Am I nearly there yet?
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..
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?