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Sick notes: CQC sends GPs back to school

Sick Notes often settles down in the evening with a glass of pinot noir and the minutes of meetings of the Informatics Services Commissioning Group at NHS England. They are usually the perfect read before retiring for the night, with sleep-inducing updates on the latest plans for a giant new database or IT project to make more NHS and social care data available to the public.

But reading the latest missive, Sick Notes was jolted by an idea raised by John Parkinson, director of the Clinical Practice Research Datalink at the Medicines and Healthcare products Regulatory Agency, who said that even foetuses should have their own medical records. Under the heading ‘Records for the Unborn’ (not a recent Metallica album as Sick Notes first thought) the minutes say: ‘The common axiom used in reference to healthcare services is “from cradle to grave”. Parkinson proposed this should go one step further and cover “germ to worm”.’

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‘As you can see, we have top marks for our caring attitude. So, stop moaning and sit down.’

The CQC has gone back to school with its new ‘easy to understand’ ratings for GP practices. Its 100-page handbook reveals that practices will be ranked ‘outstanding’, ‘good’, ‘requires improvement’ or ‘inadequate’ – a system that has been likened to the Ofsted regime in the education sector.

But this was not what caught Sick Notes’ eye. The ‘outstanding’ rating will be awarded a green star and those with ‘inadequate’ services a red dot, invoking bad memories of primary school wallcharts.

Leaving no stone unturned, the Pulse team enquired of the regulator’s press office whether these symbols would also have to be displayed by GP practices. The press officer – only half-seriously – said practices could use the symbols if they ‘really wanted to’ but it would not be a compulsory requirement. Rumours that after three red blots GPs will be asked to stay behind after afternoon surgery have also proved inaccurate.

Last month, Pulse ran an online project to chart a day in general practice. Among the touching and heartfelt posts, there were other more colourful submissions that provided a promising pile of potential material for Sick Notes. One GP admitted dropping a used otoscope earpiece into her coffee and another invited us into bed as they checked their emails on a laptop.

But the accolade for most worrying submission goes to Dr Kristina King, a GP in High Wycombe, Buckinghamshire, who pondered whether she should eat a mouldy sandwich festering in her desk: ‘I’m starving, sandwich going off in drawer calling me to rescue it but no chance, #24hoursinGP’ she tweeted. That is the reality of today’s general practice right there.

Sick Notes has rooted around the bins in the Pulse office to find the worst wording in a health-related press release. This month the award goes to whichever PR consultant wrote a release on a recent review of university campus sexual health service provision by the pharmacy chain Superdrug. The release claims the University of Bristol ‘leads the way for sexual health services’ and then, with a wink and a smile, says Cardiff University ‘brings up the rear’.

Sick Notes is a bit of a connoisseur of GP out-of-office replies, in fact some days that is the only human contact we have with the outside world. But we have to highlight the genius that is Liverpool GP Dr Andrew Mimnagh’s holding message to emailers while he is out golfing or pruning his roses. ‘I am currently out of the office,’ he writes. ‘You may assume either annual leave or death as you see fit and whichever you would gain the most personal pleasure from.’ And it goes on: ‘Routine matters will be dealt with on my return to practice or corporeal resurrection, though occurrence of either event is by no means taken for granted. Andy Mimnagh.’

‘The announcement led to many kitten pictures being printed in newspapers alongside lurid headlines.’

In the most disturbing medical development since swine flu, Public Health England has announced the first evidence of ‘mewberculosis’ in Berkshire. The public health body said it had discovered two cases of cat-to-human transmission of tuberculosis. Both cases developed active tuberculosis after contact with a consumptive cat infected with Mycobacterium bovis and were responding well to treatment. The announcement led to many kitten pictures being printed in newspapers alongside lurid headlines. The only person to come out of the episode with any credit is Robin Hargreaves, president of the British Veterinary Association. Mr Hargreaves (helpfully referred to in the article as ‘a cat owner himself’) tried to explain the nuances of absolute risk to a Telegraph reporter saying: ‘It is going to happen again. It’s low risk, but not no risk.’ One for the CPD file.

And finally for those who are ready to fight back against the Department of Health, please take note of Pulse readers Dr John Glasspool and his wife Dr Jill Graham from Southampton. They recently contacted all their patients to inform them of their imminent retirement after 30 years at the same surgery. The letter – seen by Sick Notes – explains that their reason for leaving is the campaign waged by politicians to pile more work on GPs and because they wanted to avoid compromising ‘the standards we would like’.

They go on: ‘You may have noticed that there has been a campaign of vilification against GPs in some sections of the press for some time now. Under the circumstances, a lot of GPs in their 50s are doing the same as us. We wish you all the best for the future. John and Jill.’

Now that is going out in style.