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I forecast income protection with some squalls

I forecast income protection with some squalls

Tyne, Dogger, north-east 3 or 4, occasional rain, moderate or poor. Humber, Thames, south-east veering south-west 4 or 5, thundery showers, moderate or good, occasionally poor.

Something’s wrong, isn’t it? You came here expecting a blog about the state of general practice and instead you’ve got the shipping forecast. Maybe you prefer it to my usual stuff, but that’s not the point.

The thing is, you actually read it, and by doing so, you demonstrated a level of respect, interest and cognitive function. Hold that thought. I want to drag you back to Planet Primary Care – specifically, to NHS England’s letter about the suspension of some QOF elements until April 2022, aimed at supporting GPs in their efforts to get booster vaccines into everyone and their dog.

The most annoying part of this letter was not the inexplicable failure to confirm, exactly, which bits of QOF are suspended, now rectified since they’ve discovered a spare back of an envelope to scribble it on. No. It’s this paragraph: ‘To be eligible for income protection, practices will need to agree with their commissioner a plan that will set out how QOF care will be delivered wherever possible but with priority according to clinical risk, and accounting for inequalities.’

They just can’t help themselves, can they? Even when supposedly freeing up our time, they have to chuck in some extra pointless bureaucracy which will have us scrabbling around for something useful to say, and wasting time saying it, in a report that we all know commissioners will never ever bother to read.

Why do they repeatedly do this? I can cite, for example, from years ago, the utterly futile task of producing annual practice reports; more recently, soul-destroying mandated QOF quality improvement narratives; and only last year, an arbitrary income-protection hoop-jump-through requiring us to detail how we were targeting the vulnerable. Not once, in any of these examples, has anyone responded to the information submitted, and I’d suggest that’s because it’s never been read.

And I intend to confirm this hypothesis, this time round, by emailing to our commissioner as follows: ‘Our plan is to deliver QOF care by drone, left with a neighbour if the patient isn’t in. We will prioritise according to clinical risk by working out who is most at clinical risk and prioritising them. And we will account for inequalities by providing those who are not coded as ‘living with hamster’, under the hamster@home initiative, a specially trained, signposting patient advocate hamster, which they can keep if they want. Or we might not bother.’

After all, last year, I sent them the shipping forecast, and I didn’t hear a word.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at



Please note, only GPs are permitted to add comments to articles

Christopher Ho 10 December, 2021 10:41 am

“Why do they repeatedly do this?”

– Do you really need to ask, Tony? If you knew basic Friedman economics 101, govt bodies set up to address a “problem”, tend to exacerbate rather than solve so-called “problem”, i.e they won’t reduce the “need” for their role, but tend to increase it, thereby giving them a justification for ongoing employment, increased funding, power, etc. That’s what big govt does…

C Ovid 11 December, 2021 10:18 am

Civil Service needs to keep us distracted from the inevitable moment when we all stop, wake up and realise this is a crock of s**t. This is what they fear the most. We repeatedly fail to act as a unified and intelligent group of people and every year that goes by we fall further down the ladder of feared/respected professions.
Punchdrunk, tired, disunited, refusing to stop work, obsessed with the quality of the product (rightly so) : a line manager’s dream come true.
Labrats. Institutionalised. Dedictaed. Longsuffering. Dangerously silent. Take your pick.

Patrufini Duffy 14 December, 2021 1:26 pm

Working at scale. Worked out well didn’t it.