State of Care | Care Quality Commission

At long last the Care Quality Commission (CQC) is speaking out about the state of care in the UK and especially the crisis in Social Care, which justifies the need for the petition I created, Solve the crisis in Social Care, https://you.38degrees.org.uk/petitions/solve-the-crisis-in-social-care.

By signing and sharing the petition it will add more weight to the CQC report.

I have also put together further information, should you wish to see it, being Solve the crisis in Social Care more information

 

 

 

 

 

 

Source: State of Care | Care Quality Commission

Solving the crisis in Social Care

Social Care is just as important as Health Care, but does not receive the support is should do.

With this in mind please could I mention that the forthcoming Budget is an important opportunity to address the crucial issue of funding for Social Care, but will it.

Boris has promised, but will he keep his promise and even if money is made available will it be sufficient.

Boris has now mentioned it will take 5 years to get the funding, Social Care can not wait that long.

Boris needs to be told this is not good enough, so it is essential we keep the pressure on Boris and my petition ‘Solve the crisis in Social Care could be the means.

Please see below

We now have the New Year 2020.

However, if the ‘Crisis in Social Care’ is not Solved soon there will not be many more New Years for the care, required for persons in need of care, to be provided by Local Authorities due to their lack of funding. This will then have a much greater impact on health care provision, which is itself in crisis.

I have therefore created my latest petition, please follow the link

https://you.38degrees.org.uk/petitions/solve-the-crisis-in-social-care

For more information please follow the link

https://www.dropbox.com/s/w0f2skyxy37udqb/Solve%20the%20crisis%20in%20Social%20Care.docx?dl=0

This Petition needs You, please sign to show your support for you will not know when you or someone in your family will need social care.

Social Care in Crisis

Due to years of austerity cuts to Local Authorities, these authorities are having to spread more thinly, each year the amount of money they have all over the many areas of their responsibilities and Social Care is one of those areas.

But each year with an aging population and more persons with disabilities living longer, the people needing Social Care is increasing while the money available to help care for these needs is reducing.

In addition there is an increasing need for employed carers to provide the care the people with these needs require. But there is a shortage of people wishing to come into care and why is this?

The rate of pay within the care industry is abysmal for most employed carers receive a wage based on the *National Living Wage, currently £7.83, which will increase to £8.21 on the first of April 2019.

While the Living Wage is £9.00.

Being an employed carer is more than, cleansing, washing, dressing and meal preparation, as they are, in many instances, one of the few people that the people with care needs see.

Also there could be instances where the employed carer needs to deal with financial responsibilities, provide emotional support, manage prescriptions and administer medication, monitor Safeguarding and many more areas of responsibility and paying just the National Living Wage is not sufficient to cover all these responsibilities.

It is therefore, that the Living Wage would be more near a level to pay, but Local Authorities do not have the finance to pay this, currently and therefore this current Government needs to take this on board and increase the funding to Local Authorities.

With this in mind, FLASh (Families Lobbying and Advising Sheffield) have created an EPetition, Pay All Employed Carers the Living Wage.

Please see the following

flash logo.jpg 2

 

FLASh (Families Lobbying & Advising Sheffield) are concerned about the continuance of Social Care within the UK.

The Care Industry is in a state of crisis as there is insufficient funding from Local Authorities to Care Service Providers to pay the carers they employ a wage of sufficient amount for the work these carers are required to provide which matches the responsibilities they have to undertake to the persons to whom they are providing care to.

These Local Authorities have, for many years, under this current Tory Government, been subjected to austerity cuts to the funding they receive from this Government, which impacts on the money these authorities have available to provide this funding.

Therefore, FLASh have created an EPetition ‘Pay all employed Carers the Living Wage.

Please view this EPetition and seriously consider signing the EPetition and then verify your signature though the link provided in the email you will receive. Until your signature is verified your signature will not be activated.

The EPetition ‘Pay all employed Carers the Living Wage’ can be accessed here.

Should you be unable to view the EPetition, please copy and paste the following; https://petition.parliament.uk/petitions/236151 into your browser.

Once you have verified your signature please could you share this EPetition with your colleagues, friends and any other connections.

