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The unplanned admissions DES will do just what it hoped not to

My retirement’s not imminent, so it’s not like I’m really thinking about it. After all, I’ve got another 2,484 days, 7 hours, 31 minutes and – hang on – 45 seconds to go. But initiatives like the unplanned admissions DES certainly focus the mind.

The DES spec has now been unleashed, and those of us who feared the worst have discovered it’s exactly that. A mountain of paperwork, endless reviews and meetings, and a bonkers deadline. Apparently, the release was delayed while the GPC negotiated down the level of bureaucracy – so I can only imagine what the original must have been like.

I’ve no doubt that most practices will take it on, simply because few can afford not to. But it’s not just the paperwork and the pressure which will makes us regret we ever moaned about the lunatic fringe of QOF (good old QOF – remember that?). It’s the fact that this non-evidence based crock of cack is likely to achieve the exact opposite of what it intends to do.

Just reading the specification makes me feel overworked and overwhelmed. So my 98% of non-vulnerable patients are going to get pretty short shrift for the next year. Which means, as far as they’re concerned, I’ll do what’s expedient: send them for X-rays, refer them to outpatients and yes, send them to A&E. Whatever they want/causes me least hassle, because I’m busy building my vulnerability hit list and writing up care plans.

And here’s another irony: those feeling really vulnerable are we GPs. I seriously believe we’re at high risk of admission, albeit to the local secure unit. So I have my own Admissions Avoidance Plan, which I’d like to propose to the DH. Specifically: LEAVE US ALONE TO GET ON WITH OUR JOB. You might be surprised how well we do it.

So: 2,484 days, 7 hours, 26 minutes and 30seconds. And counting.

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