Monthly Archives: October 2014

PUT UP OR SHUT UP………..

So, apparently we need to stop moaning and whingeing about General Practice, or we won’t attract the new recruits; that’s the latest arrow winging from Westminster.
No recognition of the fact that we are all struggling at the moment, just that we need to shut up about it.
No mention that to move forward with mute acceptance and obsequience would be like bringing the next round of GP lambs to the slaughterhouse, completely unequipped and unaware of the trials to come.
Okay, so rather than let our emotions get the better of us, let us look at this problem in the form of an employee appraisal (though of course we aren’t employees and perhaps therein lies the problem for the government).
Occupation: GP
Duties & Responsibilities:
  • To be the main point of healthcare contact for the whole population within the UK
  • To manage both scheduled and unscheduled care both within and outside normal working hours
  • To keep updated in all areas of medical knowledge and skill to ensure that care provided by other organisations is of an appropriate standard
  • To manage co-morbidity, co-ordinate care, manage acute and chronic illness, health promotion and disease prevention
  • To be the patient’s advocate and maintain an holistic approach
  • To prescribe not only safely, but in line with this year’s local and national guidelines and in the most economical way possible
  • To run not only a business budget of £9bn, but be responsible for the commissioning of the majority of NHS services
  • To be involved in the continuing development of the healthcare system
Achievements in Past Year:
  • Number 1 in latest Commonwealth Fund Report despite increasing consultation rates and decreasing resources
  • Took over commissioning NHS services
  • Coped with increasing demand whilst maintaining quality
What do you find Interesting:
  • Intellectually stimulating and rewarding
  • Challenging
  • Still most trusted profession
  • Degree of autonomy and flexibility especially with career path as generalist but with ability to sub-specialise
  • Satisfying and ‘Every day is different’
  • Tremendous variety of medical and other issues to manage
  • Holistic approach empowering Patients to manage their own health
  • Opportunities for a great variety of different roles to suit any time commitment, pocket or interest: out of hours GP, salaried GP, GP partner, commissioning, politics, journalism, sexual health, family planning and numerous other clinical roles, occupational health, developing information technology, property investment, entrepreneurship, management, service design, teaching medical students and training junior doctors.
Challenges in the Past Year:
  • Annual contract changes
  • Increasing climate of abuse from government, media and patients
  • Problems with retention & recruitment due to career uncertainty, increased retirement and emigration, and falling income
  • Constant inspection by multiple agencies
  • Increase in spurious complaints
  • Increase in bureaucracy and mindless box ticking exercises
  • Decrease in autonomy
  • Increased threat of litigation though exhaustion doesn’t preclude prosecution
  • Spiralling workload and unreasonable demand
  • Reduced respect for clinical judgement; as the alternative is testing and referral, this threatens the financial viability of the NHS
  • Annual appraisal & revalidation process
  • Lack of support for business/commissioning processes
  • Yearly reduction in pay and resources
  • Reduction in pension and increase in retirement age (incidentally is it really wise to push a clinician with potentially declining mental faculties to play Russian roulette with people’s health?)
  • No occupational health service
  • Rising divorce, alcoholism, mental health, suicide & drug misuse rates

What Have Been Your Goals for the Past Year:

  • Survival
What Are Your Goals for Next year:
  • Foster resilience within Primary Care
  • To engage secondary care so that we can work together
  • Engage the public to take control of their own health. (That Holy Grail of self-care)
  • Redress the wants versus needs culture
So Whitehall, we’ve completed our appraisal document, over to you.
Somehow you need to create a workforce of enthusiastic, willing doctors who are prepared to keep polishing the jewel in the NHS crown, not a bunch of beleaguered, vilified, despondent scapegoats who are looking for the closest exit.
It’s about time we all stood together as a workforce to say “enough is enough”.
You can’t ignore the elephant in the room any longer. We ARE exhausted, drowning and furious, but we haven’t given up yet because for most of us, being a doctor is vocational.
We are proud of General Practice and of looking after our patients to the best of our ability.
We want to see Primary Care survive, not thrown to private providers to tear it limb from limb, leaving a rotting carcass behind.
It would be a betrayal of our professionalism if we did not make this clear to everyone – politicians, the public, and potential future GPs.
So, stop hiding behind the rhetoric and unfulfilled promises, we say again, what ARE you going to do about it?

