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GPs buried under trusts' workload dump

Paul Cundy

  • GP leaders to call for removal of home visits from contract

    Paul Cundy's comment 11 Nov 2019 7:34pm

    Dear All,
    Bad idea. Bad politically and bad strategically. If you didn't know your contract does not say you have to visit, it only expects you to visit if you agree its necessary, which will be the housebound, EOLC etc so all you gain is a public own goal, asking for what you already have but being labelled as uncaring for wanting it.
    And paramedics doing the other "non" visits, another bad idea, we all know how good they are at reducing expectation, not doing onward referrals and generally saying no.
    lets hope the emotion and symbolism doesn't cloud the debate.
    Regards
    Paul C

  • The many disappointments behind this appointment

    Paul Cundy's comment 04 Nov 2019 11:49pm

    Dear All,
    Well how's this for mad lunacy, our local eRS service has a deadline of 3 days during which we have (sic) to attache the necessary documentation. If they aren't attached within the 3 days they cancel the referral. So they helpfully send out reminders. The reminders are sent via their fax to e-mail to whatever system. These messages take 11 days to arrive in our in-boxes.
    So their "we might cancel your referral unless...." messages arrive 8 days after their deadline has closed.
    Simply brilliant
    Regards
    Paul C

  • CQC chief inspector: no 'concessions' will be made for GP capacity issues

    Paul Cundy's comment 27 Oct 2019 6:38pm

    Dear All,
    It is absolutely staggering that she can utter these words within days of her own organisations report recognising the realities and extent of the GP capacity problems.
    Clearly someone who believes in the beatings continuing until morale improves. On a score of "How to connect with those you regulate?", are negatives allowed?
    Regards
    Paul C

  • Judge finds in favour of GP practice that refused to post medical records

    Paul Cundy's comment 21 Oct 2019 10:41am

    Dear All,
    Good news but lets not be too hasty, Pulse has not reported the story correctly. In fact the case was not about GDPR or DPA 2018 directly. The Case was about what are known as the "Court Rules", in this case a rule that requires records to be disclosed. The Judge dismissed the case because he decided that the court rules were not applicable, because the records had already previosuly been made available under a SAR, therefore there was no need for the rule to be applied.
    Don't get me wrong, i'm as delighted with the result as you are but we cannot at the moment jump to too many conclusions about SARs. I imagine the GPC IT Team and BMA lawyers will be looking at this in detail.
    Regards
    Paul C

  • GPs may have to assess mental health and mental capacity free of charge

    Paul Cundy's comment 16 Oct 2019 3:53pm

    Dear All,
    Oh dear what a half brained assessment, and these people are supposed to be setting us systems to protect the vulnerable, what a farce! Nursing home staff can't do it, they are conflicted, obviously. So we'll get the GP to do it, probably the very same person who will be asked to prescribe the DOLS enacting medication, and of course the patients personal medical advocate, so no conflict there then!
    The GP cannot possibly do, they are hopelessly conflicted. Another GP can do it, but hey ho that will be non NHS so under GMS they can't do private stuff, so no that GP can't do it either. Looks like they've manoeuvred themselves into a situation where in fact no GPs can do this. Silver linings at last.
    Regards
    Paul C

  • Pharmacists granted power to change fluoxetine strength without GP

    Paul Cundy's comment 05 Oct 2019 8:59pm

    Dear All,
    And do they pick up the liability issues?
    If i sign a prescription for a certain amount of medication, lets say a skip load of Movicnouselactuolgenericose, becasue its just as effective and cheaper, and the patient suffers Haemorrhoidal colic and dies (you need Netflix), who pays the price?
    Regards
    Paul C

  • GPs must report deaths to coroners in writing under new rules

    Paul Cundy's comment 02 Oct 2019 6:39pm

    Dear All,
    There's a mass of myth and mistake here and elsewhere. I've poured over the 1953 and 2008 Acts and amendments and its actually like this.
    If you participated in the care of the patient during their last illness you are required by law to complete an MCCD. That's it. No 14 day rule, no time limit at all. And its every doctor who did. so in theory there could be several MCCDs for each patient; GP, OOH doc, oncologist etc.
    There's no option or permisssion needed from the Coroner, no matter what they say.
    There was never any need to speak to the Coroner or get agreement, you just issue the MCCD, job done.
    It's the Registrar who has to decide what to do with it. They are the ones who have to apply the imfamous 14 day rule, not the GP.
    All that has changed with this new legislation is that there is now a legal duty to report to the Coroner any MCCD that you sign with any of the qualifying conditions. You still issue the MCCD.
    The only circumstance in which you may be given permission by the coroner to issue an MCCD is if you did not particpate in the last illness, and thus are not bound by law to complete one, but the doctor who could do it is unavailable (the GP on holiday scenario). In those circumstances any GP who becomes aware of the death is required by law to report it to the coroner. The coroner may then instruct the non participating GP to complete an MCCD.
    I hope this helps.
    Regards
    Paul C

