All posts by michelle sinclair

Priorities & Pedicures

I’m a part time GP and full time mum to a 2 and a 3 year old. Last night the 2 year old kept me up most of the night – that’s parenthood, and I was just grateful that today was one of my days ‘off’. Since she decided to catch up on her Zzz’s in the buggy on the nursery run I decided to treat myself to a brief moment of relaxation and a pedicure.

Half way through another customer walked into the shop. A woman in her 50s, very overweight with the unmistakable growl of a heavy smoker. She wanted a mani and pedi. It’s a Friday so they are busy and explain she will have to wait. “Oh” she says, “I’ve got a GP appointment in an hour” the technician shrugs, all the staff are busy, she’ll have to come back another time. “Alright” says the customer, “I’ll get the doctor to ring me instead. I mean she rang me last night already, but it was 7.30, who wants to answer a call from the doctor at that time?”. I watched aghast as she rang the surgery and claimed she couldn’t get out the house this morning and could the doctor ring her instead.

Five minutes later I watched as she reached in her handbag for a salbutamol inhaler. “That doctor hasn’t given me the antihistamines I asked for a week ago” she told her neighbour with a put-upon sign. “Two days I’ve been without them! I can hardly breath! It’s not good enough.”

So I sat, lip firmly buttoned, I’m not in the mood for another debate, I have enough of those at work. I thought about that GP, making phone calls late into the evening. I wondered if she had worked the 12 or 13 hour day many of us now consider standard. I wondered how many patients she had seen to face that day, 30? 40? 50? How many phone calls? How many lab reports? How many letters from hospital colleagues to read and action? I wondered if she had slept well last night. Had she laid awake struggling to unwind from the stresses of the day? Did she worry that the work load meant she couldn’t do her job as well as she wanted, couldn’t do what was needed for her sickest patients? Did she fret that so many decisions made in one day made mistakes inevitable? Did she pray that she hadn’t made a mistake which harmed a patient or left her open to complaints, litigation or even criminal charges? Did she continue working at home completing a portfolio of educational ‘evidence’ to ‘prove’ she is still fit to do her job year after year? Did she see her kids that night? Did she wonder where those headlines about super-rich GPs come from when her salary seems to pay for her childcare and not a lot else? Did she wonder if her physical and mental health could survive working at this pace for the 30 odd years until retirement? I know I do.

As GPs we have become used to being undervalued by government and bashed by the press. We know the headlines about £100k salaries and 9-5 working are nonsense, we know that primary care has been chronically underfunded and over recent months we have done a better job of getting this message across. At the end of the day very few of us do this job for the money, for an easy life, or for political ambition so we often fail to be our best advocates. Most of us do the job for the patients.

The patients. ‘Think of the patients’ the juniors are told when they dare to strike over imposition of an unsafe and unfair contract. ‘Think of the patients’ GPs are told as we are asked to open our doors seven days a week despite being stretched to breaking point already.

Well sitting next to me was one of these patients. A patient who preferred to miss an appointment at the doctor than one at the spa. A patient who would happily pay £40 to get her nails done but wouldn’t dream of paying two quid for an over the counter antihistamine she was ‘entitled’ to on prescription. A patient who wants her doctor to call, but only at a time that suits HER (even though she can’t be bothered to keep her appointment). A patient who would rather have tablets and inhalers than pack in the fags to improve her own health. And perhaps worst of all, a patient who despite being called by her GP late in evening to help her with her health concerns doesn’t miss a beat in slagging off that same GP because she hasn’t got her tablets exactly when she wants them. I will accept that it unusual to witness this extreme level of selfishness and disrespect in a single patient, but I’m pretty sure that everything I have described above has been experienced by most GPs on a regular basis.

I am a fervent believer in the NHS. I consider it a privilege to work in a healthcare system that is the envy of much of the world for it’s quality and cost effectiveness. I believe in primary care as the cornerstone of our NHS. I have always argued passionately that primary care must remain free at point of delivery because, you guessed it, I’m thinking of the patients.

Today I was reminded that for too many patients a service with no charge is also perceived to have no value. Cancel your solicitor, accountant or hairdresser at short notice and expect to be charged, cancel your GP in favour of a manicure and then complain that they haven’t made you better! Ha!

All the while the GPs are seeing more patients than ever before, patients who are more complex and more demanding by the day. They are working longer hours, shouldering greater risks, earning less money and facing ever greater challenges to keep their practices afloat. In doing so these GPs are propping up a system on it’s knees. A system broken by underinvestment and constant use as a political football, and now damaged further still by a government and right wing press that stoke ever greater patient expectation and demand, whilst failing to provide the funding to meet it. It’s almost as though they want the whole thing to crumble….

Today I’m not thinking of the patients, I’m thinking of those doctors exhausted, stressed, anxious, overburdened and ploughing through the endless 10 minute consultations on this sunny day. I’m wondering how long they can keep primary care afloat for the sake of the patients. I’m wondering how long they should.