Response to David Cameron 8-8 7/7 GP access pledge

Mr Cameron,

I listened with interest this morning to your political sound biting on your General Practice vision for 8-8 working, 7 days a week.

To be honest, we had been expecting this baloney for some months as your pilots for the scheme draw to a close. What’s more interesting, is that having pump primed these pilots with £50m (half of what you are offering to roll it out across the country), they have failed to deliver the reductions in A&E attendance or quality as promised. More importantly, these beleaguered services actually struggled to find any GPs to provide the service, despite having big money to play with. Not surprisingly you brushed over the lack of evidence to show that these ill advised, vote winning policies actually brought benefit to a system that tries to match cost effectiveness against consumerist demand.

In your closing speech, you pledged more funds for the NHS. Let us remember, before the last election the Conservative party promised no reorganisation of the NHS. They failed to keep that promise. How can we be asked to believe that current election promises will be kept and where are all these GPs going to come from, to deliver this 24/7 service?

However, rather than try and argue those old chestnuts, perhaps we should just stick to the facts, although I appreciate politicians are not great fans of fact over fiction.
– The NHS costs £113bn per year
– Primary Care currently uses 8% of the budget – remember here please that we are constantly being slated for being unable to provide an effective and timely service, even with this percentage and we are consistently pressing for at least 10% of the budget to sustain current levels of service.
– However, using 8%, the Primary Care budget is in the order of £9bn per year
– GP practices currently open 8-6.30 5 days a week or 52.5hrs
– If practices opened 8-8 7 days a week this would be 84 hrs or a 60% increase in hours per week

You have pledged an extra £100m for this increase in hours. This equates to 1.1% increase in Primary Care funding for a 60% increase in workload.

Do the maths, as your advisors obviously can’t! Forget the rhetoric and the arguments about doctor salaries, this fairy tale is simply not deliverable.