  • GPC chair says shared patient records are increasing workloads

    Paul Cundy's comment 01 Oct 2019 1:15am

    Dear Ivan,
    Can you actually produce solid impartial evidence for your statements? As far as I know there is actually very little thoroughly researched evidence that simply opening up each others databases (for that is what you euphemistically describe as "sharing") does actually improve outcomes. There is certainly NO evidence it reduces costs or resource burdens. Why, because if i were to "share" my records with my local hospital they will get 20+ years of 100% read coded free text poor data to pour their way through. Whereas they could alternatively receive a well crafted referral letter that contained all the data they needed. There is a concept of data overload and access to data does not equate to knowledge. Opinion is fine but express it as such.
    Regards
    Paul C

  • General practice responsible for £88m of fraudulent behaviour, claims NHS report

    Paul Cundy's comment 17 Sep 2019 11:01am

    Dear All,
    88 million from 1.2 billion. Thats 0.0007% of the total. Well worth focusing on that then. Ignore the other 99.9993%.
    What bean counting thinking. I'd have said producing such a nonsense report is a fraud in itself.
    Regards
    Paul C

  • New Government proposals set to give GPs greater control over their pensions

    Paul Cundy's comment 11 Sep 2019 8:40pm

    Dear All,
    Is it correct that MPs are some how excluded from the annual allowance cap? Their pensions are contributed to as an annuity so there is no "pot" to be taxed?
    Seems mind boggling unfair if true but not surprising, unfortunately.
    Regards
    Paul C

  • Pharmacist to dispense high-dose statins without GP prescription under NHS plans

    Paul Cundy's comment 04 Sep 2019 10:07pm

    Dear All
    On a more serious note is this not a proposal for a national screening program? Therefore should it not be within the mandate of the recently announced national screening program review?
    Ragrerds
    Paul C

  • Pharmacist to dispense high-dose statins without GP prescription under NHS plans

    Paul Cundy's comment 04 Sep 2019 7:36pm

    Dear All,
    "NHS England claims there to be estimates that two-thirds of people who are most at risk of heart attacks and strokes do not take statins but would benefit from them."

    Yes of course, they could pick them up on their way to McDonalds.

    What exactly is the evidence for life prolongation for statins given for primary prevention?

    Regards
    Paul C

  • The poverty of excess

    Paul Cundy's comment 27 Aug 2019 8:01am

    Dear all,
    Really gets my goat all this "don't ostracise obesity". We treat Anorexia as an illness, why not obesity then?
    Regards
    Paul C

  • No evidence that online consultations save time, says CCG

    Paul Cundy's comment 22 Aug 2019 11:53am

    Dear All,
    The important thing to do is for every on-line or digital appointment you offer, take back a face to face one.
    Regards
    Paul C

  • GMC's MPTS tribunals can draw ‘adverse inference’ if doctors do not give evidence

    Paul Cundy's comment 21 Aug 2019 7:10pm

    Dear All,
    So the concept of "absence = omission" has been assumed by the GMC, our law makers. Everywhere else in the world absence of evidence does not equate to evidence of absence.
    When will the GMC understand its requirements under Human Rights Regulations?
    Regards
    Happy to be identified
    Dr Paul Cundy
    GMC 2582461

  • Coroner urges revision of mental health referral form after 15-year-old boy dies

    Paul Cundy's comment 21 Aug 2019 5:04pm

    Dear All
    Just been through the same argument with our local CAMHS. In fact the Consultant was very understanding, took my point that i had satisfied my legal and professional responsibilities under GMC rules 15(c) and 22 by writing my referral letter. I did not need to do anything else.
    i also pointed out that the rejection of the referral was in fact a clinical decision made about the management of a patient and therefore the clinician who made the decision, or under who's delegation the decision was made, needed to be named on the rejection letter.
    Regards
    Paul C

  • GPs sent almost 400 incorrect discharge letters

    Paul Cundy's comment 19 Aug 2019 8:48pm

    Dear All,
    Thats at least an availability breach under GDPR. Has the Board reported itself to the ICO?
    Regards
    Paul C

  • Government to end 'one-size-fits-all' NHS Health Checks

    Paul Cundy's comment 17 Aug 2019 9:55am

    Dear All,
    Come on cut him some slack. The program alongside the annual Flu fiasco is known to be a complete waste of time effort and money. He's unlikely to say that in public, but this is undoubtedly a move in the right direction. Lets just see how much they stick to the evidence.
    Regards
    Paul C

  • NHS 111 'a cause' of growth in A&E attendances, claims CCG

    Paul Cundy's comment 13 Aug 2019 6:39pm

    Dear All,
    So NHS 111 admit that only 2 out of three patients follow their advice. Excellent, well worth funding.
    Regards
    Paul C

  • GPs send photos of skin lesions to speed up cancer diagnosis in new partnership

    Paul Cundy's comment 13 Aug 2019 12:49pm

    Dear All,
    Been done dozens of times before, allways falls over because the enthusiasts who are likely to be trialing this are the ones who least need to have their referrals policed. the GPs sending seb warts up as urgent cancers will be the last to take up the technology.
    Regards
    Paul C