too much time and hassle for NHSE and the CCGs to monitor.
Much better to get GMS /PMS/Federation GPs to pick this up if they will do it!
So sorry for your loss Dr Chand, my thoughts are with you and your family at this difficult time
Great article. Completely agree. I’m really enjoying being a sessional GP having been a GP partner and a salaried GP in the last five years too. I can see why most of the new GPs are opting for this career path at this current time as the conditions very much favour it.
No I quite like Dimping.
Completely agree. Targets without The resources just cause frustration. The young doctors are voting with their feet and not joining the profession as They can see it’s clearly unsustainable and not a pleasant working environment. 3.6% increase in NHS is welcome however will barely address the large gaps and problems that are built up in the last five years. There will need to be significant political change to address the tax issues if we are to fully fund an NHS system that meets the needs of an increasing elderly population. We are nowhere near that at the moment. I can understand how the young doctor is looking at this and decides that the best thing to do is to go to Australia for a few years, Become a portfolio doctor, or become an entrepreneurial Locum.
I have worked as a GP at a struggling practice. We found it difficult to recruit non GP health care professionals with the right skills at the right price who were prepared to do all the work required. Large gaps in care were left as we ran out of money, compared the previous situation where GP partners got on and did extra work as needed. You have a problem Houston.
Hearts in the right place. One for the personal journal I think.
Just fab. So funny.what a great writer.
Great article Jaimie, well done
This is a very important article.
In reality many GP surgeries are on this brink.
NHSE/CCG are aware and concerned, but little action to change the direction.
It will now need massive injection of resource to turn this around, whether its STPs, Federations or individual practices doing the turnaround.
As is happening in Bridlington, I think NHSE/CCG will need to offer salaried GPs £130k a year to tempt them back in to the challenged areas.