This site is intended for health professionals only


Clinging to the cliff edge



In no particular order, here are some things that have happened in the past few weeks.

• We’ve banged our heads against a PC screen trying to figure out why, despite jumping through all the Avoiding Unplanned Admissions DES hoops, our 10 grand pat on the head is showing as a somewhat less bankable zero. Meanwhile, the ‘automatic’ CQRS flu data extraction failed – another £10,000 down the back of someone’s sofa. It is, of course, our job to sort all this out.

• At 1pm on my last day duty, someone from our local care home requested a visit for a patient with a cough. At 2pm someone else from the home requested a visit for a different patient with a cough. Repeat hourly until 6pm.

• We heard the outcome of our federation’s bid for pharmacists from the pilot the Government trumpeted would save us all. Our pitch was supported by local GPs, the CCG’s prescribing committee and the Local Pharmaceutical Committee, created a trailblazing job description and aimed to ease workload in an under-doctored area. So naturally, it failed.

• A letter arrived from the police firearms department requesting a report on a patient. It contained the phrase: ‘While we understand most GPs are unlikely to charge a fee for the provision of information…’ Yeah, why would I charge for a non-NHS service to cover my time, my reputation and my secretary’s efforts? Lawyers wouldn’t charge, would they? And it’s only about a man with a gun. What’s the worst that could happen?

• I had an email from a community nurse stating: ‘While we were visiting Mr X, he passed a type 1 stool. Please review.’ Yes, really.

Etcetera etcetera. You’ve had much the same, and probably worse. Because this is what general practice life is like nowadays – a soul-destroying pisstake.

The response of the more militant is, ‘strike’. After all, the juniors did, almost. But it’s not that simple. We don’t have a single issue to pin a strike on. Our malaise is all-encompassing. We are undervalued, unpaid, abused and generally fannied around with to the point that, frankly, the job is now a crock of shit.  A type 1 shit, at that.

The rational response isn’t to strike, it’s to walk away. And that’s what’s happening. Oh, didn’t I mention? The other significant event was the resignation of the senior partner in a practice just across the corridor. He’s had enough, and the ripple effect may turn into a tsunami. So you know those things you talk about but hope won’t happen? Grey pubic hairs, cancer, the disintegration of general practice as we know it? They’re happening – at least the GP bit is, because our hastily contacted LMC told us. 

We really are clinging to the cliff edge – the most literal of tipping points, as the Government must realise. Either it will accept that the post-2004 contract ‘penance’ should stop short of actually annihilating general practice, or the conspiracy theorists had it right when they said it’s what the politicians wanted all along.

So watch the hand when it’s offered. It may haul you back from the brink. But more likely, it’ll shove you right over.

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