Please also forward to your MP and your Local Councillors.

Thank you for your support.

 

If you wish to know more about FLASh a link to their website is here. If you are a family carer in Sheffield for someone with a Learning Disability or Autism and you wish to become a member of FLASh and/or attend the monthly meetings please advise your email address to flashld575@gmail.com

Chris Sterry, Vice-chair of FLASh issues his own Newsletter, on at least a monthly basis. To receive this Newsletter on a regular basis please email Chris on ldcarersbuttygroup@gmail.com and a copy of the Newsletter can be accessed here.

 

 

 

* Contains public sector information licensed under the Open Government Licence v3.0.

How Carer Voice was Started

3 Family Carers of relatives with Learning Disabilities and/or Autism (Chris Sterry, Judith Gwynn and Kate Chapman) started working together with a PHd student (Rachael A Black) at the University of Sheffield (Department of Human Communication Sciences) using the framework of Co-production. This was initially to provide research for Rachael’s thesis required for her PHd, but also to have a meaningful outcome for LD Carers within Sheffield, UK

At the start of this co-production Rachael enquired through Sheffield Mencap & Gateway for carers of persons with Learning Disabilities to work with her on her PHd project. During the last 18 months we have had regular meetings at the University of Sheffield on how we would proceed with this project and what our initial outcomes would be. Initially through general discussions, which Rachael was recording, it became clear that the recurring situations was around carers communications with the range of Service Providers. Within the context of Service Providers it included Sheffield Adult Social Care through Sheffield City Council, various health providers ( being GPs, Sheffield Teaching Hospitals, Community Health, and many other health areas) together with the independent Care Providers including charities, voluntary and private independent providers.

So that we were not restricted around our own views we decided to create 2 surveys, 1 to be completed by LD carers reflecting on their interactions with Service Providers and the other survey to be completed by Service Providers reflecting on their interactions with LD Carers. The surveys were created on Survey Monkey and during their creation we had a number of meeting to discuss how these were to be formed, the number of questions to be included and the specific questions. When we were all satisfied with both surveys they went live on Survey Monkey and electronic links were disseminated through our various range of contacts within Sheffield, UK.

We also discussed how we wished to to use the information from these surveys in addition to the original outcome for Rachael’s thesis. and decided we would wish to do this in a form of a presentation. We looked at possible dates and venues and obtained costings and also viewed each venue and then using co-production decided which venue to book and how we would advertise the event and provide a means for LD Carers and Service Providers to book to attend the event, which we did through Eventbrite and agreed on a format for a flyer and a website (Carer Voice) and the event title being Carer Voice Working Together.

Working Together Event Presentation 2017

 

Carer Voice ‘Working Together’, The Presenters from left to right, Chris Sterry, Judith Gwynn, Rachael A Black and Kate Chapman
Carer Voice ‘Working Together’, Presenter Rachael A Black Stating the Principles of Co-production
Carer Voice ‘Working Together’ Carers and Service Providers working together
Carer Voice ‘Working Together’ Presenter Judith Gwynn answering questions at the end of the Presentation
Carer Voice ‘Working Together’ Presenter Kate Chapman answering questions

Carer Voice Final Notes

Thank you for coming today and now you have seen the presentation and been involved in the workshops in which carers and service providers have worked together. This is how it should be for we are all here for the same reason, to ensure vulnerable persons, be they be our relatives or not, have provision to ensure their needs are met and they can then led their own lives.

Communication is but one key, but an extremely important key and without it all that is there can fail.

With this in mind I facilitate a support group LD Carers Butty Group, also known as Central group or Butty Group, where there is also a website LD Carers Butty Group and a mailing/distribution list. There are other support groups and details of these can be obtained from the Carers Centre and from Cathy and Kirsty from Sheffield Mencap & Gateway (Sharing Caring Project).

If you wish to be included in the mailing/distribution list please advise your email address. While this was produced with carers in mind, it does not mean that service providers cannot be included. Information sent will include areas relating to disability both local and national as well as notes for the support meetings.

Lunch is now ready and there are some leaflets from a selection of providers please view and take away and continue to network throughout lunch.

