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Gold, incentives and meh

Alan McWatters

  • A bitter north-easterly wind

    Alan McWatters's comment 23 Dec 2014 12:07pm

    Genuinely laughed at this Dr Peverley, good stuff.

  • GPs adopting 'three strikes and you're out' policy on DNAs

    Alan McWatters's comment 23 Dec 2014 11:59am

    We have had to take the drastic measure of only having on the day appointments, with very few pre-bookables, our DNA rate has freed up a minimum of 5 hours of appointments per month for about 6 months.

    A big push on getting mobile numbers for SMS reminders has also helped, but of course the Department of Health has decided to stop funding SMS messaging - what a very smart move that is going to be.

  • The more I learn about general practice, the worse it looks

    Alan McWatters's comment 10 Dec 2014 3:49pm

    I think this article sums up working in General Practice very well: http://www.huffingtonpost.co.uk/dr-zoe-norris/nhs-frontline-the-reality_b_6279784.html

    Why was the 2004 contract offered in the first place - 1) no-one wanted to really work as a GP due to the poor conditions, something had to be done
    2) Our OOH work was undervalued on purpose and it was a no brainer to relinquish it.
    3) no-one thought GPs worked as hard as they did and no-one thought we could organis ourselves.

    These things come round in cycles, feast and famine, feast and famine and no-one ever learns or takes heed of the warning signs early enough, even if they are well signposted warning signs.

  • GPs can use Friends and Family Test to lobby for more funding

    Alan McWatters's comment 02 Dec 2014 8:15am

    Which part of my job am I to stop doing because of this lovely TLA (THREE LETTER ACRONYM) that I have to upload to CQRS? CCG meeting perhaps? Isn't only GPs leaving, plenty of really good practice managers leaving some of the best practices due to workload.

  • Local QOF replacement scheme frees GPs from ‘ticking all the boxes’

    Alan McWatters's comment 10 Oct 2014 3:30pm

    Discussing this with doctors dealing with falls patients and it is now clear that a fraility readcode is needed to stop patients over 75 being over prescribed medications for multiple co-morbidities when it may not be in their best interests to do so.

  • ‘I offer hope the NHS can be put back together again’

    Alan McWatters's comment 23 Sep 2014 3:37pm

    Reorganisation, reorganistion reorganisation. That's all we ever seem to do.

    Can any new government afford to buy 10,000 GP practice buildings and pay for all the pent up sickness leave independant contractors are going to have when they become salaried?

    GP contractors are the cheapest form of doctoring in the western world, with the best outcomes for overall £ spend.

  • Practice hands contract back after four partners are forced to resign

    Alan McWatters's comment 15 Sep 2014 6:14pm

    Is this the start of a mass exodus?

  • NHS chief brands GP recruitment strategy 'crazy'

    Alan McWatters's comment 03 Sep 2014 0:47am

    The reason there is a recruitment crisis, is no GP I know would recommend any trainee going into GP land. Trainees will speak to GPs and quite rightly take evasive action to avoid becoming a GP having heard just how toxic an environment it actually is.

    Solve the toxic environment and constant GP bashing and recruitment will look after itself, can't see it happening myself.

  • GPs to be charged for sending text messages through email in 'short-sighted' DH move

    Alan McWatters's comment 15 Jul 2014 10:24am

    They are about to do the same with the fax service Hadrian, & it's a simple turn the taps off situation, no enforcement needed. The cost to government is huge but surely they can get something cheaper than the 2p a sms text message Vodafone were charging.

  • Recruitment crisis leaves 60% of out-of-hours providers unable to fill gaps in GP rotas

    Alan McWatters's comment 11 Jul 2014 1:02pm

    All this on the day that has revealed that it has been announced that: The number of patients visiting out-of-hours GP services has dropped by a third over the last seven years, according to a report by financial watchdog the National Audit Office (NAO).

    No wonder we are overwhelmed.

    How to square the circle of not being able to fill OOHs GP rotas, less people using OOHs and more people overwhelming in hours GP services. Is something starting to click Jeremy Hunt?

  • One in 10 GP practices decline £20,000 unplanned admissions DES

    Alan McWatters's comment 11 Jul 2014 12:53pm

    If the care plans are doddle to do, you probably aren't doing them right IMHO. I think the principal is probably fine, its the poor support and the constant change that is killing us all off.

