Knowledge is Porridge
GP in North Devon, likes to surf (obviously)
There is hope from @lowcarbGP dr david unwin.
His outstanding results show what can be acheived, and how we should achieve it.
Low cost, high impact...dont lost hope with obesity yet!
We had a man deliver PPE along with a case of beer for good measure. What a hero!
Reading the comments we are all just fed up with covid, especially as the remote workload has been growing each week, but very few places to send patients to. Still no dentists, no physios, mostly no outpatients. No psychiatry (some things never change)
I hate being a remote GP working by phone, but cant see any other way in near future?
If PPE delivery brings beer and pork scratchings next time, I will nominate for a nighthood...
Surely dial in for a quick video chat with care home is a very good solution all around?
Good opportunity to establish "Digital" as normal, rather than GP boots on ground.
I know we dont like being dictated what to do, but this could potentially be very light touch?
First a big thank you to all of the volunteers.
Part of the "problem" may be that front line GP is LESS busy than usual for the last couple of weeks now. We are hearing that hospitals are generally quiet too, with half the number of A&E attenders. And since the lockdown, many GPs are working from home, very little self isolation required as all the coughs and bugs are being locked down.
The biggest workload is the 2hrs of daily updates, online meetings with CCG / network. Issues regarding SHIELDING lists. Changing rotas, worrying about PPE and HOT / COLD streams and workloads. Training staff with Accurx, eConsult, updating phone systems, using new laptops...Feels like an awful lot being done to acheive very little!
If you are a qualified dispenser / pharmacist there is an ongoing backlog of work there.
I think a fair number of "vulnerable" older people will struggle to ever leave their homes again. And if many people remain too frightened to visit shops and pubs, imagine the damage to airlines, cruise ships, coach tours.
This will still be a very different world in 12-24 months, even with a vaccine. Have grumbled about being forced to do video consults and total triage, but to be fair we need to reach out and provide access to some very frightened people.
Happy to be open, its a good idea. Would colleagues really propose we close for a 4 day weekend right now?
Plenty to grumble about in recent years, but this isnt it.
Wouldn't hospital be a great place to test with a sats monitor. Stay parked in car, we will come to you, sats OK? Great, home for now.
Not sure why setting up hub a few minutes away.
Its been a stressful and hectic couple of weeks, but I will be happy to open for the upcoming bank holidays and support the wider NHS family at this exceptional time. Especially if my many self isolating staff can return to work, so i'm no longer having to dispense, blister pack and hoover.
My biggest frustration is all the grumbles from patients who feel entitled to a letter stating they can have supermarket delivery slots, because they old, or have asthma or take methotrexate and are self isolating. 35% of my practice is "vulnerable", while around 2% are "extremely vulnerable" and in receipt of a letter. How is everyone else managing them all? Should I just have a "vulnerable patient" template letter, tick the box for the reason they are vulnerable and charge them £20 for a copy with their name on it. (free letter for the appropriate extremely vulnerable).
I absolutely fear the spread of this virus. Especially for all frontline staff. But my patients are taking this very seriously and self isolating in large numbers and amazing community organising and staff flexibility.
I think the tide could be turning already (reflected in numbers in 2 weeks time).
We have a few weeks to ignore all the usual crap and just focus on what we trained for. This is a chance for retired GPs to work for the common good, and I welcome / salute all those who bravely put their hands up. Their assistance - perhaps remotely by phone / video, could be amazing. Thank you all.
Perhaps some might stick around if government takes another look at why they all left in the first place?
Not MORE overloaded guff from 111. They need to use something to filter out the useless information they send us, or to highlight the useful bits.
While we are recognising and removing the barriers to good care (cqc, qof, appraisal, revalidation) can't we use this moment to try life without 111 data overload?
Any views/experience here on eConsult.
Looks terrible to me but CCG keeps pushing...
Thanks for the helpful insight Clare and sorry to see some frankly bizarre comments.
Am I missing something. Is it the lifetime limit people are still unhappy with? Looks like good news to me...I want some positive news before my dose of covid19 comes!
Wow, so simple and so sensible. Count me in.
OK, I have been quite keen so far, but just been reading the frankly incomprehendable Comprehensive Geriatric Assessment (CGA): multidimensional holistic assessment of an older person.
Oh dear. Its over 2h per patient of scores and guidelines, within scores and guidelines ad infinitum, inception style.
The patient will end up with big red "this is your life" folder with little really helpful output.
There is still a great opportunity to build experienced teams with continuity of care supporting our most frail and elderly, but not if all we do is "comprehensive assessements".
Is this why our mental health teams write 10 page detailed assessments but see very few people?
Do we want to try and deliver a Rolls Royce service with Reliant robin funding? Hmmmph.
I have read the document and to me it looks fantastic. It's no free lunch and strings are attached but 100% reimbursement for additional roles was the only way to get us out of the draft proposal mess. I didn't expect NHSE had the balls to back down, and therefore game over for everything PCN.
Cheer up everyone, this time its good news. Go and read it!
I think some OK ideas in terms of future care, just not the workforce to deliver, or contract mechanism to pay for it.
No way forwards...NHSE can't just back down, BMA can't carry the profession. I haven't thrown in the towel as "only a draft", but feels like PCNs need an end of life care plan.
I think the network DES would be viable with a few months delay AND 90% paid for extra staff, not 70%.
Would we be able to get behind that?
The problem now is we have seen the PCN destination.
The gloomy partners are now the wize and sage. They said it was a trap!
The enthusiasts are now the betrayed romantics, with PCN directors resigning as matter of honour.
The spec will be scrapped of course, too late.
Who can argue with an overworked GP in and overworked practice who says no thanks?