Caught on hop by CKD
GPs were hardly looking forward to their CKD caseload spiralling under the revised QOF, but the prospect now looks even less appealing. Nephrologists, it seems, have no intention of being lumbered with the extra work.
A Pulse survey reveals renal units are bringing in tough new referral guidelines, designed to screen out all but the most unquestionably complex cases. Many are already starting to shunt back to GPs patients who have always until now been managed in secondary care.
Easy as it would be to blame the specialists for leaving GPs in the lurch, in this case it would hardly be fair. All the evidence suggests renal units are hopelessly ill-equipped to cope with the expected surge in referrals, so it's hardly surprising they're desperate for primary care to shoulder the burden. But how did GPs end up effectively having to screen for CKD when the health service is so patently unprepared?
Hewitt needs to deliver not offend
Patricia Hewitt survived as Health Secretary in last week's reshuffle, suggesting a penchant for aggravating those who work in the NHS is not something Tony Blair holds against his ministers.
He will probably hardly bat an eye at Mrs Hewitt's latest faux pas her claim that GPs are at least partly to blame for the crisis in access to depression services. But unless Mrs Hewitt acts soon to improve access to psychological therapies, GPs may be less willing to forgive her.