Resilient GP

Dr Michelle Sinclair, GP Partner, Fleet, GU52 7US
Dr M Suresh, GP Principal, Woodsetton Medical Centre, B13 8QJ
Alexis Manning, Sessional GP, CF11 0SF
Nitika Silhi, Salaried GP, Lynwood Medical Centre, RM5 3QL
Mark McCartney, Locum GP, SE Cornwall, PL12 6UR
Dr M Suresh, GP Principal, Woodsetton Medical Centre, B13 8QJ
Dr Freda Bhatti, GP, The Hollies Surgery, The Green, Gt. Bentley, Colchester, Essex, CO78PJ
Dr David Shore, General Practitioner, Rugby, CV230LU
Iain Hotchkies, GP, Merseybank Surgery, M21 7NN
Siobhan Brennan, GP Partner, ordsall health, m5 3ph
RANJAN Pruthi, gp, phc mawney road, RM78NX
Dr O’Reilly, GP, Essex, Co78pj
Christopher Earnshaw, GP, Lever Chambers Centre for Health, BL11sq
Dr Hannah Gibbs, GP, St Paul’s Surgery, Winchester, SO22 5DD
Hala Atkin, GP, Green lane, Cv3 6ea
Hussain Gandhi, GP, Wellspring Surgery, Nottingham, ng2 7ep
Alexis Manning, Sessional GP, CF11 0SF
Dr Noim Amin, G.P, BR1 3DR
Prit Buttar, GP, Abingdon Surgery, OX14 3LB
Rachel Blackman, GP, Hartley Corner Surgery, Blackwater, GU46 7TJ
Rajesh Mahadevaiah, GP, Aylesham, CT3 3BB
Dr Howard Sunderland, GP Partner, Marple, Stockport, SK66AB
Dr Alan Woodall, GP Principal, Machynlleth, SY208EQ
Lorna Macgregor, GP, NHS Highland, PA318AE
Dr James Higgin, GP Principal, Downlands Medical Centre, BN26 6AE
Bastiaan Kole, Free Lance GP, Fulham, SW6 4HS
Dr Pamini Ledchumykanthan, Sessional GP, Shepherds Bush, W12
Vic Sivanesan, GP, Mansell Road Practice, UB69EN
Dr Natasha Collins, GP Partner, St Lukes Surgery, np11 5GX
Dr Alasdair Gallagher, GP, Oakley Medical Practice, Leeds, LS11 5HT
Shivani Vinayak, Gp, Ne31 1nu
Nicola Waldman, Gp principal, Merton medical Practice, London, SW19 1DG
Rhianna McClymont, GP, London, NW62HJ
Dr R Adam, GP, Hounslow, Tw135jg
Lynette Saunders, Salaried GP, Wantage, Oxfordshire, Ox12
Dr Rachel Ali, GP Registrar, Plymouth, pl4 6px
Catherine Jones, GP, Lighthouse Practice, Eastbourne, Bn21 4hy
Sukhdip Jhaj, GP, Silsden and Steeton Medical Practice, BD20 0DG
Dr Lynette Saunders, Salaries GP, Wantage, Oxfordshire, OX12
Sagar dhanani, GP HILLINGDON, Ub77dp
Ross wentworth, GP, Poplars medical centre swinton, m27 0na
Alixe Thiagarasah, GP, N211rn
Dr Murali Nair
Samir Dawlatly, GP, Jiggins Lane Medical Centre, B32 3LE
Dave Jones, GP, locum, M32 9AE
Alison Lawton, Salaried GP, Park View Medical Centre, Long Eaton, NG10 3RJ
Rob Mawdsley, Dr, Bridge of Earn, PH2 0PQ
Thirza Deboo, GP, Marlborough, Sn8 4by
Rebecca Gidley, Salaried GP, E1 0LS
Alexandra Taylor, GP, Chatfield healthcare, Sw113uj
Dr Ashley Southall, GP Partner, Larksfield Surgery, SG5 4HB
Dr Tom Hodges-Hoyland, GP Partner, Ashgrove Surgery, CF37 2DR
Dr Sophia Galloway, GP, Steyning Health Centre, West Sussex, BN3 5ND
Katherine Robertson, GP, Colinton surgery, Eh13 0LB
Lenin Vellaturi, ST4 4QF
Dr Helen Phillips, GP, Burney Street Practice, SE10 8EX
Yusuf Rajbee, GP partner, Portland Medical Centre, Se25 4qb
Mei-Ling Lancashire, GP, Surrey, GU15
Clare Dyer, GP, Baldwins lane, WD3 3LG
Naylea Choudry, GP partner, Darwen health centre, Bb3 1py
Robert Hegedus, GP Partner, Builth Wells, SA200YW
Dr Tabassum Ahmed, GP, Arnos Grove Medical Centre, N11 1BD
AMIT TIWARI, GP, MERSEA ISLAND SURGERY, CO5 8RA
Dr Nikki Prasad, GP, Ch medical, fields new road, West Didsbury, M202ED
Dr Shama Shaid, General Practitioner, Hemel Hempstead, Hp12ld
A.Butt, GP, Sw4
Dr Tom Caldwell, GP Partner, Thorneloe Lodge Surgery, WR1 1RU
