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Gold, incentives and meh

'Be positive' about seven-day working, advises extended hours pioneer

GPs should be positive about seven-day working because the alternative is ‘much more scary’, says a CCG leader pioneering extending practice hours.

NHS Central Manchester CCG clinical director Dr Ivan Benett said that managing more care outside hospital was the only way to sustain the NHS and that extending practice hours was part of this.

Dr Benett was speaking after the Manchester ‘demonstrator’ project for extended practice opening - in which Central Manchester is one of four CCGs taking part - was hailed as ‘pioneering’ by prime minister David Cameron in the autumn.

Asked what he would advise other GPs regarding seven-day working, Dr Benett said: ‘To be positive about it, I think we can do this. In fact we have to do it because otherwise NHS is not sustainable, so we have to manage that urgent care activity particularly out of hospital and in primary and community care.

‘I think we can do it. We are just one of a few pilot sites that are trying out different ways of doing it and time will tell whether that works.’
‘But be positive because actually the alternative is very much more scary than anything else.’

NHS England is taking applications to receive funding from the prime minister’s £50m ‘challenge fund’ to extend general practice until 14 February.

Readers' comments (94)

  • Ivan Benett

    Let me try again. No one is saying any individual will need to work more than they do now, unless they want to. Let me say it again, as people don't seem to have heard. 7 day working will need more GPs and Nurses, it can't happen with the same capacity as is current. Let me try once more to say that in order to do this, and make the NHS sustainable, we need to manage activity out of hospital that need not be there.
    Is there anything else I need to repeat?

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  • I think we need to look at the Husley Practice model for providing a pre-filtering system on web/mobile , addressing the most common GP patient ailments and backed by p[hone access to nurse/GP.

    The algorithms are based on NHS Direct Content, and are safe and effective, and have significantly reduced patient demand in the ongoing 3m trial.

    HAve a look and sniff the future!

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  • Ivan Benett

    David Connoly 2.03 pm - Funnily enough I've been working rather than following these comments by the minute. I'm happy to answer any questions, but I do have other things to do! Unfortunately some of the comments are not worthy of response e.g. the 'save the NHS bigade'. Presumably whoever said that is looking forward to his NHS pension and has valued his NHS training ( I say his because I can't emagine a woman being so offensive).
    So which is it 'Ministers lacky' or 'save the NHS brigade'

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  • Ivan - none of this is personal.

    I gave a cheap shot earlier with the Bee Gee joke, I recognise that. But hey, it's a compliment.

    Look - my impression is that you have come up with an idea that resonates with government rhetoric, the health minister has picked up on it and as a result you have become a 'champion' in health care.
    This has convinced you to run with this idea of 7 day care.

    The problem is that your proposal could not possibly be more out of touch with every GP in the land except those with vested interests and ministerial aspirations.

    It feels like the final stab in the heart of an utterly demoralised profession.
    We have all gone past the 50 ways of reorganising a terminal NHS, all of which want us to work more for less.

    Approaching 50, I've already built up a bit of a pension but I am fit and have a good 10 years left in me and need to work.
    Frankly, I am terrified at the prospect of the next few years in whatever form primary care will take, and will be taxed to hell if I stay where I am.
    I have looked at a job in Sydney but don't want to drag my kids half way round the world when they are settled in school and have a British identity.
    Sydney, Perth? Cities - yes, but not as we know them. Not a London or my own Leeds with its beautiful architecture and Dales on the doorstep. Just some faux tropical dead-ends without any seasons.

    Anyone else sharing this dilemma, ideas welcome.

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  • This comment has been edited by the moderator

  • I am in my mid 40's. I am knackered. I am working 12 hour days. My kids are growing up - so my wife tells me - I don't see them much during daylight hours anymore. I have nothing against working Sunday's - but don't expect me to work every other day of the week as well. Of course that means there will not be enough Partners around during the week to do the prescriptions, the visits etc etc. Today I sat in my surgery in between the 50 or so patients I have seen and for the first time since qualification I regret my career choice. I think I just burnt out.

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  • Vinci Ho

    (1) I think there are all reasons why we have so many comments on this subject last 72 hours. Good to have different views. Anonymous or not , they are still important opinions
    (2) One person's crusade cannot represent the majority of the profession , no matter how noble it is. There are limits of what we can do although one can argue everybody has different limit.
    (3) Nobody is to deny there is a problem of sustaining the system. But who has the biggest responsibility after all? The agenda of this government is too obvious if you have been following the stories so far. Very easily , it will use our desire to 'get it right' as a bait to retract its responsibility to uphold the flag of NHS. The concept of Big Society is telling the society to fix it by itself . The government will spend and do the least.
    (4) Blindly imposing something on the majority of us and telling us this is the way forward will be met by more confrontation . I am sure about that . The day Agent Hunt said he was not picking a fight on GP , the war has already started. The profession simply does not trust this government
    (5) Steve, editor , I think you should have enough material from this forum to write your next editorial ( if you are going to write one) Look forward to that.
    (6) Just finished evening surgery , still got prescription queries and lab results to deal with . Happy New Year to all.....

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  • Well it's sensible to admit that we will need many more (many) more GPs and nurses and much better (much much better) funding of general practice for practices to be able to provide seven day care even if we federate. I can't see it happening soon.
    Interestingly the new DES seems to be making a bit of a flop (the one where we are supposed to reduce hospital admissions) which will mean I will have to attend another meeting...taking me away from patjents calls and paperwork.
    If there was an eighth day, GPs would be working it! The challenge, the real challenge here, is to really pump money into primary prevention, tv ads, papers, bill boards, plaster it everywhere, what people are supposed to do with management of minor ailments. Creating more access creates the problem of having to create more access and that's something we won't have much more of if we open seven days.

    Kind regards

    A non anonymous troll.

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  • @2.48pm "We need to manage activity out of hospital that need not be there" - why should this involve further disrupting general practice? Why not educate patients not to attend A&E inappropriately and to use GP OOH services if they cannot wait. More than one of my patients recently has spent unnecssary hours in A&E believing there is no OOH provision - media and political reporting to that effect presumably.

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  • Dear Ivan,

    Two words for you ( and they are not the obvious)


    Where on earth are you going to get all these GPs and NPs from? We need 50% medical graduates to enter general practice just to break even.

    I find it utterly disingenuous that in these times of austerity when budgets are being slashed by the tens of millions, we are promising patients the earth. Vote catching comes to mind.

    Don't be sucked into the political games Ivan. I look forward to debating this issue at the Pulse live conference.

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  • Vinci ho you are the voice of reason! everyone is entitled to their opinion, but please do not ridicule your colleagues, or make this a 'personal attack'.

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