GPs warn face-to-face appointments plan could lead to exodus of doctors | GPs | The Guardian


British Medical Association says blueprint could exacerbate GP shortage and see many leave the profession

 

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This may be correct to some extent, but is it the Government or the GPs who are out of touch, as I feel patients will largely welcome face to face, rather than the impersonal telephone appointments or video if you are lucky. In fact you are extremely lucky to get any form of appointment currently.

Currently my own health is not good so I am contacting my GP more often than I would normally have done and when I have managed to get through, after, more often than not, having been in a queue for going on 30 mins and sometimes a hour, only to be told all appointments have gone and never even offered any face to face, for those gone are only telephone appointments . My practice does not extend to video and telephone is the only form of communication as they have not joined the email age.

So are my practice offering face to face, who knows for the Receptionists are not forthcoming.

In the past, well before COVID, I have said that some face to face are not required, especially  if it is just to get results of tests, but then you were never offered telephone appointments, only face to face.

So it has gone from one extreme to another, when it should be a suitable mix.

I sometimes get the opinion that patients are just getting in the way and that no one in the practice cares anything for patients, this is, to some extent, also the way with hospital appointments, but not as grave as with GPs.

It is also one of the reasons why A&E visits are more in demand than previously, as people know when you get there you will be seen, even though the wait will be very lengthy. But not so with GPs for you are not allowed to enter a surgery unless you have a face to face appointment, when you can get one.

GPs could well be voting with their feet and yes they are under great pressure and well over worked, but so are very many of us.

But by not seeing patients many diagnosis are going unknown, for much of a diagnosis process is by observing patients, which can’t be done over a telephone and also not in some instances by video, if you can get them.

This is leading to many conditions not being diagnosed until it is too late, as many with, say, Cancer have found to their cost.

There is a shortage of GPs and if some are leaving this will make a serious situation very much worse, but there are shortages in many areas and in some of these health is also at stake, such as lack of social care, but the Government is virtually doing nothing on this.

All parties need to be listened to, being GPs, Government and patients and a suitable package worked out for all concerned.

I feel it is going to get much worse before there are any signs of any improvements.

Source: GPs warn face-to-face appointments plan could lead to exodus of doctors | GPs | The Guardian

Ministers to crack down on overprescription of medicines on the NHS | The Independent


Government-commissioned review finds 10 per cent of drugs prescribed by primary care doctors are not wanted or needed

 

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This may or may not be true, for we can only know if we see how this conclusion was reached.

For medications are given to individuals and like all individuals we could all experience problems in many different ways.

Unfortunately the NHS does not treat people as individuals, especially in these times of non-face to face consultations. and then the problems in getting repeat consultations when needed. This is the same for both GP and hospital consultations.

They all treat the condition in a ‘one fits all’ approach, instead of a ‘person centred ‘ approach. Also and especially hospitals treat conditions in isolation, but many have multiple conditions and with GPs and some extent hospitals appointments are time time related., otherwise the appointment system get out of line and appointment times are then not met if appointment times are exceeded.

But, if you have more than one issue when seeing a GP and want to relate to your list, the GP could well say, just give me the top of your list and we will discuss the rest on your next appointment, and that is a major problem for when will that next appointment be, certainly not the next day or even the next week could be weeks or months. Even getting through to a GP surgery is a major exercise for it could take time to get even in a queue and then wait to be connected to the receptionists, to be then told all that days appointment haver been taken, no offer for any face to face for the appointments referred to are telephone appointments. It was said sometime ago that going on 80% of a GP consultation was from the patient and not any GP checks, but with a telephone appointment the only vehicle of communication is voice, no understanding of tone, body language and any other observations, so again the appointment is somewhat not sufficient.

As I said, even with a face to face you are usually restricted to around 10 mins, which gives no time for many patient to mention all they wish too and a patient is not an expert of medical issues only on their body and how they are feeling, much of which can’t be expressed over the phone.

Yes, GPs are over worked and there are too few of then, but don’t we all have stressed lives and who is to say how much effort it took a patient to try and get an appointment in the first place, is there any wonder why A&Es are so busy these days, as patients will mainly take going to A&E and suffer the long waits there for they know they will be seen, but again by an overworked, mainly junior doctor, not saying they are not fully trained, but long hours can lead to mistakes being made and they are made and one mistake is one too many.

The NHS has been underfunded for many years, but then so as Social Care which is another story, but as equally important, if not more so.

Money is not everything, for there has been much Government interventions into the NHS and mainly not for the better. Care of any nature is more than likely to be long term and costly.

Don’t get me wrong for we in the UK are extremely lucky to have the NHS, and I bless the Labour Government in the 40s for all their work and will to create the NHS in 1948. But in those days Doctors and Dentists and the BMA were not fully in favour of the NHS, as I am lead to believe they did not wish to lose their access to their private practices, so a compromise was reached. This was on the lines that if they agreed to be brought into the NHS not as employees, but as self employed they could retain their private practices and still work for the NHS. So even tough they are contracted to be in the NHS it is the practice and not the individual doctors. So they can withdraw from the NHS if they wish and still work on  private patients, which many |Dentists have done, so creating many problems for |NHS Dentistry, in that there is a very serious lack of capacity in NHS Dentistry, as so many people are experiencing in not being able to find an NHS dentist, and then afford it, for Dentistry was removed for ‘free at the point of delivery’ many years ago, although the NHS payment is subsidised through the NHS.

|Both the N HS and also Social Care need to be fully funded, but that takes money and one of then should not be left short to fund the other. This is not the fault solely of this Government, but of many previous Governments who have left the NHS somewhat underfunded and even more so, Social Care,  latter even true today, in fact very true and the question is will both be able to survive, especially social care, for the current lack of social care is already having an effect on the over use of the |N HS and if it were to get worse,which it is every day, or even disappear, the NHS would not be able to cope and that would mean disastrous consequences for all who need these services and have no ability to pay.

