The Shape of Things to Come

[Sam Handwich]

I also questioned of what use is my local GPs. The last year I needed them twice but all I got was a Nurse Practitioner over the telephone. I wonder whether the doctors have disappeared into an underground bunker and only raise the periscope once in a while to check if the pandemic is over. On the other hand you have front line nurses and doctors operating in the equivalent of a war zone.

One thing i have gleaned, is that GP's like the inflated wages they earn but don't really like to do any work i.e. meeting the general public.
The widely adopted Cancel Culture has given them the perfect excuse to continue to earn whilst doing nothing more then talking on the phone.

 

[Gaz]

Nope. If these checks are so vital then they should be included within the normal care of a patient and the per capita payment the GP receives. A GP shouldn’t need to be motivated to do this work by extra payments. Though the GP doesn’t actually do the work it’s passed off to nurses and pharmacists and health care assistants.

But referring back to an earlier post where a Doctor is phoning patients to change their medication even though the patient is perfectly happy as they are, does it not seem odd that in the middle of a pandemic a doctor has nothing better to do than faff around with admin tasks to keep the CCG happy and make sure that all the boxes are ticked? Bear in mind that this task should be delegated to a pharmacist - and given the change the doctor was making it might be done better by a pharmacist to protect the patient from harm.

You do realise that funding was removed from GP Pactices at the time QOF was introduced, and these indicators must be met for them to get income that was guaranteed before. All of this work is dictated by NICE based on what is good practice and required in each disease area.

The work is given to the best qualified to do it, Nurses / HCA / Pharmacists /ANP are an important part of Practices and have been for a long time.

They also get no funding for removing medication like pain killers / opiates etc. That is work they are expected to do still as part of national or local guidance, it isn’t optional even during covid

 

[royalmush83]

stop spending ludicrous amounts on aircraft carriers and divert it to nhs.

Personally I'd fuck our nuclear deterrent off altogether and invest all of the proceeds into our healthcare system, schools, social housing. And I'm certainly not a socialist by any stretch of the imagination.

 

[Kenna]

Support the NHS

We have a Tory government the only thing the NHS will be receiving when this is all over is even more cuts.

 

[Sir Lancelot]

You do realise that funding was removed from GP Pactices at the time QOF was introduced, and these indicators must be met for them to get income that was guaranteed before. All of this work is dictated by NICE based on what is good practice and required in each disease area.

The work is given to the best qualified to do it, Nurses / HCA / Pharmacists /ANP are an important part of Practices and have been for a long time.

They also get no funding for removing medication like pain killers / opiates etc. That is work they are expected to do still as part of national or local guidance, it isn’t optional even during covid

They get money for removing medication from patients in pain!!? Point me to the legislation for that please.

 

[Gaz]

They get money for removing medication from patients in pain!!? Point me to the legislation for that please.

thats not what i said, they get no money for monitoring pain meds / opiates but have to do it as part of national / local medicines guidance

 

[Sir Lancelot]

thats not what i said, they get no money for monitoring pain meds / opiates but have to do it as part of national / local medicines guidance

There’s a difference between monitoring and removing.

 

[Gaz]

There’s a difference between monitoring and removing.

not in some cases, pain meds & opiates is a major problem throughout the country and has been a priority for a while now.

GP’s don’t save money by removing, if anything it ends up costing them more on alternative meds & referrals to secondary care / other services

 

[Sir Lancelot]

not in some cases, pain meds & opiates is a major problem throughout the country and has been a priority for a while now.

GP’s don’t save money by removing, if anything it ends up costing them more on alternative meds & referrals to secondary care / other services

It costs nothing for a doctor to remove medication and then refer the patient to a drug that is not advised for them.

Its cost them nothing to remove my medication either as there has been no suggestion of replacing it with something else.

 

[Gaz]

It costs nothing for a doctor to remove medication and then refer the patient to a drug that is not advised for them.

Its cost them nothing to remove my medication either as there has been no suggestion of replacing it with something else.

it costs every time they refer, it costs every time they prescribe or make changes to meds, it costs every time they see / phone a patient, it costs every time they have to do audits / returns on pain meds / opiates.

National guidance says there is a big problem with pain meds & opiates, its only right its targeted in the same way other meds are at times. Its up to individual GP’s / pharmacists to make decisions on individual patients on a case by case basis under the guidance

 

[Mercia Blackcat]

it costs every time they refer, it costs every time they prescribe or make changes to meds, it costs every time they see / phone a patient, it costs every time they have to do audits / returns on pain meds / opiates.

National guidance says there is a big problem with pain meds & opiates, its only right its targeted in the same way other meds are at times. Its up to individual GP’s / pharmacists to make decisions on individual patients on a case by case basis under the guidance

For the record my son does not use codeine continuously but only when required so he is certainly not addicted to codeine which he orders only when he has a flare up of pain in his head. He is prescribed 2 x 30 mg tablets of co-codamol. He receives two asthma inhalers every month so that should be clear on his medical notes. Quite frankly the doctors at the surgery which we have been at for 12 years are a waste of f***ing space. They couldn't care less. My wife was taken to hospital after having a night seizure and the neurologist sent a letter to the GPS requesting an ECG and other actions but three weeks later when I asked them what was happening it turned out they had completely ignored her letter. I wasn't a happy chappy. She is averaging 4 or 5 fits a weeks in the nine months since but as they are not considered life threatening they couldn't give a fuck and have not checked up on her since. They will give a fuck if something happens to her as a result because at the inquest I will be there and wont give a fuck about their team of barristers and solicitors in front of a coroner because that happened when my daughter died 10 years ago due to medical negligence.
PS I am glad he stuck up for himself and told her to go fuck herself. They expect respect but have none themselves.

