Spot the irony in GP Working at Scale or GP(WAS)
Very well written and coming from a renowned evangelist for GP, all the more powerful.
Still think it's doomed - and very worried about what will replace it.
I am lucky enough to work in health IT with some really talented people, some of whom specialise in designing user interfaces. But when they see the records we have to deal with, they just shake their heads in disbelief at how awful they are.
I just saw a patient this morning who is a software designer - she just laughed at the electronic record I am using - and its a market leader!
It's not the electronic part, it's the design and usability that's so bad.
Quite right that an unfunded pension scheme is very similar to a Ponzi scheme. Other public servants are in the same position. Except one group, who have a "proper" funded scheme. Who might that be? Could it be our MPs? Yup!
Cue Daily Wail headlines on drunken doctors complaining about working a four-day week and earning £150k.
That initiative was designed to serve one purpose only - to enable JH to say in the House that they are addressing the issue of GPs' morale and GP recruitment. Job done!
Spin = reality.
Inconvenient truths = fake news.
Mac med - spot on. It's not easy to walk away from a principal GP post. I did. But it took me a good 6-7 years to build my "ark". Only a small minority make it out. A small number of GPs contribute to these comments sections. The vast majority will stick it out. Formally educated people are naturally selected to conform - that's precisely how we got through the hoops we needed to.
I'll tell you what will happen, right here and now - NOT MUCH.
The "elephant in the room" is the mis-match between demand and resource. No amount of "efficiency savings", "working at scale", "new ways of working" will solve that one.
Nobody wants to run for election on a ticket of putting taxes up (John Smith tried it - remember?).
So, we drift inexorably towards an uncertain end, through progressively larger crises along the way.
The US has an expression "whistling past the graveyard", which seems strangely and ironically appropriate.
4:52 - That is EXACTLY the point. Nobody does.
Contrast with the GMC, NMC et al which are overseen by the PSA. But the CQC is not answerable to anyone.
An unregulated regulator? Sound creepy to me.
Just had an invitation to find applicants for the "Next Generation GP" programme
Never seen a finer example of an oxymoron...
Yes, very good reporting, IMHO.
3:50 - totally agree. not even Ch4 News gets to grip with this and yet it's such a vital issue.
I think we're caught in that trap - on a personal level people cherish their GP; but collectively, society feels we're privileged to be doing a satisfying job with public respect and good pay.
"We're all dooooomed!"
This is extremely suspicious. Anything that smacks of good sense and reasonableness is just so out of character that there must be a sting in the tail...
NICE advises referral if guidelines indicate a patient crosses the threshold of a Positive Predictive Value of 3% now, from the previous 5%, so doesn't that mean that...?
No, sorry I must be seeing this too simplistically. Silly me.
A consultation - any consultation - is much like an investigation inasmuch as it has a false positive and false negative rate. Simple concept of sensitivity and specificity. But that seems to elude most politicians or medics who've crossed over. Anybody whose referrals are 100% "deserving" is either psychic or missing some others.
Not by chance, is it named DoH!
Not linked to funding but absolutely linked to practice size. Right.
Does anyone have any doubt any longer that the CQC is dancing to the tune of HMG? And Steve is headed for a gong, no doubt about that either. Well done, mate. Your mother would be proud of you.
Superb - do keep it up.
"Crisis? What crisis?"
Babylon Health is using algorithms - albeit in addition to real doctors. And offering £3k for a successful referral for recruitment.
PushDoctor is advertising on the Tube and on TV. Should we be worried? Well, it's really hard to compete with "free" so maybe not. On the other hand, the public is not with us. Individually, they may love their own GP but collectively they still believe we're part-time at four days a week and play golf on the fifth day, perfectly secure job etc, etc.
Very similar reasons to mine for giving up appraising. A worrying parallelism between the strictures being placed on appraising and the over-regulation of general practice. We are producing an army of ex-GPs who seem to have found a new career in slowly strangling those who are left in the ***t. I escaped some years ago and foolishly thought I could do some good helping GPs navigate A&R. Not so easy, I'm afraid. Too many boxes to tick. We all know what a good appraisal looks like. But we have to dissect the process and in the process kill it.
Re the "It’s not all doom and gloom" rhetoric: -
Really sorry - but it is. The population won't get any younger, no fewer pathologies, no fewer drugs, no more money.
The halcyon days of GP ended around the late 80's. A brief blip in 2004 and then the decline resumed.
Hunker down until retirement, try to enjoy seeing patients and doing some good, be thankful you don't have to do a job like politics. That's the best you can do, short of leaving.
Centralise, de-centralise, centralise...
Plus ca change...