So urgent action is still required and the announcement a few weeks ago was way to little and way too late.

So medication is but one problem in many others. But I would not just say there is over prescription, which in some instances there will be, especially in some instances of antibiotics and in some anti depression. But please before any thing is done view the patient and not just the assumed overt prescribing.

 

 

Source: Ministers to crack down on overprescription of medicines on the NHS | The Independent

GPs condemn new specifications for primary care networks | The King’s Fund


This article was first published on the BMJ website. General practices have been working together in primary care networks (PCNs) for more than a year, but now growing numbers of GPs are threatening to pull out of PCNs and the associated contract. Richard Murray explains how this situation has unfolded and suggests some potential solutions.

Source: GPs condemn new specifications for primary care networks | The King’s Fund

GPs reject merger ‘driven by NHS England’ | HSJ Local | Health Service Journal


  • GP members have rejected proposals for six-way merger of clinical commissioning groups in Staffordshire
  • LMC had warned benefits of merger were “speculative” and claimed NHSE had driven proposals

GPs have voted against proposals to merge six clinical commissioning groups in Staffordshire, after being told the plans were “driven by NHS England”, HSJ has learned.

The CCGs’ shared management team outlined the intention to merge last year, but various concerns have been raised among the GP members.

The outcome of the vote is due to be formally announced after an extraordinary meeting this evening, but HSJ understands members in a clear majority of the CCGs have voted against the proposals.

The CCGs, which share an accountable officer and several other senior posts, declined to comment on the vote ahead of the meeting, and it is not clear whether they will now pursue the plans.

As reported in the Healthcare Leader, prior to the vote Paul Scott, chair of the North Staffordshire Local Medical Committee, advised his members to reject the merger.

He wrote in an email, seen by HSJ: “Much has been made of the potential benefits of having a single CCG in Staffordshire, yet few if any of these arguments hold true or are at best speculative.

 

Source: GPs reject merger ‘driven by NHS England’ | HSJ Local | Health Service Journal

DWP has sent 150,000 of the ‘fit for work’ letters that ‘risk patients’ health’


If the DWP was a competent Government department none of these problems would be occurring, but competence is the main word in all this.

For this department has shown over many years how incompetent they are.

Where an appeal is in process or there is the probability of an appeal this letter to GPs should not be sent and a competent and responsible organisation would comply with this.

But we have to look at the agenda and this appears to be to cause as many problems as they can do to people claiming benefits.

Any reasonable, competent and responsible organisation should not have to have it pointed out to them that these letters should not be issued and that GPs still need to send the ‘fit note’.

But that is the point the DWP are not a reasonable, competent and responsible organisation. and wish to cause as much harm as they can to benefit claimants, even to the point of the death of the claimant.

DWP tells GPs not to support benefit claimants with sick notes : Welfare Weekly


Yesterday on Twitter, I posted one of my previous posts – Jobcentre tells GP to stop issuing sick notes to patient assessed as ‘fit for work’ and he died in which I discuss a letter addressed to a GP regarding a seriously ill patient. It said:

“We have decided your patient is capable of work from and including January 10, 2016.

“This means you do not have to give your patient more medical certificates for employment and support allowance purposes unless they appeal against this decision.”

The patient, James Harrison, had been declared “fit for work” and the letter stated that he should not get further medical certificates.

However, 10 months after the Department for Work and Pensions (DWP) contacted his doctor without telling him, he died, aged 55. James clearly wasn’t fit for work.

 

Source: DWP tells GPs not to support benefit claimants with sick notes : Welfare Weekly

FCC to vote to allow U.S. devices to use European navigation system : Reuters


WASHINGTON (Reuters) – The U.S. Federal Communications Commission said on Wednesday it will vote in November to allow U.S. devices to access the European global navigation satellite system known as Galileo, a move that could improve the services Americans use.

Galileo is a 10-billion-euro ($11.40-billion) satellite program being developed by the European Union as a rival to the U.S. Global Positioning System (GPS) that launched initial services in late 2016.

FCC Chairman Ajit Pai said in a Wednesday statement that “enabling the Galileo system to work in concert with the U.S. GPS constellation should make GPS more precise, reliable and resilient for American consumers and businesses alike .”

The FCC is proposing to waive its licensing requirements for non-federal operations with Galileo signals known as E1 and E5, subject to certain technical constraints, officials said.

The FCC includes conditions to ensure users of satellite-based positioning, navigation and timing services in the United States will benefit from Galileo signals. The systems are interoperable under a 2004 agreement.

Pai noted that GPS “is integral to numerous everyday applications – ranging from driving directions to precision farming.”

The EU has had to rely on Russian or U.S. GPS signals.

 

Source: FCC to vote to allow U.S. devices to use European navigation system : Reuters

What does the NHS need to survive for another 70 years? | Richard Horton, Clare Gerada, and others | Opinion | The Guardian


As the health service marks its 70th anniversary, experts offer their prescriptions for keeping it going

 

Source: What does the NHS need to survive for another 70 years? | Richard Horton, Clare Gerada, and others | Opinion | The Guardian

The DWP has been caught trying to ‘coerce’ GPs into saying their patients are fit-for-work | The Canary


The DWP are saying that their DWP Assessors know better than GPs on whether a person is fit to work, on what basis, surely the evidence is says otherwise.

The DWP letter to GPs is showing the contempt is has for GPs. GPs are highly trained professional, what training have the DWP assessors had?

sdbast

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