another last man standing
It’s the GPs problem because we get blamed for everything, didn’t you know! The identified problem of post discharge medication problems isn’t really anything new and, in my experience, has been going on for years.
With a workforce in the NHS that’s essentially understaffed and overworked it’s hardly surprising is it? With further budget cuts and cost efficiency savings likely the situation here will certainly worsen.
Solution: don’t get ill or be admitted to hospital!
Perhaps someone at the DOH has suddenly realised that our ever increasing workload may result in our early demise whether single handed or not and the bureaucracy has no contingency plans for this event so pass the buck to anyone else be they dead or alive. It’s good to know that we have such caring support.
Okay let’s go a bit historical! At the dawn of time (!) when I was a student at a London Medical School we did 3 months on a dental firm where each of us were required to perform at least 12 dental extractions with patients admittedly under GA! We learned a lot about dentistry during that time and this helped our future knowledge.
As far as anatomy was concerned during preclinical time we had six students per body and strangely even dissected head and neck! In those days we couldn’t go onto clinical firms unless we passed 2nd. MB exam and had full knowledge of anatomy etc.
How times have changed where we seem to take less responsibility for fear of litigation and have apparent less generalised knowledge despite seemingly being able to do more.I am so glad that I’m not a student now!
The most accurate answer to which areas of general practice are on the brink of collapse is: everywhere! If only those who seem to wear rose tinted spectacles could see it.
Nothing new here and I wonder how much this investigation cost! Of course the DOH were convinced that us GPs were down at the golf course every minute of the working day.
Wasn’t that what implementation of QOF was all about? ie. to make us work more to justify our ever decreasing salary and nothing to do with improving patient care!
I had been working 70-90 hours per week as a a single handed GP for years and the demands meant that even 168 hours weekly wouldn’t be enough to satisfy demand.
It’s really time something was done but not just token efforts to paper over the cracks in the sinking ship HMS NHS.
A large proportion of patients feel that their appointment needs are ‘urgent’ but this seems to reflect the staggering selfishness of humankind in our part of the world.
In my experience this only meant that I couldn’t give time to those that genuinely needed it.
Soon, and I mean very soon, there may not be a service that the selfish ones can complain about even if they have money to pay for it.
The cavalry isn’t coming and has long gone. Oh yes! With cuts to defence budgets there isn’t a cavalry to come anyway!
Whatever significant benefits IT has given the world it’s left us ever more vulnerable when systems don’t work and in the real world no system is ever perfect.
This begs the question when rather than whether we should become reacquainted with hand writing again or using a typewriter!
Just a thought as it may yet be safer or more efficient than crossing our fingers and hoping that the e-referral has gone to where it was meant to go!
Come on now NICE guidelines are all about cost. You know that cheapest is best. New treatments are by definition more expensive but unless they are used then one will never know how much more efficacious they may be compared to older treatments.
NICE guidelines seem to repeatedly be flawed as time goes by so who is funding the apparent specialists who make these decisions?
At grassroots level (coal face GPs) we are chastised or penalised for using more expensive treatments even if they have better efficacy. Thanks for offering me a TCAD for my depression but if I have to take something then can I try a SSRI first but that is unlikely to work until the NHS is sorted!
So we need a lifeboat to escape the NHS do we? It will be like the Titanic where 19 lifeboats were provided but 67 were needed to save all passengers in event of a disaster and this was a cost saving decision.
Does that sound familiar? I presume that it will be the politicians and public first priority and leave the GPs behind to wither and die. Sounds all too familiar again doesn’t it?
Another brilliant result for Mr.Hunt! Anyway not only is there an overall shrinking of GP workforce but a large proportion of those now entering general practice choose to be part time (both male and female) which compounds the deficit even more.
If you make a job so unattractive then it’s hardly going to attract anyone but that also applies to the public services as a whole ie medicine,nursing, teaching, police, prison wardens etc.
What depressing times that Prozac won’t solve!
Actually some home visits do have to be done the same day and in a minority of requests immediately but that is where appropriate triage would be helpful;or is that an oxymoron?)
Yes truth finder I would have thought that some medical care was better than none at all. Could the CQC allowed the practice to continue functioning, even if policed, so patients could have some medical service rather than none at all. Unless that is the CQC have suddenly found enough satisfactory locums to run the practice for free!
As usual both sides have correct and incorrect opinions. For a start, Shaba, Dr.Finlays Casebook wasn’t totally fictional but a semi autobiographical story about the author A J Cronin who was a doctor pre NHS before he became so disillusioned with medicine that he left to become a successful author. Do you recognise that decision which is prophetic relating to the state of NHS medicine today.
In the remote mountain practice which ran single handed for 33years then home visits were both necessary and useful. The 200 sq.miles that I covered had no public transport available and elderly patients had no way of getting to the central surgery especially in winter when we could be under a few feet of snow for extended periods even up to May.
And yes I practiced in UK! However with the time constraints caused by DOH, QOF etc.it did become impossible for me to do 10 home visits a day as well as surgeries, emergencies, minor surgery.
So the answer to whether home visits are a waste of time is both yes they are and no they’re not.
Oops I meant professional competence!
That’s really making me feel so much better....not. After the worry and anxiety that appraisals caused me which paled into insignificance compared to revalidation (which incidentally I got through without any criticism)they now tell me that it didn’t reflect my professional competition!
I finally jumped ship a few months ago as the oldest working GP in my region at age 65 but with my head held low. As a result all those years seem wasted in a profession that has lost direction even if it was enforced.
Or maybe I should just misquote Wilfred Owens anti war poem: Dulce et decorum est pro NHS Mori! If is a sweet and wonderful thing to die for ones NHS! .......not! It used to be for us older ones whose medical career was truly our vocation for life but as already said “that was then and this is now”.
Perfect as always Copperfield! And for those of you who want the T-shirt you can get one from Millwall FC supporters shop as the club chants from the terraces are “no one likes us we don’t care”. I’ve had the T-shirt for years and years and proudly wear it under my shirt! It has helped me keep sane! Go on you lot and splash out on one !
And who’s going to take responsibility for the mental health and well-being of us doctors? It certainly won’t be the DOH. Since we are blamed for everything then it must be our fault. The attitude of the DOH and GMC seems to be “play by our ever changing rules or wither and die” which is exactly what is happening to us!
Only 34,000 left without a GP? I think it’s best to add another zero or two onto that figure soon the way the NHS is heading! The patients could always try going to the OOH service if they need except there’s hardly anyone left to run that service either. Maybe Jeremy Hunt thinks he can give a better service than we do!
Alan and Catherine are having a full 15 rounds even though I see both sides of their arguments. However Catherine your rampant feminism is showing through a bit too brightly tinged with a hint of paranoia. I presume that you were brought up not with nursery rhymes but on the Queen song with lyrics “I want it all and I want it now”! If you miss my humour then you may be related to Emily Pankhurst so if you are determined to get your message across have you considered chaining yourself to the railings at Westminster!
I may be pale and male etc but know that we both have an equally important place in the NHS. Oh yes, noting a spelling error when there were more important issues to consider (some of which you touched on) was both petty and pedantic. I could say more but will leave it at that for the moment