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Brave new world

I’ve just endured four hours of meetings at a cost of 112 appointment slots and a big chunk of my sanity, simply so my colleagues and I could update each other on our QOF/DES ‘progress’. So you’d imagine I’d be delighted by Jezza Hunt’s recent announcement that he’s going to commit primary care bureaucracide by removing all the irksome hoop jumping and box ticking that was introduced by…er…let’s think…oh yes, him.

And I am. What worries me is what’s going to replace it. Get this: we’re going to have to proactively ‘manage’ our vulnerable elderly patients, ensure they have proper care-plans and co-ordinate all aspects of their care. Say goodbye to targets and incentives. Say hello to annual elderly health checks, endless multidisciplinary meetings and reams of documentation no one will ever read. This isn’t a Brave New Bureaucracy-free World, it’s simply another version of Hell to destroy our souls.

But it gets worse. We will, of course, have OOH dumped firmly back in our laps. And while that’s hardly a major shock, the way Mr Hunt’s phrasing, with each pronouncement, nudges us ever closer to being personally responsible for OOH care is a slow-burn horror.

And how is this all going to be paid for? Well, ‘additional funding…will come from savings made by a reduction in unplanned admissions.’ We all know how easy that is, so I’d estimate that the overall contribution that’ll make to the pot will be, approximately, sod all. The rest – and I’m guessing here –  will come from us having to re-earn that recycled QOF and DES money.

According to a DH commissioned survey, stress levels on Planet Primary Care are the highest they’ve been for 15 years. Call me a reactionary old doom-monger but I don’t see this latest contract revamp as the thing to restore to the profession a sense of Zen-like calm. On the contrary, it’ll have me itching to tick a box again. The one marked ‘I retire’.

Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield.