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Gold, incentives and meh

Have I got NEWS2 for you

Copperfield 

Every morning, I wake with the joyful realisation that, yes, it is another day, yes, I live in a glorious democracy and yes, I’m employed as an independent contractor in the world’s greatest health service! Then I think ‘oh f**k, I’ve got to go to work.’

Which means, of course, a dose of Brexit-induced inglorious undemocratic soundbites via the car radio, followed by a day of micromanaged madness at an increasingly bleak coalface.

And if you need examples of the latter, of how ‘GP independence’ is becoming as risible a concept as the ‘democratic process’, you need look no further than two recent Pulse headlines, separated by 24 hours only because the Pulse editor correctly realised that splashing them on the same day might push us over the edge.

First, we had ‘GPs asked to proactively contact patients taking fluoxetine to avoid shortages’.

This tells you everything you need to know about this story, except why these stupid shortages are happening; why they are my responsibility to sort out; why the Department of Health and Social Care is making a particularly big deal about fluoxetine when with every other drug shortage we’ve simply muddled through; why this diktat can’t be directed to pharmacists, rather than GPs; and why they are specifically engendering anxiety in a group of anxious patients by implying that the drug they take for their anxiety may be unavailable?

Why is the Department of Health and Social Care making a particularly big deal about fluoxetine, when with every other drug shortage we’ve simply muddled through? 

Then we had ‘GPs requesting ambulance will have to provide a score of level of emergency’. Now, I have to be honest, the NEWS2 score was news to me.

And sure, there may be some merit in an objective measure of acute illness severity.

But this still feels like yet another example of GP judgement and experience being sacrificed in favour of an imposed deconstruction and arbitrary standardisation of our job, with the implicit threat that, if we can’t/won’t jump through this latest hoop, then some ambulance control admindroid might downgrade our call.

And it feels like it because it is.

Look, people, which bit of ‘independent contractor’ do you not understand? Stop telling us what to do, especially when that telling just involves a top-down reorganisation of what we’ve already been doing for years, only better.

In fact, stop dictating our jobs, but start doing yours. Because if you want to know my prognosis on the current state of democracy, well, have I got a NEWS2 score for you.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield

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Readers' comments (7)

  • Cobblers

    TC mate don't sweat the small stuff. "GP to contact" is in the same category as "GP ideally placed to". Non contractual and therefore Foxtrot Oscar.

    As for the ambos coming up with the NEWS2 gambit. Come up with your own. Call it TOPCAT1 and state that it means it's a blue light get your arse here in as short a time as possible.

    Sorted.
    /Dusts hands off. And breathe.

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  • Admindroid, I’m having that!

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  • Having been a bemused and exasperated victim of a NEWS2 ambulance control admindroid very recently, I shall be quoting NHS England advice, namely "GPs can and should request a higher priority ambulance response on the basis of clinical judgement and regardless of the NEWS2 score"

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  • normoTensive - 0or1
    Orientated-0or1
    Pulse - 0or1
    Capillary refill - 0or1
    Afebrile - 0or1
    Tachypneic - 0or1
    1 for 0or1 - normal/abnormal
    Score - any number from 0 to 6 admit urgently to hospital to seek consultant opinion.

    I like it Cobblers, it’s just as good as any other scoring system and it has a real world application.

    Now all I need is 2 million pound funding to study the bleeding obvious to confirm internal and external validity and quality assurance, and we are good to go.

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  • Spot on! If only you are the health secretary, the NHS will be a lot more sensible. I do not feel professional or independent at all. In fact I feel worse athn your usual worker with worker rights that I have not got. Time to pull a sicky as soon as that comes with stress and working to rule clock watching.

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  • AL "4 TRIES IN ONE GAME" BUNDY

    news2 works both ways ..
    ambulance team phones ooh asking if gp can see
    if news2 is high
    sorry .. needs a+e assessment

    scores are all good and well
    but for some patients who may otherwise look well
    or who have abnormal obs but which are usual for them
    .. common sense then goes out the window

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  • AL "4 TRIES IN ONE GAME" BUNDY

    See other article in pulse
    patient died in cardiff
    as ambulance took too long..

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