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Big shout out to NICE

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DEAR NICE

I KNOW YOUR LATEST GUIDANCE ON TYPE 2 DIABETES IS FOR DISCUSSION. BUT I’M WRITING IN CAPITALS BECAUSE I DON’T WANT TO DISCUSS IT WITH YOU, I JUST WANT TO SHOUT AT YOU.

I SPENT A LARGE PART OF YESTERDAY SCANNING THE 160-ODD PAGES. AND THEY CERTAINLY ARE ODD.

IN FACT, FOR ANYONE TRYING TO FIGURE OUT WHO’S GOING TO BE RESPONSIBLE FOR IMPLEMENTING THIS FAB NEW IDEA OF SCREENING FOR DIABETES IN EVERYONE OVER THE AGE OF 25, THEN IT’S IMPENETRABLE. IT SEEMS TO SAY THAT IT SHOULD BE INTEGRATED WITH VASCULAR CHECKS, BUT THEN THEY’RE NOT BEING DONE EVERYWHERE AND, BESIDES, THEY DON’T COVER THE ENTIRE OVER 25 AGE GROUP AND, OH YEAH, WE GPs HAVE LOADS OF PATIENT INFO ON OUR COMPUTERS ALREADY, DON’T WE, SO, OBVIOUSLY, WE CAN DO IT.

WELL, THANKS FOR THAT. SO LET’S SEE. YOU WANT US TO SEARCH MOST OF OUR RECORDS, CALCULATE A DIABETES RISK SCORE, SEND AN INVITE FOR A BLOOD TEST FOR THOSE AT HIGH RISK, DO THE TEST, INTERPRET THE RESULT, CONVEY IT TO THE PATIENT AND CLEAR UP THE MESS CREATED. AND REPEAT AS DICTATED.

THAT’S FINE, BUT I ALSO WENT THROUGH THE GUIDANCE CAREFULLY TO FIND THE BIT WHERE, TO FREE UP THE TIME FOR THIS LATEST BRIGHT IDEA, YOU’VE ADVISED THAT WE GPs CAN STOP DOING X, Y OR Z, BUT IT’S NOT THERE. WHICH MEANS THAT, WHERE I THOUGHT X, Y OR Z MIGHT BE CKD MANAGEMENT, OR GOING TO COMMISSIONING MEETINGS, OR SEEING ILL PEOPLE, NICE OBVIOUSLY TAKES X, Y OR Z TO MEAN OUR LUNCH.

TO PUT IT ANOTHER WAY, IT READS AS IF THOSE WHO’LL DO 90% OF THE WORK HAD ABOUT 5% OF REPRESENTATION ON THE PROGRAMME DEVELOPMENT GROUP, WHICH IS INDEED THE CASE. OR TO PUT IT ANOTHER ANOTHER WAY, YES, I’LL DO IT, IF YOU COULD SEND MEMBERS OF THE PROGRAMME DEVELOPMENT GROUP ROUND TO DO MY ROUTINE SURGERIES FOR ME BECAUSE I’LL BE SOMEWHAT DISTRACTED SEEKING AND DESTROYING DIABETES. OR TO PUT IT ANOTHER ANOTHER ANOTHER WAY, AS MY SENIOR PARTNER - ALWAYS A GOOD LITMUS FOR THIS TYPE OF THING - COMMENTED THIS MORNING, WHY DON’T YOU JUST PISS OFF?

ALSO, WHEN ARE YOU GOING TO DO SOME GUIDANCE ON HOARSENESS?

LOVE

DR C

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder