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You couldn’t make it up



Copperfield surveys the latest issue of Pulse with a deepening sense of despair


There’s a lovely flow to the current crop of news stories in Pulse. On page one, we’re told GPs will have to cut unplanned admissions by a fifth. I hesitate to state the bleedin’ obvious, but doesn’t the fact these patients were, in fact, admitted, rather justify their unscheduled attendance? Or is the implication that we, or they, should now adopt an ‘expectant’ approach for, say, the odd infarct or leaking aneurysm?

Which leads rather neatly to page three. In certain publications, this would mean a pair of tits. But Pulse’s page three features only one: whoever it was in the CQC that decided it was a good idea to incorporate practice mortality rates into ‘quality risk profiles’. It’s a rubbish measure of anything, given the demographic issues and statistical limitations, but you knew that already. On the other hand, if we really are to cut unplanned admissions to hospital, that’ll involve a realigning of our threshold for making an urgent referral – taking risks, in other words. And risks may mean deaths, pushing the dial on our risk profile, embarrassingly and accusingly, into the red zone.

And that, of course, might be of interest to appraisers in our toughened appraisal process. Page four tells us that one in ten volunteer GPs in new stylee revalidation pilot appraisals had concerns raised about their performance.

Think about that for a second: one in ten. And those ten were volunteers. That means either they thought they were pretty shit hot GPs, or they had a strange desire to commit professional suicide. This is at once hilarious and shocking. Hilarious because, obviously, it just is. And shocking because, what hope is there for the rest of us?

Never mind. At least, if all this grinds you down into clinical depression or frank psychosis, you can refer yourself for some shrink-wrapped head-straightening, thanks to the Improving Access to Psychological Therapies (IAPT) programme. Er, except you can’t. Because, according to page six, in certain parts of the country the programme is being decommissioned.

Deep joy. Given the dire current state of the service, and the fact that IAPT was supposed to solve our problems, this in effect means that psychiatry has been cancelled. Which will result, inevitably, in some indiscriminate prescribing of SSRIs to the emotionally incontinent. Which will lead to more overdoses. Which will lead to more unplanned admissions…

I’m looking forward to the next issue of Pulse. I just hope it comes with a revolver.

‘Sick Notes’ by Dr Tony Copperfield is out now, available from Monday Books.

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