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CAMHS won't see you now

The abolition of practice boundaries is complete twaddle

Home visits: love ‘em or loathe ‘em (I loathe them), they are a part of our everyday workload.

Finish surgery, hungry and generally needing a wee, and head to a visit with a heavy heart. We have started phone triaging, which has helped hugely to cut down on them, but we still have some to do. Some of ours up to 20 mins away, and when we get back to the surgery we face a bunch of paperwork.

And it’s all about to get more fun. With weeks to go, NHS England is still intent on implementing the removal of practice boundaries, but after giving a level of detail that I would expect from my three-year-old if asking her about which mortgage we should get.

There has been no national announcement, some surgeries havent even heard of the plan and those who have, have nothing to work with when deciding to opt in or not.


It think this may be the most extraordinarily ill-thought-through, politically-driven load of utter codswallop that we have been faced with in a long time.

There is talk of payment for GPs coming from a ‘national specification’ but no news about what that means.

We sign up people who we don’t have an obligation to visit we get less money, which is great for commuter areas, but not so good for everyone else.

If a person asks for visit who’s registered in London, but lives near us, we’ll have no notes, and no prior knowledge of patient. Do we visit? And if so, who pays for it - our CCG or their surgery? 

Or do we send them to A&E, whilst at the same time slogging away doing unplanned admission no-care plans for patients who get admitted the next day?

Or, because no one is quite sure, am I to be paid to visit my own patients who live 100 miles away? If so, may I suggest all my patients move to the Maldives - I’ve always wanted to go.

So much could go wrong with the Government’s plans.

GPs of the UK, say no. Please. This is twaddle - and any money will dry up after a year anyway. For once, let’s stand together and refuse en masse.

Dr Stephanie de Giorgio is a GP in Walmer, Kent.

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Readers' comments (17)

  • If you 'loathe them so much no doubt your attitude will not be therapeutic towards those who you have the priveledge of calling on. Given the choice do you think they all want health visits in their homes? Presumably you knew the score when you took the job which gives you the flexibility many would wish for. For goodness sake anon 10 29th oct above try to relaise that insults do'nt change anything they just give the rest of us a laugh try to instead understand that GPs are only part of the team and 'other healthcare professionals' make many more home visits than GPs.

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  • this is yet another policy to suit London commuters being forced over the entire country where it is not appropriate. The London centric governance of this country is crippling us.

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  • Took Early Retirement

    Yes, 10.51 I expect DNs do a lot more, but they do NOT do 2 surgery sessions in a day nor all the admin that goes with running a practice.

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  • I think twaddle is a very generous description. And I think hat describing the level of detail as even approaching that of a three year old is positively gushing with generosity.

    The serial demands made on General Practice, principally in the name of patient choice are removing that very thing.

    Soon you can have access to General Practice surgeries whenever you want. But the inconvenient truth is that there will be no GPs for patients to see, less choice of who you want to see and less continuity. Keep on slamming and damning us because if you don't give us a break we will do just that...break.

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  • Vinci Ho

    Sorry. Excuse me to my English . I originally thought twaddle was a 'new' swear word which does sound like the other one anyway(you know what I mean?). Could be a very powerful headline !😝😚😁
    Great article, well done 👍👍👍👍

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  • alleged other healthcare professional again shows he hasn't the first clue and doesn't see that practice boundaries are for good reasons of time efficiency and good patient care.
    please talk about something you understand in future.

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  • I feel the big problem is that in areas with commuters they will register near work and been seen rarely for easy stuff. Resources will follow them to the place they work. But when they really ill they will then expect a GP where they live to provide often a short period of highly intensive input especially if it is palliative care. But there has been no resources to provide said GP for several years until suddenly it is needed. And if they re register for 3 months the GP will likely only be paid £20 for multiple visits and lots of work.
    It is a bit like going to tescos 20 miles away for years in your car, then losing your license because of ill health and finding the small shops within walking distance are not there.
    It can only work if GP care is done on an item of service basis. So much for an appt and so much for a visit. But the government will not go for this as it transfers the demand financial risk on to them rather than GPs who are carrying that risk essentially on a fixed price all you can eat buffet.

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