Seema Haider, GP, Haiderian Medical Centre, Rm142yn
Anna Morris, GP, Orchard Medical Practice, LE9 6RG
Monah Mansoori, GP, TW1 2JU
Dr Dax Tennant, GP Partner, Polegate, BN245FH
Jonathan Ferdinand, General Practitioner, Wickhambrook Surgery, Suffolk, CB8 8XU
Sarah Worboys, GP, Nw52be
Dr Donagh O’Riordan, Consultant Physician, Colchester General Hospital, Colchester, Essex, CO4
Rajeev Kanwar, gp, kineton, cv47 2qa
Yogasakaran Arjuna, GP Principle, The Woodberry Practice, N21 3LE
Dr Victoria Ingham, Salaried Gp, Hawthorn medical centre, Swindon, Sn2 1uu
Dr Asha Pillai, GP Partner, Surrey, KT12 4HT
Dr Ben Williams, GP, Poplars Medical Centre Swinton, M270NA
Jeremy Goad, GP Partner, Victoria Practice, Aldershot, GU11 1AY
Russell Brown, GP, Manor Park Medical Centre, BN26 5DJ
Anna Martin, GP, Queens Walk, W10 6HT
Graham hoggard, Pharmacist, Barnsley, S71 3qw
Dr David Barrett, GP Partner, The Old School Surgery, LE9 4LJ
Dr Alistair Richardson, GP, The village practice, N7 5JJ
Nadim Azar, GP, The Glebe Practice, LN1 2NU
Dr John G Hughes, GP, M25 9GD
Dr Nasir Nabi, GP Trainer, Walker Medical Group, NE6 3BS
Damian Fogarty, Consultant Nephrologist, Belfast Health & Social Care Trust, BT9 7AB
Alison Johnston, GP, Ulverston Health Centre, LA12 7BT
Jonathan Harte, GP, Aspley Medical Centre, NG8 5RU
Kamal Sidhu, GP, Durham, TS27 4LQ
Danielle Hann, GP partner, BD12 9NG
SIMIONESCU OZANA MARIA, THE POPLARS MEDICAL CENTRE, M27 0NA
David McLees, GP, Wallace House, SG14 1HZ
C Patel, GP, London, sw66hx
Zoe Neill, GP (soon to be ex) principal, Gibson Lane Practice, HG2 9PE
Stewart Rutherfurd, General Practitioner, Morrab Surgery, Penzance, TR18 4EL
Ruth Spencer, GP, 55 Hunter St, G4 0UP
Dr Amy Banks, GP, N1
Colin Brunt, gp, poplars medical centre, m27 0na
Dr Paul Evans, GP Locum, North East England, DH1 4BE
Ian Davis, GP, Cirencester, gl77ey
Dr Michael Weymar, GP, Overseas
Leena Menon, GP partner, Courthouse Medical Centre Caerphilly, CF83 8 NJ
Teresa Tang, Villa Street Medical Centre, SE17 2EL
Deborah Webb, GP, The Old School Surgery, Le9 4lh
Lisa Griffiths-Brown, GP, South Wigston, LE18 4SE
Catherine Lewis, GP Registrar, Hounslow, TW1 2AU
Dr Kirsty Shepherd, GP, Thw Wychwood Surgery, Shipton under Wychwood, GL7 3PH
Ruth Marchant, GP, manorbrook medical center, SE3 0EN
Dr.Brenda Moran, Salaried GP, Herne Hill Group Practice, SE24 9QP
Dr RJ Pinto-Wright, GP Partner, Ambrose Avenue Group Practice, CO3 4LN
Karuna Sharma, GP, Richmond Surgery, Richmond Close, Fleet, GU52 7US
William Gordon-Wright, GP, Horsham, DT6 6DA
Dr Sharif Hossain, GP Principal, Highcliffe Medical Practice, Higham, ME3 7DB
Dr P Bradbury, GP, Walkley House medical centre, S8 0BY
Justin Ilott, gp partner, courthouse carphilly, cf83 3gh
Dr Bunmi Adeniji, GP, Windhill Green Medical Centre, Shipley, West Yorkshire, BD18 1QB
Dr Robert J White, GP, Westfield Surgery, TN35 4QE
Dr Tom Caldwell, WR37JW
Dr Paul Fitzgerald, GP, Minster Medical Practice, LN2 2JP
Tesan Hadzikadunic, Cv34 6fs, United Kingdom
Stephanie De Giorgio, GP Principal, Cedars Surgery, Deal, CT14 7DN, United Kingdom
Carol Millington, M276HG, United Kingdom
Eilish Davoren, DT6 5FD, United Kingdom
Ian Bruce, G41 2AF, United Kingdom
Nick Beedie, M47aj, United Kingdom
Siobhan Stapleton, GP Partner, Mansell Road Practice, UB6 9EN
Sharon Swallow, Post Grad Law student, Former Hospital senior manager, UB8 3DS

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