Do not forget to put on a post it the message you are taking away from this event and an evaluation form will be emailed to you, please return with your comments.

Our thanks to

University of Sheffield, Department of Human Communication Sciences for funding the event

Sheffield Central Fire Station for the room

Healthwatch Sheffield for the pens

Carer Voice ‘Working Together’, Chris Sterry giving the closing statement

 

After the Carer Voice : Working Together event we sent the following email to everyone who attended the event and also to those persons who could not attend but did express an interest in the event.

“We just wanted to get in touch to give you an update on the work we are doing following the Working Together Event in October.

 As a group we have met once to go through the feedback and will be meeting again in December. Where we will start drafting some standards and guidelines for communication between family carers and providers of service based on the information you gave us.  

 In early 2018 we will email these to you for your feedback. If you would not like to receive these emails then please do let me know and I will remove your name form the mailing list.

 We are also planning to pull together a small working group in the New Year to ensure the standards are accessible and practical. If you would be interested in being in this group, please do let us know. It will consist of 2 to 3 meetings at the University of Sheffield.

 Please also find attached some information about care workers in the independent and charity sector and the flu vaccine which we hope will be of use to you.

If you would be interested in receiving a copy of the presentation we gave on the day please do get in touch and I will send this to you.

Many thanks

Rachael and Carer Voice”

Flu Vaccine for Care Workers

Supporting People with Learning Disabilities get Flu Injection

 

We have now met in December and have started drafting some standards and guidelines for communication between family carers and providers of services based on the information given to us during the Carer Voice : Working Together event.

The draft documents were produced.

So we could enage with service providers we held 3 meetings.

Intialy we met with  representatives of Sheffield Adult Social Carer and Sheffield City Council Commissioning who viewed the documents and made some comments regarding some minor alterations.

The second meeting was with some service care providers who also made some contructive comments.

The final meeting was with representatives of Sheffield Clinical Commissioning Group, who also welcomed the documents and wished to use these in conjunction the their ‘For Pete’s Sake’ campaign’ and offered us a 15 minute presentation slot in the Assistive Technology event on the 28 June 2018.

Chris gave the presentation at the event and it was very appreciated by the atendees.

The presentation can be viewed  here

 

 

Homecare costs outstrip funding from councils, says report – BBC News

Well, at long last home care is getting some coverage, for on the few occasions social care is mentioned it is usually only regarding care homes and the elderly. But Social Care is much more than that, for there is home care, respite, care, supported living, hospices and more and covers both children and adults.

Here we have home care, which as stated, is mostly paid for through local authorities (LAs) who obtain their funding from Government. However, LAs have suffered 10 years of austerity cuts and going on 2 years of increased costs from COVID and are still not being paid the equivalent to what they were being paid in 2010. So, there is major Government failings here.

Home carers are paid, mostly from £8.91 per hour,the National Living Wage to £9.50 per hour, the Real Living Wage. So, the Care Providers have to be paid much more so they can pay their care workers, which is why there are much higher rates mentioned in the article. For Care providers, have other expenses than just paying care workers, being, office expenses, administration staff salaries, training, recruitment, payroll costs, etc.

In the article it is stating that the pay rate needs to increase to £11.20 per hour, but this is the very bare minimum, but to have any real affect the rate needs to be increased to at least £14.00 per hour and more likely £15 per hour, to offset the rates at Amazon and some supermarkets.

Most people, even the Government class care work as unskilled when it is far from it, as to provide good quality care the care workers need to know who they are caring for, provide emotional support as well as personal care, respect the choices of the person being cared for and their property, be able to understand how to use all the equipment the care for person has, adjust the care to how the person being cared for is on any particular occasion, provide meals as wished for by the person being cared for, understand their medication and much more. So, depending on the person being cared for it is very skilled to provide good quality care. Therefore not everyone is capable of being a skilled care worker.

Due to the insufficient pay there are a vast number of vacancies in social care and to get anywhere near the numbers required the UK Immigration Policy has to be altered to enable more workers from out of the  UK to gain entry to work in the UK. and this needs to be done urgently.

