I have never seen a discharge summary giving the reason for admission as 'overprescribing'. They are usually discharged back to the care home on more medications!
Some patients may experience unavoidable adverse effects from appropriate intensification of therapy, but that does not mean it was over prescribed. Unwell patients do need treating, that's what doctors do.
It was all predictable, how do you manage fabricated illness over the Internet? How do you check who has parental responsibility? Especially when divorcing parents are throwing allegations at each other. Just two issues that give cause for concern.
A further survey finds 100% of doctors prefer face to face interviews over phone consultations.
The qualitative part from study reported that doctors found it easier to examine patients and see that patients looked ill.
An obuturator hernia is another good one.
When patients had non-discript pain I used to refer them to exclude it.
A lot harder now with the ease of getting of MRIs.
GP training is a great way to extend your medical training with excellent support and mentoring. Once you are done after 3 years, you just simply leave the profession. Simps.
Appraisal means you have to endure the hardship of seeing patients occasionally, and no one is going to stand for that.
Extending GP training to 4 years would make no difference to recruitment.
The least worst of two bad options, is not a choice
If a woman has failed to attend for a smear test, then the medico-legal onus was on the GP to remind her at every attendance thereafter. That's why the GPC should be campaigning for smear tests to be taken out of primary care and placed in sexual health / family planning services, so that we have no responsibility for the national screening programmes. The complexities of transgender health care make this more imperative.
Yet I have to pay an additional £94 for 2 weeks cover at start of April until renewal. Such is life.
I don't think it is greed. GMS partners have staff wages to pay and building and overhead liabilities. Lists can't be closed that easily if at all. No choice, stuck on a treadmill until the end, unless released by death or insanity.
It's also a collective noun.
An oleaginous of NICE fellows.
Mmmmh, so as property values devalue, which business properties inevitable do, you are now in hock to the government. What an invidious position to be in.
Doc - 16 Feb 2019 8:05pm succinctly reviews the difficulties.
The new contract addresses none of this, so the intolerable situation persists.
I see no one ever suggests striking any longer, as it failed miserably.
One way workload may be controlled better is by us all becoming locums. Unfortunately this can not be done on mass, as so many have building liabilities and redundancy costs to bear as a minimum.
In one way, retiring early is a form of strike action, by withdrawing your labour. You can always return to work and discontinue this form of industrial action if conditions ever improve.
So, all of us who work part-time can say, on the days we are off, we are in effect, striking on those days.
"We will not return to work until the employers side meet our demands through a negotiated settlement by respecting our workers rights and lifting the conditions imposed upon us".
If you work part time, don't say you are off, say you are striking today. We can see how that plays out, nothing else has achieved anything.
Pulse - how about a poll, of how many GPs would be happy to declare that the withdrawal of their labour on days off can be considered as industrial action?
I sent off my last referral dictation at 23.14, only because I was stupid enough to take a break and have an evening meal and drink some water. Did anyone go past midnight and would that count for the survey as it rolls into the next day?
How can you control workload if the GP recruitment crisis leaves you covering the work of absent colleagues due to unfilled GP partner or salaried postitions? On my last day as a partner I was doing the work of three GPs. The survey will presumably show that any variance in activity will be highest in under doctored areas.
Indeed, this seriously questions the RCGPs governance procedures which is also exemplified by its recent blatant political statement on brexit.
Re 10.03 PCNs, They will have no choice but to keep them, the contract states that PCNs will have to cover all patients in the PCN geographical boundary even if a practice refuses to join its PCN. This will make it all the more easier, when practices close, as the patient list can be dispersed among the remaining practices in the PCN by NHS England.
More details -
By 2024, NHS England expects that a typical network will have five clinical pharmacists (equivalent of one per practice), three social prescribers, three first contact physiotherapists, two physician associates and one community paramedic.
- This is across 5 practices with 10k patients each.
A drop of additional roles in an overwhelming ocean of unscheduled care.
Does anyone have information on how the logistics of this will be handled? Which department is going to co-ordinate, investigate and respond to complaints now that the MDOs are no longer involved?
The relentless march towards corporate privitisation of primary care continues apace. Packaged into neat networks ripe for the health corporates to cherry-pick and bid for.
I notice that small independent private care has been snuffed out by the new contract. It has ridden a coach and horses through the business models of GPs being able to provide care for private patients within their own NHS funded surgeries.
Reporting figures across England of 22,000 extra staff sounds impressive, but works out on average as an extra 2.75 per practice. I'd rather have another GP, as more efficient than the 2.75. Introducing these numbers over the next 5 years is unlikely to compensate for the existing short fall or the numbers of GPs expected to leave over this period. Nothing in this to entice GPs who are considering retiring in the next couple of years, to linger on.