PCN's are a political compensating device for a poor estates strategy, zero workforce plan, zero public education plan about using public services wisely and are just spreading workers more thinly. There is no other workforce on the planet that is micro-managed more than UK GP's. We are measured on everything that has only a numerical value. It is not up to PCN's to contract manage their peers, solve the workforce and burn out issues within the profession, sort out the hospitals burning money, picking up everyone else's problems and managing their risk for them and wrapping into a legal contract!
GP or other healthcare professional should immediately leave the room and close the door with the patient inside.
Do you think I would get away with doing this for all my patients!
Completely ignorant of the issues which his why he should be renamed to something which rhymes with banker
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
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
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
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!
‘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'.
Just get on with it!
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'
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!
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.
To do them or not, excluding the online DES which is easy, is a business decision - value for money works both ways.
'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!
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.
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.
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