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#GPnews: General practice ‘remains in a stone age’, claims report author

15:30 There is a lot of comment following Reform’s report on GPs not needing to see patients.

On the Conservative Home page, the author of the report, Andrew Haldenby, claims that general practice has been slow in adopting technology.

He wrote: ’General practice remains in a comparative Stone Age, with only seven per cent of appointments booked online, for example.’

The future, he claims, is ’ the pioneering GP “super-practices” which have emerged as a reaction to these problems’. 

He adds: ’The average GP has 7,500 patients on their list.  Super-practices such as Modality, based in Birmingham, have over 100,000 patients and that figure is rising fast.  These organisations are proving able to develop the NHS at speed.  Lakeside Healthcare, a Northamptonshire-based super-practice, has provided a new urgent care centre covering 200,000 people.  Its appointments are one-third of the cost of an A&E visit.’

Meanwhile, in an attempt to outdo his colleague in the insulting stakes, Alexander Hitchcock, also from Reform, writes in the New Statesman: ’For those who require care, video consultations should become the norm. Waiting in GP waiting rooms has become a miserable tradition for many. Contacting clinicians from a living room is much more appealing. It also saves time: video consultations are 40 per cent quicker than face-to-face meetings, excluding waiting times.

‘Private-sector companies, such as Babylon Health, are pioneering this approach by allowing people to contact their GP through their smartphone: sending text messages, photos and prescription requests. In 2016, this should be the norm in the NHS.’

12:10 A health minister has admitted ‘GP workload may be increasing’ when asked by a fellow MP what ‘assessment he has made of the effects on general practices of increases in the number of patients presenting at GP surgeries in the last 12 months; and what steps he is taking to ensure that GP surgeries can cope with the number of patients presenting’.

In a written answer in the House of Commons official records today, Alistair Burt said: ‘Figures from the Health and Social Care Information Centre show that the number of patients registered with a GP has increased from 28,595,310 in 2015 to 28,893,403 in 2016, an increase of 1.0%.

‘The GP Patient Survey, published in January 2016 shows a slight decline in the number of patients reporting that they are able to get a convenient GP appointment. Taken together, this suggests that GP workload may be increasing.’

However he insisted the Government’s £220m uplift to the GP contract this year and plans to boost the GP workforce by 5,000 by 2020 would provide the support GPs need so they can spend more time with patients.

He suggested the £175m GP Access Fund (formerly Challenge Fund) was also, somehow, helping.

12:00 An interesting tweet here on the junior doctors strike next week, using an airline analogy:

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There might be an element of mischief in this – the RCGP used an airline analogy to call for GPs to take breaks yesterday.

10:50 ‘Tough’ new guidelines for cosmetic surgeons have been announced today by the GMC.

Under the new guidelines, surgeons will be expected to:

Advertise and market services responsibly, including stopping the use of promotional tactics such as ’two-for-one’ offers and a ban on offering procedures as prizes. 

  • Give patients time for reflection;
  • Seek a patient’s consent themselves;
  • Provide continuity of care – the doctor must make sure patients know who to contact;
  • Support patient safety – making full and accurate records of consultations.

Professor Terence Stephenson, chair of the GMC, said: ‘It is a challenging area of medicine which deals with patients who can be extremely vulnerable. Most doctors who practise in this area do so to a high standard but we do sometimes come across poor practice, and it is important that patients are protected from this and that doctors understand what is expected from them.’

9:20 Elsewhere, our exclusive top story this morning centres on comments made by a member of NICE’s back pain guidelines group, who says that GPs will need to review any patients taking paracetamol for chronic low-back pain with a view to weaning them off it.

The draft NICE guidelines launched last week completely ruled out use of strong opioids as well as TCAs, SSRIs or SNRIs for acute low-back pain, and put much greater emphasis on offering a short-term group programme of exercise, including a much wider range of exercises than in previous guideline – including mind-body exercises, such as yoga, and and stretching and strengthening exercises.

9:15 We start this morning with a report by the think-tank Reform, which claims that the take-up of Sunday routine appointments in increasing.

This is despite the official evaluation of the Challenge Fund pilots released late last year supporting Pulse’s evidence that there was little demand for Sunday GP appointments from patients.

Dr Maureen Baker, RCGP chair, said: ‘This support for seven-day general practice services flies in the face of our own research – and the fact that a number of surgeries that have piloted seven-day working have had to scale-down services due to a lack of patient demand at weekends.

‘Access to general practice services is undoubtedly important, but patients recognise that prioritising weekend and evening access must not come at the expense of access and services during normal hours. They have better things to do on a Sunday afternoon than have their ears syringed.’

Reform’s report also found that half of patients that are currently seen by GPs could be seen by other clinical staff.

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