I’m sorry to bang on about PCN matters again, but as I need make no apology for bringing to your attention utter outrage and bonkersness, then, in fact, I’m not sorry at all. Not least because history has shown us that PCN developments tend to get trailed so far in advance that the fury they ought to generate gets put on a mental ‘to do’ list which then gets lost down the back of the surgery sofa. Which means that, by the time we realise what’s happening, it’s too late.
So just in case you missed them, here are three highlights from the recently released new PCN service requirements.
1: We must review patient records to identify any with a historical BP of >140/90 (or >135/85 in a community setting) to ensure they’ve had the full potential hypertension work-up. The obvious flaw here being that every patient who’s ever had their BP recorded will have had a BP above these levels at some point. Cue utter shitstorm.
2: We must try to opportunistically detect atrial fibrillation during BP checks ‘in line with NICE guidance CG180’. Er, a few problems here. CG180 does not exist. And this is most certainly not ‘in line’ with the guidance that replaced it. And this initiative is completely non evidence based, is not recommended by the National Screening Committee and represents the introduction of a national screening programme by the back door.
3: Before I introduce you to ‘3’, which, believe me, is the real coup-de-grace, I suggest you take a massive slug of whatever your favoured alcoholic drink is, then another, and another, and then sit down somewhere very quiet, away from walls, sharp objects, people etc. Take a few deep breaths. Hold on tight. And read this from the ‘Personalised care’ spec: ‘By 30th September 2022, a PCN must ensure all clinical staff complete the Personalised Care Institute’s 30min e-learning refresher training for Shared Decision Making Conversations’.
No, I didn’t make #3 up. It’s there, check for yourself if you like. What the people who invent these directives don’t realise is that, while it may only be half an hour’s mandatory training representing thirty minutes of our life we’ll never get back, it’s also a significant nudge for those GPs who are already on the cliff-edge of quitting ie all of us. And those people must also, I’m forced to conclude, work for the department of Fatuous, Misguided, Infuriating, Deprofessionalising, Infantalising, Whimsically-Based Bollockyfuckwit Nanomanagement. That is to say, in short, they’re twats.
And I make no apologies for saying that, either.
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield