GP for 30 years
Bexley Cardiology & COPD Lead
GP-Commissioner of the Year 2011-12
VISION 2010 winner
3 HSJ winner & 1 Finalist
As the population ages, demand for medical services is sharply escalating, but little has been done to provide a corresponding increase in supply. Patients are aware that most doctors lack the time to provide optimal care. The situation will soon worsen as newly qualified doctors shun general practice and existing GPs are planning an early retirement. Shifting more GPs from the front line to offices can only make matters worse. Perhaps, it may be prudent for academics to consult practising clinicians before they utter their potentially dangerous aphorisms sitting on their tripods.
Comment on: The NHS has its own currency crisis
When it comes to “the right message,” this is one of the best articles I have ever read in the last two years. Sadly, too much Salsa Marinara has turned it into a bit dyspeptic. Here is a bullet points résumé, with Alessi’s permission, whom I have never had the privilege of meeting: * Rash of reconfigurations - essential * The currencies that drive activity and behaviour in the NHS remain rooted in the past and they need urgent attention. * It is difficult to see how foundation trusts can ever be really part of an integrated care approach when their very oxygen is driven by a currency which is the antithesis of a capitated system. * Heading from the sterile biomedical disease-focused care models to whole-person ones. * The quality and outcomes framework needs to accelerate the shift in emphasis to embrace population health outcomes, not retain an obsession with individual medical targets. * We do not have the luxury of waiting till the financial situation is more favourable. * The dinosaurs need unseating As for managers knowing it all along, shame they didn’t do anything about it.
Comment on: Private sector must face reality
I am quite mystified. Is the article referring to the clinicians? But there are very few independent consultants, most of them are working for the NHS as well as privately. Are they going to learn from themselves? Or, is it referring to the managers? In which case, what the NHS managers can learn from Hinchingbrook and what private providers can learn from Mid-Staff? Sorry for being a cynic, but Health Care UK is in a mess, because we spend less than 10% of our GDP for health.
On the other hand, GPs have to deal with a spectrum of persecutors such as the General Medical Council, PALS, solicitors lurking outside surgeries, employment tribunals, managers exercising their powers and, more recently, hectoring editors. On the other hand (apologies to my hero Topol), the Department of Health, the National Commission Board and just about every other NHS powerful agency are run almost exclusively by people with a hospital background. They appoint each other ignoring basic employment laws and they are accountable to no one but themselves. Francis is a noble attempt to put right this anomaly. If the august HSJ is to survive the current publishing crisis, it must shed its bias.
“very small number” of CCGs were “reporting deficits in [their] latest draft plan submissions” for 2013-14," It seems that a very small number are honest enough to admit their financial problems and not cover up with creative accounting, But I like the next bit better: "in areas where their predecessor primary care trusts had “known financial problems”. Forgive me, but are they not the very same people whose incompetence created the debt in the first place and have now renamed themselves from PCT Finance Directors to CCG Chief Finance Officer? It would have been laughable if it wasn't for the fact that this time next year the lemmings, sorry, the GPs, will be asked to foot the bill.