Dr Laura S

Open letter from Grassroots GPs to Junior Doctors

AN OPEN LETTER FROM UK GRASSROOTS GPs TO JUNIOR DOCTORS
5th November, 2015
Dear Colleagues,
We are writing to you as your trainers, colleagues, former junior doctors and most importantly as your GPs to express our support at this testing time. We have been watching the events unfurl in the Junior Contract debate and have been appalled by the misuse of statistics, untruths and spin being uttered by the government about this unfair, unsafe new contract and the refusal of the Secretary of State to return to the negotiating table without pre-conditions.
Junior doctors work very hard. We have all been Junior Doctors at various times over the past 30-plus years, and consequently we know how unsafe working once was. The Government is refusing to negotiate on vital safeguards; putting patients and staff at risk and now suggesting that the CQC should be put in charge of hospitals adhering to their agreed working times. A somewhat misguided plan would be a charitable interpretation of this move.
The training you need to become the GPs of the future will be threatened by this contract.

General Practice benefits from the wealth of experience you have and will most effect:

• Those who may transfer over from other specialities to join General Practice.
• Those of you who wish to spend time doing research.
• Those of you who wish to take time out to have children.

This life, clinical and academic experience should be welcomed and encouraged, not
undervalued and underfunded. Although there have been reassurances that the GP supplement will not be removed, we are uncertain as to the validity of this reassurance until proper negotiation can take place without preconditions. Mr Hunt’s new offer via the media yesterday does not reassure us.

We know you work long hours and anti-social shifts that affect your lives, your relationships and your families. We know when you are not at work, you are studying for exams and attending courses. We know you do this for a fraction of the income the public believes you earn. Strike action may compromise care in the short-term, but we firmly believe the long-term effects of this ill-conceived contract are far more damaging. As GPs, we will try to support you through the stress that this contract change is having on you all as individuals. Please talk to your clinical supervisor or registered GP if things become too much.

We will support whatever decision you make.

Signed on behalf of UK GPs by the Committee of GP Survival,  the Committee of
Tiko’s GP Group and the Partners of Resilient GP

“Illness is rarely convenient”

Letter to the Editor

Dear Sir,

http://www.telegraph.co.uk/news/nhs/11686981/Patients-deserve-a-better-deal-from-their-GPs.html

“Illness is rarely convenient.”

How very true. Acute illness can strike at any time, so thank goodness we have the NHS, which incidentally was set up to provide 24/7 emergency care, not 24/7 routine care.

“When it does, people often find that they have to take a day off work to seek treatment, which reduces productivity.”

I ask you, if someone is acutely unwell, is it unreasonable to allow them a day off to attend a doctor? I’m not entirely sure ‘productivity’ is high on their agenda.

Your argument here is that when people are unwell, they should be able to access a doctor; they already can, it’s called the Out of Hours service (OOH) and has been in existence long before the 2004 contract changes. Incidentally, the 2004 contract took away the obligation for GPs to make arrangements for that OOH cover, the cover itself was already in existence and did not change. The OOH service is available for anyone who is ill or needs advice via the national 111 service. Patients can access telephone advice, face to face appointments and visits, 7 days a week, when GP surgeries are closed.

The Conservative clamouring for 7/7 opening is to enable a select group of the population to access their routine medical care at weekends and in the evenings. Whilst it may be a wonderful utopia, there is a woeful lack of funding or workforce to enable this pipe dream.

General Practice already sees 90% of NHS consultations with only 8.5% of the budget. From a funding perspective, Primary Care provision would need to be increased to at least 11% of the NHS budget in order for this 7/7 opening to occur and this doesn’t take workforce requirements into account. The risible extra non-recurrent funding thus far discussed by the government is a mere sticking plaster to that really required.

The normal output of GP training schemes is about 1K per year. If Hunt wishes to increase the workforce by 5K, he needs to double GP training output, every year, for the rest of this parliament. He starts with 30% vacancies and no funding for expansion, a tall order I think you will agree, especially with the hordes of GPs who are already planning to retire early or emigrate because they are sick to death of your type of misleading, inaccurate reporting.

Much like your comment,

“Historic spike in the use of A&E departments can be directly linked to the GP contracts drawn up by labour in 2004.”

I draw your attention to this article by John Appleby Health Economist:

http://www.kingsfund.org.uk/blog/2013/04/are-accident-and-emergency-attendances-increasing

In light of your article, I feel compelled to cite the new IPSO standards which state (clause 1a) that articles must be accurate and not misleading and thus ResilientGP demands a print correction and apology to our GP colleagues as per Clause 1b and for it to be given due prominence.

Yours faithfully

Dr Michelle Sinclair
Partner ResilientGP

The Cat is Out of the Bag

Well the cat is really out of the bag this week; not one, but two ‘elephants in the room’ that many of our leaders are just too afraid to address.

Cat walks out of the bag

First of all we had Zoe Norris incensed by yet more “useless, fat cat GP” rhetoric, and then in the wake of the “Christmas 4 day break” A&E/OOH apocalypse, we had a superb blog by Prit Buttar on the access/demand issue.