 

[Kevsgreat]

I've had x2 consultations with a GP since this all started, both over the telephone and one referral to primary care & practice respectively. I found it much more efficient for all parties than having me drive to the practice for an initial consultation.

Both of these consultations started with an AI process as it happens, with a series of questions which either direct you to a GP call or advise you call 111.

Definitely improvements and innovations to be made but at the centre of it need to be actual GP's.

Twice I've used 111 who've said to see my GP, once my GP said I'd need to wait two weeks despite 111 saying it was urgent, the second time they wouldn't see me at all because it was chest related.

I think 111 is a great asset, likewise my GP when I get to see him, but unless all these services work together they become a bit pointless.

 

[Mercia Blackcat]

No real sense of a duty of care among some GPS. That is at least something that could be programmed into an AIU.

 

[Billericay Dichio]

The manager of a Wrexham care home has committed suicide because of the effect of watching so many of his clients die from lack of oxygen when no GP would go to the care home because of Covid to authorise more oxygen.

Reading the news reports it was way more complicated than that.

 

[Pnematic]

I went to my GP he said “ I ve not seen you for ages”

I said “ I know , I ve been ill “

 

[Mercia Blackcat]

One thing i have gleaned, is that GP's like the inflated wages they earn but don't really like to do any work i.e. meeting the general public.
The widely adopted Cancel Culture has given them the perfect excuse to continue to earn whilst doing nothing more then talking on the phone.

I am all in favour of local medical centres offering a wide range of services as they do now but I would aim towards developing AI as an alternative to GPs. If you are to told that your illness is terminal a specialist councillor could provide care rather than a GP to break the news.

Three close people to me have died during the pandemic but none for coronavirus. One an old friend of 50 years died as a result of COPD. She was 61. A nephew died who was severally disabled, he was 54 and recently my brother in law died of cancer at the age of 60. He was in remission from cancer but went to his GP just before Christmas who told him that he didn't think it was cancer returning but they would send him for a chest x-ray in a couple of months at Wolverhampton Hospital. Two weeks later he was dead.

People are dying and all my GPs are bothered about is ringing people to hassle them over codeine. I suppose targets must be met for the returns.

 

[peachy]

Nope. If these checks are so vital then they should be included within the normal care of a patient and the per capita payment the GP receives. A GP shouldn’t need to be motivated to do this work by extra payments. Though the GP doesn’t actually do the work it’s passed off to nurses and pharmacists and health care assistants.

It isn't extra payment, it is the payment. From what I understand, healthy patients earn the doctor a per capita payment. Patients on health registers have to have certain tests done, and if the targets aren't met then the doctors don't get paid.

 

[Gaz]

For the record my son does not use codeine continuously but only when required so he is certainly not addicted to codeine which he orders only when he has a flare up of pain in his head. He is prescribed 2 x 30 mg tablets of co-codamol. He receives two asthma inhalers every month so that should be clear on his medical notes. Quite frankly the doctors at the surgery which we have been at for 12 years are a waste of f***ing space. They couldn't care less. My wife was taken to hospital after having a night seizure and the neurologist sent a letter to the GPS requesting an ECG and other actions but three weeks later when I asked them what was happening it turned out they had completely ignored her letter. I wasn't a happy chappy. She is averaging 4 or 5 fits a weeks in the nine months since but as they are not considered life threatening they couldn't give a fuck and have not checked up on her since. They will give a fuck if something happens to her as a result because at the inquest I will be there and wont give a fuck about their team of barristers and solicitors in front of a coroner because that happened when my daughter died 10 years ago due to medical negligence.
PS I am glad he stuck up for himself and told her to go fuck herself. They expect respect but have none themselves.

that sounds like a shit surgery tbh which you can get, in fact it sounds quite shocking. I’d complain and consider moving Surgery. Hope your wife gets the care she deserves.

Your son isn’t the type of patient to target for pain meds either, its the longstanding high usage or those abusing it that should be looked at not someone taking it occasionally for pain

 

[peachy]

Though the GP doesn’t actually do the work it’s passed off to nurses and pharmacists and health care assistants.

The gp probably is paying these staff and is then free to do other work.

 

[Sir Lancelot]

It isn't extra payment, it is the payment. From what I understand, healthy patients earn the doctor a per capita payment. Patients on health registers have to have certain tests done, and if the targets aren't met then the doctors don't get paid.

Which is what I said before. If the targets aren’t met then the doctor doesn’t get paid, and so sick people who need to see a doctor can’t get near because doctors are ticking boxes to meet targets.

The gp probably is paying these staff and is then free to do other work.

Chance would be a fine thing.