Am I nearly there yet?
Play the safety card. CQC can only back you up on this. The only other option for them would be to put you into special measures. Should go down a treat
Shame. I well understand the time pressures but if you take this out of the GP role I would fear GP role is ever more becoming just a job rather than a treasured vocation. Nice as it sounds superficially to ditch home visits, how more monotonous will daily working become?
Capacity is the issue, why else discuss this move.
We need to Bolster the GP speciality not cut it down. certainly set more stringent tests of need for a visit. certainly renegotiate the contract terms, especially the afternoon "urgent" call but don't cut visiting out. Your life will be more dull for doing so.
when the regulators don't understand the "Issues" then what hope do we have and what's the point of CQC?
It is actually quite nice and refreshing to have an area that is dependant on "Clinical judgement" rather than a protocol... Perhaps this is indicated by why there are so many "Internal" referrals from those whose ability to cope outside of these stops. This despite the fact that they all wish to be classed as "Clinicians".
From experience Fly bites tend to inject cellular toxins and quite often lead to more tissue damage. Mozzies, etc are more allergic. Pain is probably a deciding factor as to whether Infection is present and is very unlikely to be evident in under 24hrs of bite. Therefore timing and pain, clinically would be my deciding factors. certainly a watch and wait approach with "Reserve," post dated script seems sensible. after all what else are you going to do after advising antihistamines as an initial management strategy. Roll on judgement! For others try to cope outside of your comfort zone - Evidence/protocol permitting of course
I think if a GP calls for an ambulance via 999 then there is probably a need for one - ?
Will everyone in ivory towers addicted to protocols and scores get off there arses and smell the coffee in the real world.
I would simply suggest to the ambulance that if a GP calls then NEWS2 = 10 and go!
Seems at present politicians have moved so far up their own arses and entrenched in their own views they forget that anyone else can actually hold and express a valid opinion. JR-M really needs to pull his socks up if he expects any respect. Arrogance is now ruling debate not argument and fact.
Para 3 of article. case find and test symptomatic people ? As hypertension has no defined symptoms [except when too late] what are pharmacists going to be looking for. surely for the intentions of case finding they simply have to offer opportunistic testing to anyone. why complicate the simple? - whoops sorry, forgot this is an NHS initiative.
Good on you Nigel.
Drop in FTE Partners is actually the most telling.From personal experience we know what the loss of a Partner means - our [taxable] earnings went up [Great?]. unfortunately our ability to manage the practice went down and has now been [taken over] merged. Roll on last man standing... but watch out for the tax bill.
Good on you mate... Talk it up then. - Sorry, "What was that you said?" Still cant hear much...
Obesity may be "Complex" but lets not forget it usually results from more calories in over calories out. by all means "Have the conversation" but we really must avoid Medicalising essentially a current social issue. If governments are so concerned then they need to get off the high horse, Tax the Fat and subsidise the alternatives. Clothe retailers need to stop adjusting dress sizes and revert to what was normal. stop fudging the issue, stop using PC terminology. We all need start singing from the same hymn sheet and provide consistent messages.
so what's new? All "New" initiatives are thin end of wedges. Why get sucked in? (again)
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.