Am I nearly there yet?
I think the cartoon unfortunately applies to many professions not just doctors. Having gone through most of a career starting with 1:2 rotas and 24/7,365 day GP/Red book contract Maybe its time for the newer generation to hit the world as it is today and just get on with it.
It is amazing how simplistically Health ministers actually view the NHS. You can have all the technology in the world but unless you have the basics in place such as a GP to book an appointment with, what is any of it worth?
Really cant't remember whether Jeremy's 5,000 extera GPs were full time partners or any doc with a license to practice.
I feel, sadly that zero toleranz is right. What is the incentive to become a Partner? You carry all the responsibility with no chance of influencing any health policy or strategy. No one higher up the bureaucratic tower ever [wants] to listen to the Grassroots. they only set up more quangos and authorities like CQC to kick you in the nuts when you haven't gold plated the last edict.
I left as a Partner for these very reasons cited by zero. To save myself from insanity for a very modest pay drop. My only regret, should have done it two years earlier.
it would be simpler to simply remove NHS choices as a means of anonymous comment and ridicule for those trying to provide a service underfunded, undervalued, and underinvested by politicians who proport to support a true NHS.
It is actually sad to see that some nerds are employed to monitor an unnecessary and demoralising activity.
Personal observation over many years is that those who value you, even in times of adversity take the time to WRITE to you while trolls use anonymity to complain.
I took last year to send all emails "A comment about xx surgery has been posted on NHS choices" to JUNK.
If all practices and GPs did this how could any expense on a totally un-needed activity be justified and the nerds could be sent home to play at something else.
I agree entirely. the problem is that I don't recall it being GPs that initiated this blanket antibiotic/steroid "In-case" strategy in the first place. as rightly stated it was promulgated by the "Experts" and dumped on General Practice as a belief that it would reduce some strain [yet again] on hospital admissions.
The swing seems to be returning if not mistaken to an odd phrase of "Use clinical judgement?" - perish the thought! The problem here is that blanket dic-tats have eroded the very skills needed to do this and demoralised those who have tried.
typical. a system that works in London must "work" for everywhere else? How many more times does the rest of the NHS and country have to bow and concede to what happens within the M25 and the enclosed yuppies? When will the system learn. What people want and what NHS should provide are not always the same. What they actually need is a stable Primary care system accessible to all on equal terms. - Anything else then PAY.
Quite happy to keep the finger out. So any man with symptoms refer fast track?
Why not just give GP direct access to mri if its that good?
Standard advice. When departmental nerds don't know - "See your GP". Really could be anything just this time its individual countries and international law. Surely you remember this from Medical training or did I miss that lecture?
Maybe, painful as it may seem that it is time to stop "medicalising" obesity.
Why should the NHS be involved in "Treating" a condition of indulgence and simple lack of self control? The only reason you gain weight is continual calorie excess over output.
Surely the onus is on the person to change. Weight watchers, Slimming world offer excellent service to those with a commitment to change. Although i can fully understand a co-morbidity argument, medicalising this issue just ends up shifting the blame to a health professional to manage a personal problem and lifestyle. (i'm obese so who's to blame attitude)
Maybe withdrawal of a service is actually a recognition of this.
By contrast once you have undertaken to bypass someones gut you certainly do have an ongoing commitment to manage them.
Tax the fat and subsidise the fruit and jogging trainers but keep "Treating" it out of the NHS
This is quite a shame given the whole industry that has been created around appraisal and revalidation. however if you create a façade just to placate the vocal over Shipman what can you expect?
What may have started off with good intent was soon hijacked and diluted by the political elite set on making statements to pressure groups rather than concentrating on valid outcomes. it has over time by promoting tick box medicine distorted the clinical values it was supposed to improve
627 extra deaths for primary care prescribing errors. this has to be a number derived by a theoretical statistician and not a real person. as we know, anything can be done with statistics.
for once i find myself agreeing with Jeremy Hunt; Lets get over a blame culture and look at the reasons. certainly it needs to be taken out of a political arena and into the everyday world of general practice and real life. a sense of reality is very much needed not point scoring or purist ideology. sometimes shit does happen. patients do have more than one disease. Daily GPs see twice the number of patients they should do. Hospitals continually shift prescribing into primary care.
627 deaths may be too many but how does this compare to the 1800 who die ach year on uk roads. Do we think twice about getting in the car to collect our prescription.
Lets really keep this erudite number in perspective.
Ditto. Commission of Questionable Capabilities is my take. I have nothing good to say about it other than like my compatriots, i'm out! Bully for the CQC. At a time when general practice is on its knees through workforce collapse we have a priority to gold plate bureaucracy as if nothing else matters. we now have qualified nurses ticking a box and auditing the fact they wipe down treatment room sides. we have GPs being advised to go on chaperoning courses. CQC has successfully pissed off those with the most experience and longest serving of all. well done professor. Sorry what was the purpose of CQC? - destroy by attrition- box ticked.
fine if there's a protocol to remove protocols from specialists and a supply of adequately experienced GPs to apply common sense without fear of retribution when they are next admitted.
Professor of Whatever, he is right.
After 28years in the job I have failed.
I can no longer work 60hrs a week.
I can no longer keep up with inexorable bureaucracy.
I can no longer run my practice with clawbacks, PMS reductions and short term funding.
I can no longer recruit any clinical staff.
Never mind i am sure a new breed of physicians assistants, HCAs and Virgin health will make a better job of ensuring continuity of care.
neil tallant barn surgery, christchurch, dorset
CQC sabre ratling to make up for its own past failures and beef up its public image. Patients in general dont like organisations denegrading "Their" NHS so may end up an own goal.
is this not CQC beefing up attacks on the nhs to justify their own existance? If 10% are "Avoidable" then 90% must be justifiable. I never assumed Pneumonia was an avoidable disease - unless pressure not to use antibiotics is now delaying appropriate treatment, which can of course include admission.
Can we not accept that successful treatment of heart failure, cancer etc does actually lead to older and inevitably "frailer" people? As yet we dont have a policy to deal with that - ie the DoH led by politicians remains incompetent at longterm forward planning and management of the NHS. [Too tied up in soundbites and short term gains that, temporarily, appeal to voters]
undoubtedly a report that damns the NHS for societies failings will produce the expected government knee jerk reaction. - more targets. What is needed is a trebling of tobacco tax and and a food fat tax. Obesity and smoking are not the result of the NHS.
30 pages. great. can you give us the nuggets for a statement that can be put in every GP waiting room. its the patients we are ultimately accountable to. we need something straightforward that explains to them - we now call them voters - as to why they have to wait for appointments and services. state the financial losses. state the dangers of tick box, target medicine. its the government policy thats driving us bonkers lets tell the punters / voters.