So, much needs to be done in respect of social care in the UK and this starts with the Government

Source: Homecare costs outstrip funding from councils, says report – BBC News

Budget 2021: NHS in England to receive £5.9bn to cut waiting lists – BBC News

It is good to see more funding coming through for the NHS, whether it is fully sufficient is open to debate.

But, the other major problem is social care, where no funding is coming forward except the way insufficient amount announced earlier and even then the main focus is on the NHS and what is coming to social care is not immediate.

So again Social Care is forgotten about, when it should not be as it is as important as the NHS, if not more so and should been seen as such. Unfortunately no one appears to recognise the importance of social care and even if they do are not prepared to do anything about it.

But, to disregard social care is done at peril, not only for those who desperately have to rely on social care, but for every social care failure it rebounds two-fold on the NHS, for it further increases care inequalities, but also causes more reliance on the NHS.

So to ignore social care is in fact a very false economy factor, for to sufficiently fund social care will provide benefits, not only for those on social care, but will mean that health deteriorations will be much minimised and therefore save costs on the NHS.

Source: Budget 2021: NHS in England to receive £5.9bn to cut waiting lists – BBC News

‘Tsunami of unmet need’: Care watchdog contradicts government with dire NHS warning | The Independent

Everyone is now telling the Government they are wrong and wrong again, for during this COVID pandemic they have been wrong more than they have been right, for they have only been right once, that being the COVID vaccine programme. Even there, that success is beginning to wane, but this Government still clings to that one success as though they are scared to do differently.

But they need to think of those who are suffering and will continue to suffer due to their inactions.

All areas of care are suffering but social care much more than health, even though the suffering in health is considerable.

Both areas are suffering because of lack of investment, social care much more than health, while both are severely short of staff for in these areas there is insufficient workforce in the UK and more are desperately needed for out side the UK.

So there are a number of actions this Government needs to do, which includes

  • ensuring the COVID vaccination programme continues to be successful both 1st and 2nd vaccinations and also the booster
  • replace the new Minister for Vaccines and Public Health Maggie Throup MP with someone who is more capable
  • increase the investment in social care so that care workers receive a salary more inline with the responsibilities they undertake, around £14-£15 per hour
  • change UK Immigration Policy to allow more persons to enter to work as care workers in social care
  • look to provide a sick pay scheme for care workers
  • improve care workers terms and conditions of employment

Only then will social care be saved, for currently it is doomed to fail and then the pressures on the NHS would increase considerably so it too would fail.

By not looking to improve social care the Government is causing much unnecessary pain and suffering.

But their first actions need to bring back mandatory face coverings and social distancing and even consider making it compulsory for all eligible persons to have the COVID vaccinations, even the booster.

 

Source: ‘Tsunami of unmet need’: Care watchdog contradicts government with dire NHS warning | The Independent

Disabled Man Hopes To Challenge Benefit ‘Hospital Rule’

Another benefit rule which makes little sense for many reasons.

But one of the reasons it is there to offset double charging for while in hospital it is deemed that the hospital will provide all means of care so therefore there should be no costs for any other person to do so. However, this does not take in to account persons with Complex needs, whereby care needs to be provided by someone who really knows the person.

But is it really cost effective, as how many instances does this occur in, and in doing so is the cost of stopping the benefit and then recommencing more than paying the benefit double.

Then in this instance when the usual care is required in order to to stop suffering for the cared for person to be present, then it needs to be paid but there are no mechanisms to do so, so this requires and urgently requires a change in the payment rules. For it would not be cost effective and again no mechanism to do so for the hospital to take over payment to the carer.

What also needs to be considered as by not paying a carer what is the carer supposed to do, for they will most likely not be able to care for themselves without the payments and may need to start caring for another person and therefore not be available when the original person is eventually to be discharged from hospital. So then is the person discharged without suitable care being there, or not discharged thereby retaining a bed from being freed for another patient.

The common thought that care can be provided by anyone is is very misunderstood, for in most instances, if not all, it is not true, that is for good quality care to be provided. To get someone will take time and then to be well trained even more time, so discharge could be delayed for months.

