Am I nearly there yet?
after 29years at the coalface I can assure you that bigger is definitely not better. with your experience if it doesn't feel right then it isn't right. its all another smokescreen to divert attention from the real underlying issues you have raised.
When will someone up there start to realise that Bigger is not Better. Possibly when local PCNs becomes PCN England? But what then after that??
Depends really on how much the governments of the day value experience within the NHS. Surely the simple thing to do if they do is to raise the thresholds? - Job done and workforce keeps working... Opting out of the pension contributions just pushes your earnings up which are taxed but at least you know where you are with this.
Resilience can only last so long if the fundamental issue of a depleting workforce is not reversed. I am now there and retired early[ish] with no regrets. I've done my time, starting with 1:2 rotas and 24/7, 365 red book contracts. I recall it being said for decades that a quarter of the workforce will be retired in 5 years. well it seems the final five years is now up. Clearly smelling the coffee for too long just means the incumbent Health minister just moves on... What can anyone expect?
1. Agree with chris Ho.
2. Let her speak then make her listen to others speak. If we only listen to the "party line" what is there to debate??
3. to all those who can only throw in there membership if they feel "Offended" - grow up
Hopes and Wants have done nothing to address the actual NEED. the words are meaningless.
And the point of the analysis being ??
A bit of title creep here I think. what happened to "Physicians Assistants"? As a GP I couldn't have learnt all I have done with a post grad course. Where are the Doctors? surely another layer of patient interface just muddies already murky waters.
agree with turn out the lights. the whole concept of PCNs is just another diversion away from the intrenched decline in proper General Practice. it will create yet another industry in "Managing" GP but nothing to restoring General Practice. All the funding for parapatetics will only create increased diversity and nothing for continuity of care or patient benefit.
seems the obvious reasons for discrepancies as always overlooked in an obsessional drive that all must be equal. When will this "Diversity" obsessed agenda finally see reality? Clearly to address this (im)balance the answer is that males now have to do less work or those that have chosen a 9-5 option resume weekend on-calls.
Never mind the online systematic questioning process to start with. It then does decry belief [or not!] that Capita devise a submission form that when completed is then too big to upload onto their own site. fortunately my PM was able to "dumb it down" to the required 3Mb required. How much more evidence is needed by DoH that their support service ain't fit for purpose?
Excellent article. the whole issue needs to be debated publicly. I suppose the big issue is whether as an individual you want to live well until you die or do you want to live on no matter what. Doctors have to remember we are managing those individuals. unfortunately Guidance and protocol are derived from populations and seem to be formulated to cover the lowest common denominator who is applying them. Protocols dumb down your ability to think. if your not thinking then individuals suffer not the population.
Agree with stelvio. you may clear a uti bug in 24 hrs but sx don't settle for 4-5 days. worse with the "Old Chest infection Doc.." It has always seemed very arbitrary how long a course of abx should be. Why not just advise patients to take treatment until they feel better? After all how many "Courses" are ever completed for the full length issued no matter what the current guideline is?
Is there a need for another survey? The issues are all well known the problem has been with hierarchal denial.
I disagree with anon 2016. technology will not solve the NHS or GP situation. simply combining practices and adding other means of "consulting" [unless AI will take over] only adds to the problem. When really have computers lessened workload, it end up with the tail wagging the dog. unfortunately the dogs now dead. sorry. GP and patients need good people not technology that no one understands.
Simple. Technology will not solve the NHS's problems. People will. People able to concentrate on patients needs, not politicians and pressure group wants. Until technology can tell us what should be done rather what can be done then keep it in room 101 and make sure when its out the tail don't wag the dog this time.
I suspect there is evidence to state that what is needed is more GPs [J Hunt certainly staked a claim on this] over bigger practices. This knee jerk policy is yet another reason why the NHS needs to be taken out of Political control. It can then concentrate on what is needed rather than what wanted and use evidence rather than whims to create policy. The policy here is the opposite. it enhances government control and anyone at the grass root level with any nouse of sense will simply be diluted and drummed out.
Really does mean the end of Partnerships running General Practice. Get out now. This is General Practice entirely on the Government [of the days] choice. The bureaucrats must be rubbing their gold plated pencils devising many hoops you'll have to leap though to bid for their work. This will be General Practice as per protocol. To meet certain demands that shows a policy is working.
GP was and should be about continuity of care - that's where the long-term savings really are. Enlarging Practices without the capable, experienced and committed workforce will only undermine this. It will have to be run by managers set on hitting a target. How often do we experience duplication of investigation? Good money is going back into general practice. Bad - it's too late. The current belief that technology will solve the nations health problems is bizarre. Technology, good as it is has also created the problem. Good luck to you all as I am now there.
As a human I would like to be treated by one. AI may be an advancement in computerised technologies and may well work out quicker a diagnosis and therefore what CAN be done. with already technologically assisted long levity and therefore resultant multi-morbidity the bigger problems are increasingly what SHOULD be done. unless you want microchips to make this sort of decision then I think we still need hands on Humans under the guise of well trained, experienced Doctors not remote or virtual technicians.
the technological solution is a fallacy. it is however an entrepreneurial's wet dream. unfortunately it has all the hallmarks of coming to a sticky end... [ every pun intended]
if only there were the GPs left able to spend it.
joe bloggs is right but i'm afraid Big and Smaller is Righter... guidance may be general but it ends up being applied to individuals and believe me legal teams [and NHSE] will pursue that principle to the end..