  • It's finally time to say yes to Health Checks

    Alan McWatters's comment 15 Apr 2014 5:55pm

    If you truly want to make money at this, you need your phlebotomy and nursing team to take up the cudgels. No more letters booking people in, only for them to DNA. Your phlebotomy team have a captive market of people across their doors interested enough in their health to come in for a blood test, now is the time to get them interested in a Health Check too, if eligible. Make them walk to the reception to book in for the clinic, if they don't make it, they were going to DNA the appointment that phlebotomy could have booked themselves.

    Then you get the results through the computer, do the risk calculations, don't do a 20 minute appointment for those with lower risks and who the Specification says you don't have to see again, send these patients a text for them to collect their results from reception.

    Try this method, very useful for those looking overtime, if they can book the patients in, you can pay them the overtime, no bookings, no overtime.

    Stop messing about with regard to the higher risk patients, get these into see their GP, it will have a bigger impact than the HCAs and Nurses will. Just my 2p that seems to have worked reasonable well. 20%+ of eligible patients seen two years in a row so far, next couple of years are going to be harder though.

  • PMS practices face QOF clawback after calculation error

    Alan McWatters's comment 10 Apr 2014 7:50pm

    How can anyone tell, without the calculations behind the payments. The bits of CQRS I can access doesn't show how prevalences are calculated, or any calculations. However bad QMAS was, at least you could get the figures on how the calculations were made.

  • CCGs missing out on quality premium payments due to secondary care troubles

    Alan McWatters's comment 02 Apr 2014 7:05pm

    We are not getting a quality premium because of accounting anomalies on specials something we as a CCG had absolutely no control over. The figures were a whisker out for a payout, but I think the CCG will have to whistle for it in the future, lots of work done and absolutely no reward, despite so much progress. The CCG goodwill account is now very empty at my practice.

  • GPs and practice managers rank in top ten of happiest jobs

    Alan McWatters's comment 02 Apr 2014 6:58pm

    They are having a laugh. Certainly wouldn't say I was in one of the happiest professions.

  • Analysis: What does the 2014 contract really mean for GPs?

    Alan McWatters's comment 31 Mar 2014 11:14am

    How can you have a contractual duty to offer online appointments when your appointments system isn't funded centrally via GPSoC. We currently have Informatica's Frontdesk and everything is a cost extra including online appointments.

    While I welcome the removal of the stupidly high thresholds, which harmed patients (patients exception reported on first refusal, rather than allowing us to catch them later in the year), if we can't measure these items, we can't set up the recalls as easily and this will reduce the measurements taking place.

  • GPs set for funding boost as NHS England considers 'redirect' of £3.8bn integrated care funds

    Alan McWatters's comment 10 Sep 2013 11:48am

    How does NHS ENGLAND taking £8million next year from our local area budget square with this announcement.

    How does taking money out of QOF help practices either.

    How does completing tenders for Public Health and soon to be Locally Enhanced Services help practices to bring care to their patients, too busy box ticking to concentrate fully on patient care.

    You can't do more with less resources, no matter how it is dressed up. Continuity of care is not helped when your budget is cut and you have to do more box ticking.

  • NICE recommends stricter QOF blood pressure targets for patients with CVD

    Alan McWatters's comment 13 Jun 2013 4:50pm

    Is the pressure too much, am I going potty? Surely this is already spelled out in - HYP003 (new). This requires that in those hypertensives aged <80, their last BP should be ≤ 140/90 from July each year.

    Bah humbug.

  • RCGP chair challenges Hunt for using GPs as 'scapegoat' over A&E failings

    Alan McWatters's comment 26 Apr 2013 3:49pm

    Anonymous (1:49pm) The minor cut for OOH was exactly how valued the Government saw that particular service. The Government wanted to smash the Doctors Co-Operatives and open it up to a big business salaried service and they did this by undervaluing these Co-ops and introducing unnecessary bureaucracy they couldn't comply with and remain the organisation they were. The public and the rest of the NHS service are now reaping the rewards of this short-sightedness.

    Just like the killing off of single-handed GPs the Government wants to kill off smaller General Practices via bureaucracy and tickbox exercises, which can really only be completed by bigger businesses. Now we all know these services will go down the route of OOHs & big business, is this really a wise decision?

  • Has the hospital run out of steroids?

    Alan McWatters's comment 19 Dec 2012 3:41pm

    Had exactly the same request to prescribe an orthopaedic boot (not on their formulary) for a long term inpatient. They all have their own budgets to think of - don't-cha know.