Care is very skilled to do it correctly, again not fully realised if realised at all by many, especially the Government who make up all this ridiculous rules and regulations, without any consideration for the carers and those being cared for.

All this , also assumes that there are sufficient people available to do care which there is not again down to the Government in many ways, some which are

great insufficiency of investment in care

this also does not provide sufficient funding for a sufficient salary to be paid to the carer for providing care

lack of reasonable terms and conditions of employment for carers

restrictions in UK Immigration policies to allow more persons to enter the UK to be employed in the care profession

plus much more

Everything is against carers and care being provided of good quality and sufficient remuneration, so the care for are being abandoned by not only this Government all all previous Governments and this and those other Government should be ashamed and made accountable for their inactions with regards to care and allowing carers and the cared for to suffer.

Same Difference

A disabled man who had his welfare benefits paused when he spent more than 28 days in hospital, is hoping to challenge the rule in court.

Cameron Mitchell, 20, from Carlisle, cannot walk or speak, and has seizures. He spent 128 days at the Royal Victoria Infirmary.

Current rules mean he lost his payments while still needing carers, and he has applied for a judicial review.

The Department for Work and Pensions has been contacted for a comment.

‘Needs don’t change’

Mr Mitchell receives Personal Independence Payment (PIP) and his mother and carer – Nicola Clulow – receives a Carer’s Allowance.

Under current regulations, known as the “hospitalisation rule”, a person’s entitlement to their benefits is suspended if they have received care in hospital for more than 28 days.

Legal firm, Leigh Day, has applied for a judicial review – where a judge considers the lawfulness of a decision or…

View original post 165 more words

Covid cases Sheffield: Infection rate on the rise as Government dicusses ‘Plan B’ to tackle autumn infection spikes | The Star

Too much is not being done, as Plan B needs to be implemented now before the situation worsens any further. However, this Government are Ace at not doing and leaving plan to the last minute to implement, or more often than not well after than they should have.

Their only success was the COVID vaccination programme and now that appears to be failing, but this Government still looks at the success as the only way out. That is completely wrong as all measures have to be implemented, for only relying on one is a very false premise.

So with immediate effect they need to bring back mandatory wearing of face-masks and social distancing, maybe, even working from home.

Also sack the new Minister for Vaccines and Public Health Maggie Throup, MP as she appears to be worse than useless, unlike her predecessor, the former Minister for Vaccines and Public Health Nadhim Zahawi, MP.

What they can’t do is nothing, which they are doing currently, for if they had implemented actions, previously then, perhaps we would not be in this situation. The former is now with hindsight, but not now, so Plan B needs to be implemented immediately, so there is more to rely on than the vaccine and booster vaccination programme.

To not do so will see COVID continue to take off and the collapse of the NHS, as well as Social Care.

 

Source: Covid cases Sheffield: Infection rate on the rise as Government dicusses ‘Plan B’ to tackle autumn infection spikes | The Star

Covid: Bring back rules amid rising cases, urge NHS chiefs – BBC News

I completely disagree with the Government, but then when have I ever agreed.

But the proof is there for when has this Government been right over the last 2 years, well very little with exception to the COVID vaccine programme, which has said is no longer as successful as it was.

This is a Government of dither and mainly due to the view of the current Prime Minister, Boris Johnson, MP that he does not wish to place restrictions on the population of England. But, in doing so, he is playing with the lives of people in England. This is wrong, as when he does eventually change his mind, which he does with regularity, it is way too late, too late which means the many losses of lives and very much suffering on the people of England.

If he can’t manage effectively then it is well time for him to go and the sooner the better.

The case of Social Care is another good example, but here he is not alone with dithering for many Prime Ministers before him are just as guilty if not even more so. Actions need to be swift, rather than not as by waiting many hours, minutes and seconds are lost, leading to days, weeks, month and very many years , creating years of neglect, much suffering, loss of lives and very much increased demand on our NHS, which, itself is in great danger of becoming unstable.

This is seen very clearly by many in the NHS and while they have been very supportive of the NHS, many have now had enough, especially with COVID adding greatly to the stresses, of working extremely long periods and being virtually ignored by successive Governments. Funding has been insufficient, although not nearly as insufficient as that with Social Care, which is very much bordering on criminality of much neglect and great abandonment.