What still amazes me, especially given the Twitterfest that ensued, is why addressing demand is seen by some as being so recalcitrant.

Appropriate use of resource is now part of our everyday life; we are encouraged to recycle at every turn, we are exhorted to reduce our carbon emissions, protect our rain forests and limit our consumption of fossil fuels. We have publicity campaigns to ‘switch it off’ for electricity, and ‘turn it off’ for water. The police judiciously remind us that unless we use their services wisely, they will not be free to respond when we really do need them. So why is healthcare so different?

“Free at the point of access” is the tenet of the NHS, but of course it isn’t really free; like any other commodity, it is paid for one way or another; unless people are prepared for more public money to be put into the NHS pot, we have to learn to use the budget wisely. There is no ‘magic porridge pot’ of health provision, somehow we’ve got to work with what we’ve got.

To our detractors, on the subject of GP pay, I say this. Any system that provides 90% of the activity for 9% of the budget is good value. Forget about individual pay, General Practice is a slick business system that represents huge value for money for the UK taxpayer. To those that complain about the fact that we are better paid than most of our European colleagues, I say, do you understand the complexities of the Primary Care role in the UK compared to that on the continent, where people only go to see a GP if they have a ‘simple’ self-limiting illness?

To those that complain that access is not adequate and that we should be open all day, all evening, 7 days a week, I say ok, so how are you going to pay for it? Unless the GP budget is doubled, we can’t provide the same service 24/7. And if the appointment isn’t available for you to access for your cancer diagnosis or if Granny is left waiting for 12 hours, struggling to breathe because the system is buckling under the weight of demand from people who have forgotten to order their oral contraceptive along with the Christmas Turkey are you going to be happy with that?

I actually embrace patient involvement in service provision. Believe it or not, it’s easier for me to say “Ok, you choose. Do you want cereal or toast, you can’t have both?”

For anyone that knows me, or has read my blogs, you will know that I am an upbeat, happy soul. Crazy though it seems, I really did go into medicine to help people rather than make money though I could have quite easily chosen a more lucrative career.
Stranger still, despite the constant barrage from the politicians and the media, I still enjoy my job. There I’ve said it, I still like being a doctor and helping my patients. Unfortunately, a lot of my colleagues are not so blessed with naturally high serotonin levels and are emigrating or retiring in droves and I cannot tell you how many are simply looking for a different career path.

A welcome and timely article was printed in The Sunday Times only this morning, by Professor Angus Wallace, on the looming crisis.

The trouble is, this isn’t what we signed up to. Across the land, in GP surgeries and hospitals, Doctors are collapsing under the weight of criticism & burgeoning workload. This isn’t a General Practice crisis, this is an NHS crisis.

We’ve tried to ration the services, to spread the jam as thinly as possible, to try to keep the system afloat but, now it’s time for patients to take some responsibility for their NHS and learn to use it wisely & considerately, before it’s too late.

A Deafening Silence Waiting to be Broken

I read with disappointment the downright malicious article written in the Daily Mail by J Meirion Thomas.

In many ways it reminds me of something we are more used to Nick Griffin spouting than an esteemed and highly educated colleague (it is interesting that NG came out on twitter to defend JMT – who needs enemies when you have friends like him!).

I sat down to write some cathartic reparté on behalf of my entire GP fraternity when I realised that mine is not the voice we should all be hearing.

This, therefore, is a challenge to all the ‘Powers That Be’ to do the right thing and publicly sanction JMT. Their inaction would be yet another example of their indifference to the public denigration of our hard work and very existence that appears in the media on a daily basis.

To the GMC……

JMT is clearly in breach of the ‘Duties of a Doctor’. This article is a brazen challenge to your authority and (in) ability to act. The GMC receives the bulk of its funding via GPs (40000 GPs paying £400 per year) and is duty bound to not just put out a statement condemning JMT but owes it to its members to act in a show of strength and support. Do your job.

RCS and RCGP……

I don’t know how these two organisations would choose to respond to such hate. However, the RCS should be feeling very, very uncomfortable about their colleague essentially upsetting every doctor in the UK who is female, non UK in origin and now also GPs. Anything other than condemnation in the strongest strength fundamentally undermines the ‘linear integrated primary / secondary care’ approach the next five years is meant to bring. Dr Maureen Baker – this is your MTAS moment, a failure to act will set college relationships back a decade.

Mr Hunt……

I laugh at him even bothering to comment. However, his views would be facinating!!!

The NHS trust and the Private Hospitals (x 3) that he works at…….

Your patients all come via their GP. You rely on positive working relationships with all of these individuals to provide the level of care that we all aspire to. It is the community teams we lead that gets a patient home and appropriately supported, to try and avoid bed blocking, our admission avoidance efforts that stops you breaching all of your targets. Is this mouthpiece someone you want to be representating your organisation? A lack of response would suggest you think he is, or you just don’t care.

The BMA/Londonwide LMC….. I would suggest you send copies of this and JMTs other article in the Daily Mail about Female Doctors to every one of your member practices, stand back and wait to see what happens.

Ben Davies

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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