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paul cundy

  • 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

  • ​Genomic testing in five million patients could worsen GP workforce problems

    paul cundy's comment 12 Aug 2019 10:51pm

    Dear All,
    To what extent cn genomic testing actually reliably predict anything?
    Can we have a list with predictive values please?

    Regards
    Paul C

  • BMA ‘exploring’ legal action after Capita wrongly archived patient records

    paul cundy's comment 09 Aug 2019 10:25am

    Dear All,
    Failing to deliver 47,000 cervical screening letters is an "availability breach" under GDPR. That scale of breach should be notifiable by the data controller (Capita) to the ICO. If they took 2 months to tell NHSE I wonder if they reported themselves to the ICO? if they failed to do that, that is in itself another breach.
    Regards
    Paul C

  • Lyme disease in UK three times higher than estimated

    paul cundy's comment 01 Aug 2019 0:07am

    Dear All,
    so we need to sense check this amalgam;

    "may"

    "be three times higher than expected and"

    "could reach".

    Full stop, next sentence.


    "the combined number of cases recorded on the database from between 2001 and 2012 was 4,083 cases detected among 4,025 patients."

    hmm interesting, thats almost 90+%????

    "The number of"

    "treated suspected"

    i.e not diagnosed

    "cases continually grew from 2009 to 2012, in contrast to the number of"

    "clinically diagnosed"

    "cases, which researchers suggest is due to 'greater cause among the GPs and willingness to treat the illness early"

    "before"

    "confirming the diagnosis.'"

    In other words treating blind. Clinical suspicion of this diagnosis being equivalent to treating on suspicion.

    All this study shows is that more patients are being treated for a condition with no better an evidence base than greater awareness. This coud be a good thing or it could not. The only conclusion that can be reasonably drawn from this hogwash is that we need better diagnostic tools for this very fashionable illness.
    Regards
    Paul C




    lets repeat that;""The number of treated suspected cases "

    repeat "suspected"

    "in contrast to the number of clinically diagnosed cases,"

    had

    "continually grew from 2009 to 2012,"

    which was attributed to a

    "greater ...... willingness to treat the illness early before confirming the diagnosis.'"

    err so there is no positive diagnosis.








  • Lyme disease in UK three times higher than estimated

    paul cundy's comment 31 Jul 2019 11:24pm

    Dear All,
    "8.4 million records makes up 8% of UK population". Err so total UK population is in excess 100 million?
    looks like a case of lyme encephalopathy?
    Regards
    Paul C

  • Pharmacists are just as capable as us at negotiating useless contracts

    paul cundy's comment 28 Jul 2019 8:39am

    Dear All,
    Advising Dioralyte is bad enough, but many of our colleagues actually prescribe the stuff. That really is a scandal.
    Regards
    Paul C

  • GPs in England receive over 250,000 inappropriate NHS 111 referrals per month

    paul cundy's comment 16 Jul 2019 10:14am

    Dear Pulse,
    I did a survey in my practice. i just looked at dispositions, i make no comment about appropriateness. Over 100 sequential reports analysed.
    35% of all contacts resulted in a blue light ambulance or a doctor or paramedic dispatched within 1 hour.
    55% advised to see a clinician within 6 hrs
    10% advised self care.

    A complete disaster.

    luckily(?) most of our patients realise they are being given rubbish advice so don't panic but invariably see us to get a sensible opinion.
    Regards
    PauL C

  • HPV vaccine expanding to boys from September could prevent over 100,000 cancers

    paul cundy's comment 10 Jul 2019 8:13pm

    Dear All,
    Good, but why is it voluntary?
    Regards
    Paul C

  • Welsh GP practices face six-month delay to IT switch due to safety checks

    paul cundy's comment 09 Jul 2019 10:55pm

    Dear All,
    If i read the article correctly it is Microtest who have requested NWIS that in their opinion the changeover should be delayed? So this is a new supplier acting honestly and appropriately?
    Otherwise NWIS would have just raced ahead (and we all know what happens when NHS IT Managers think they know what they are doing with our systems!)?
    Come on Pulse you can do better then that.
    Regards
    Paul C

