This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

Paul Shenton

  • Boris Johnson pledges to reduce GP waiting times in first speech as PM

    Paul Shenton's comment 31 Jul 2019 6:10pm

    Completely ignorant of the issues which his why he should be renamed to something which rhymes with banker

  • GPs asked to do early home visits to avoid 'surges' of patients at A&E

    Paul Shenton's comment 21 Nov 2017 12:49pm

    Usual clumsy approach by people who don't understand what the issues are.
    Surely it would be better fo GP's to triage visits as and when they come in, and they obviously need to be available for this by phone, then if it is not clearly an admission use the community rapid response teams to try and avoid an admission. This is something that ambulance crews use locally to myself with effect and the GP does not need to see the patient. All helps if the community services are commissioned to use the same IT as GP's. Failing that use a paramedic a on his bike - if you are lucky enough to have one

  • 'No long-term evidence' backing GP streaming in A&E, says leading GP

    Paul Shenton's comment 21 Nov 2017 12:42pm

    Paul is correct.
    The target is politically and not medically driven.
    Triaging should always been done by senior professionals who are pragmatic and quick.
    The best model surely is a co- located UCC which is manned by GP's etc talking all the GP problems and minor injuries etc and then passing through suitable patients to an ambulatory emergency care facility and if all else fails then ED. You cannot get into ED unless you are in ambulance , referred by GP or as part of the inherent UCC triage process.
    As my colleague has said if you parade token GP's in front of an ED they will become part of an obsolete model.
    ED should have what's left

  • QOF has led to no significant improvement in mortality rates, says study

    Paul Shenton's comment 18 May 2016 11:16am

    Unlikely thay even GP's can change death rates in 7 years, despite the fact that we are responsible and accountable for all the ills in the universe apparently. I think that there has been a lot of collateral benefits which are not entirely measurable in terms of chronic disease management

  • GPs' independent status may change under Labour, says Burnham

    Paul Shenton's comment 05 Jun 2014 4:00pm

    Bring it on Boy Wonder! - but do you sums first and then re-check them, understand that it will be unaffordable (and I don't mean exclusively in the financial sense) and then work out how you will backtrack and not do it !
    GP's are quite capable of making 'passive agreement' into an art form.
    Do your worst because you don't know what best is!

  • QOF payments thrown into chaos as NHS England apologises for major calculation error

    Paul Shenton's comment 10 Apr 2014 1:14pm

    ‘We apologise for any concerns that this has caused for practices.’
    Not good enough and limp to the point of nausea.
    Its now a cliché and means about the same as someone who keeps saying 'I love you'.

  • GP contract will allow sharing of records around the whole of the NHS, claims Hunt

    Paul Shenton's comment 18 Dec 2013 10:41am

    Just get on with it!

  • GP recruitment concern is 'no compelling reason' for pay increase, say NHS managers

    Paul Shenton's comment 12 Dec 2013 11:01am

    My understanding is that 23% of the health workforce in London is over the age of 55 - a perfect storm. I like money as much as everybody else and its value as a reward is increased exponentially as all the other terms and conditions of employment are gradually eroded or imposed by those persons who have singularly failed to understand the critical role of GP's as navigators and gate keepers of a demand led system. As to nurse practitioners I am not aware of any evidence whatsoever that they yet have the capability of repeatedly refocusing and processing complex situations within the dynamics of a surgery with the efficiency and speed that GP's have proven for the last 50 years. The real crime is that at the age of 57 and still standing I am pretty much on top of things and thought I would die on the job approaching 70. The job has become so devalued over the past 5 years that I shall leave at 60 - what a tragic waste. Furthermore you will be unlikely to find any of the newer Dr's or nurses coming into to the profession tolerating the service conditions that my fellow colleagues have largely enjoyed over the past 30 years but now are only enduring. We will vote with our feet because one of the three R's of any valued workforce is retention. Good luck on retraining and recruitment

  • NHS England insists GP practices remaining fully open on Christmas Eve and New Year's Eve is 'non-negotiable'

    Paul Shenton's comment 12 Dec 2013 8:56am

    It is interesting to observe the distortion of the word 'reasonable' to achieve a specific aim.
    It is 'reasonable' that NHSE can't cope with LES's which they pass back to CCG's to organise, is it 'reasonable' that the scandal over the lack of patient level data has paralysed the commissioning process, is it 'reasonable' to become hysterical over Xmas when nobody gives a toss about the 4 day break over Easter and is it 'reasonable' to bully and intimidate practices who are doing their best, under very difficult conditions, that almost constitutes harassment.
    The only thing that is lacking is guidance on when I may 'reasonably' go to the toilet and when I may 'reasonably' see my family and when I can 'reasonably' get a life!

  • Half of GPs in favour of charging for routine appointments

    Paul Shenton's comment 25 Jul 2013 10:25am

    Stupid idea - no evidence that it would manage demand at all, all political parties are against it and the vey people in genuine need would bounce around the system as previous comment says i.e UCC/MIU/WIC/UCC. You want to manage demand then reduce choice - close all the WIC's, front all ED's with UCC's who redirect Johnny Junior with ear wax at 3pm back to practices and reinvest the money in a breeding programme for practice nurses 7 days a week primary care 7am-7pm thus giving the patient 2 choices which we had 30 years ago - if you are dying or injured go to ED otherwise see your GP. The current choices have bred a neurotic public fuelled by political promises and have put back GP education to patients by some 30 years.

  • Revealed: GP practices face pay cut as DES uptake rates dip to 55%

    Paul Shenton's comment 25 Jul 2013 10:14am

    To do them or not, excluding the online DES which is easy, is a business decision - value for money works both ways.

  • GPC negotiator calls for move towards virtual consultations

    Paul Shenton's comment 25 Jul 2013 10:05am

    'Some way off' just about sums it up - its bad enough having to Skype the children to micromanage them!
    There does remain of course something plastic with a wire in it called a bleedin' telephone!

  • GPC negotiator threatens to report health minister to the GMC

    Paul Shenton's comment 30 Apr 2013 9:23am

    There has to be some sensible strategic thinking and culture change which will take a generation. Until all the leakage is sorted in terms of too much choice things will never improve. How on earth can you possibly control and manage a system whereby patients can go to WIC,s UCC's MIU's ED's all on the same day none of which require a negotiated appointment and all generate income for the provider. As a model it is absolute madness and absolutely doomed. The OOH should really stand alone outside the core contract and be run by the government as they not me are statutorily responsible for the nations health - I am a mere subcontractor and as such have no problem from working from dawn till dusk Mon - Fri.

  • GPC negotiator threatens to report health minister to the GMC

    Paul Shenton's comment 29 Apr 2013 5:59pm

    There will be no progress on this matter until an adult conversation with the public takes place about appropriate use of emergency services. That conversation would need to be supported by politicians (which it will never be) and the perverse incentives of OOH attracting business needs to be removed. I have spent nearly 30 years educating patients and almost at a stroke UCC's and WIC's have reversed all of that.

  • Dr Peter Swinyard: 'Hunt seems to be waging war on GPs'

    Paul Shenton's comment 25 Apr 2013 11:04am

    Usual political bile - of course he has missed the point about public education and nuking walk in centres which have created such instant demand and put general practice back 30 years. What is his answer to a patient who walks past the surgery brimming with available appointments to a UCC? Patients should have 2 choices - A and E who should turn people away if not actually ill or GP land in core hours. Leave OOH alone or fund it properly - cretin has no idea about cultural shift in perception and usage especially from out eastern bloc friends