Actions are required not in the future but now as the inactions are causing many safeguarding issues with neglect being one.

Source: Covid: Bring back rules amid rising cases, urge NHS chiefs – BBC News

Covid: Bring back rules amid rising cases, urge NHS chiefs – BBC News

I agree with the NHS Confederation that face-masks should be immediately reintroduced to indoor settings and I also feel social distancing be reintroduced for neither of them should have been withdrawn.

Once again this Government is dithering in COVID requirements, as nothing been learned over the last 18 months. Too much is being relied upon with the vaccine programme, which itself is beginning to wane.

All this dithering and uncertainty of this Government is leading to more of the population of England to believe COVID as gone, which it certainly has not.

If we are to avoid any more lockdowns then face-masks and social distancing has to be reintroduced on a mandatory basis.

Also this Government has to learn from its past mistakes and not to ‘put all its eggs into one basket’.

 

 

 

Source: Covid: Bring back rules amid rising cases, urge NHS chiefs – BBC News

GPs complain of ‘malicious criticism’ over plan to increase face-to-face appointments

I  believe there is misinformation and lack of understanding on all sides, being doctors, Government and patients and no one is listening to the others.

For GPs to say patients are not wanting face to face is far from what I hear, as this is leading to many misdiagnosis leading to some deaths and much suffering on patients.

Some telephone appointments are better than face to face, but many patients are not even being given a choice. There is talk of some patients being given video links, but certainly not at my practice.

But the Government is not listening as they are totally blaming GPs which is not right for much of the problem is serious lack of funding by Governments over the years.

Then patients are not seeing the true picture as they can’t believe the information coming from GPs and certainly the Government.

So it is not just down to money for there is  a serious lack of trust from and by all parties, so trust has to be gained and then also have the required investment. For trust there has to be total transparency and this is down to Government and GPs, which I can’t see coming from either side.

But it is not all down to health funding, but also a greater need for substantial funding in Social Care, which could even be a greater issue than funding for health and even a greater need on Government to fully understand all the issues in Social Care, which they are totally unwilling to do currently. For even when the Government does mention Social Care, they only appear to believe this is for the elderly, when it is for all age areas from young children through all the years to the elderly.

By not dealing with Social Care issues the Government is putting much more pressures on health, which health could well do without.

So, on reflection the Government is the major cause of the problems, followed by GPs and then patients, but to solve all need to be on-board

 

 

Source: GPs complain of ‘malicious criticism’ over plan to increase face-to-face appointments

Minister invited 44 ‘leaders’ to care summit, but not one disabled people’s organisation – Disability News Service

Am I surprised at this, well the answer is no, for, really, I feel this Government does not care about persons with disabilities and just going through the motions of showing they do care and not even doing a good job of that.

But is it that they don;t really care or is it that the despise them, for the actions of governments, this one and those previously appear to do so and when looked at it is a reasonable conclusion to come to.

Just look at the history, created a welfare system that is not easy to obtain benefits from, unless you are criminally minded, the reason the Government states to make it difficult. But criminals always find a way, while those that deserve the benefits will more than likely not. For criminals are unscrupulous and real benefit claimants are not.

Not only are the benefit claim forms confusing, but the assessment process is weighed against claimants, with a fair number of benefit assessors purposely misrepresenting claimants and is some instances putting total untruths in the assessments.

Then we have the funding, which is totally inappropriate and is greatly less than required. But not only that as successive Governments have refused to do anything to make Social Care any better and when they do it is wholly insufficient, ‘way too little and way too late’.

When the banks were in crisis the Government came forward, but then they were benefiting their own, where with Social Care they are not, as the persons in the Government either do not need Social Care or if they do, can afford to pay for the care themselves, which the majority of the UK population can not.

 

Source: Minister invited 44 ‘leaders’ to care summit, but not one disabled people’s organisation – Disability News Service

Government’s “rescue package” will prompt more GPs to quit, leaders warn | The BMJ

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.

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

Source: Government’s “rescue package” will prompt more GPs to quit, leaders warn | The BMJ