  • Welcome to Planet Advanced Nurse Practitioner

    paul cundy's comment 01 Jul 2019 7:53am

    Dear All,
    How very true. Unfortunately its not just the noctors. A long term bug bear of mine is the many colleagues who advise Dioralyte for that less than perfectly formed stool. the number of times i've been consulted by patients not getting better after their gastroenteritis evolves into dioralyte maintained diarrhoea.
    Regards
    Paul C

  • Babylon set to join primary care networks across England

    paul cundy's comment 27 Jun 2019 4:26pm

    Dear All,
    And I bet Ian Dodge will allow the APMS contracts to be paid more than the GMS going rate. Now if he does price it at the GMS rate things will get interesting.
    What happens to the 1 - 2,000 patients registered at the orginating practice, will they be forcibly re-registered back to their new CCG?
    Regards
    Paul C

  • Digital services will help ease GP shortages, says Simon Stevens

    paul cundy's comment 21 Jun 2019 8:55am

    Dear All,
    Palpably nonsensical and countered by the evidence. Even the ex head NHSE IT leader, Dr Arvind Madan admitted his own digital first product had not solved his workload problems. As the Babylon experience has shown, if you lower the threshold for access to a thing it will be accessed more, doubly so if its free.
    As to the new workforce, yes it could help but it could also end up with warehouses full of zero hours contracted GPs gazing at screens and not generating the wisdom and experience that comes from face to face interaction.
    Regards
    Paul C

  • GPs 'should stop using inflammatory markers as non-specific test'

    paul cundy's comment 20 Jun 2019 0:46am

    Dear All,
    How raised? WHat was their threshold for a raised crp, anything out of range or the age related calculation? And how many of the follow up tests were repeats of the crp to see what it was doing?
    We all have patients who've lived happily for years with raised ESRs.
    Regards
    Paul C

  • GP at Hand expands to Birmingham with limited 2,600 list size

    paul cundy's comment 18 Jun 2019 4:13pm

    Dear All,
    Given the recent Ipsos Mori report, how on earth can the CCG approve the service?
    Regards
    Paul C

  • Major GP guidelines mostly ‘based on expert opinion and not evidence’

    paul cundy's comment 17 Jun 2019 2:44am

    Dear All,
    Perhaps it might help by correcting the articles fundamental error, in calling any of these people who sit in these ivory palaces as being "experts". They are more properly described as "people with opinions". So we should take due account guidelines drawn up by a group of people who have opinions. Excellent.
    That makes the way forward much easier. Also remember what Professor Sir Michael Rawlins, then Chairman of NICE, said about NICE guidelines.
    Regards
    Paul C

  • GMC chief executive admits Bawa-Garba legal advice was wrong

    paul cundy's comment 12 Jun 2019 11:13pm

    Dear All,
    In these circumstances the person at the top of the tree normally does the honourable thing and resigns.
    Regards
    Paul C

  • Global sum 'may not work well' for GP at Hand model, finds official evaluation

    paul cundy's comment 23 May 2019 7:55pm

    Dear All,
    So if patients are de-registering after 2 weeks that means no payment at all for the practice for a massive proportion of its "List". We are only paid on basis of patients on the list on each quarterly date. So this model is not financially viable? If they leave after 2 weeks and they've had one or two GP@Hand consultations GP@Hand will receive no funding for providing those interactions, unless the 2 weeks spans a quarter payment date.
    I'd love to have a look at those accounts.....
    Regards
    Paul C

  • GP at Hand receives ‘good’ rating from CQC

    paul cundy's comment 23 May 2019 7:49pm

    Dear All,
    £60 million backing and only 47,000 patients to spend it on, all you can achieve is a "good". Can CQC factor in this when they next inspect a traditional physically present GP practice.
    Regards
    Paul C