GPs must not be allowed to hold patients to ransom over working hours – Jayne Dowle | Yorkshire Post

When starting out life in a workplace where possible, it is best to look at the prospective working hours as some jobs fit well with 9.00am to 5pm and other don’t.

But generally it is best to be flexible about the hours you work as sometimes flexibility will suit you and other times your employers, so flexibility works both ways.

However, with service professions not only is the flexibility with yourself and your employers, but also your customer base.

Whereas some professions can be viewed as Monday to Friday, while others being a 7 day service.

Office working could generally be seen as Monday to Friday but not always as sometimes Saturdays could be included but not Sundays.

But with hospitality, shops, care and health and others are generally looked upon as 7 day working with much flexible hours starting before 9am and finishing after 5pm.

Care is generally a 365 day service 24/7 and in many instances health also, especially hospitals, but also why not Community Health, including Primary Care (GPs). We can become ill at anytime and not between certain hours and care and health should be available as and when it is required.

So, GPs wishing to work only 5 days between 9am and 5pm is not providing the service which is required, how would people feel if hospitals where only a 5 day service between 9am to 5pm, not feasible as you can’t have inpatients being sent home for the weekend and only being readmitted between 9am and 5pm. The NHS needs to be a 365 day service 24/7 and not only hospitals, but every part of the NHS, with no exceptions. Remunerations needs to be a consideration and all persons in the NHS being remunerated accordingly. This is even more so in the care profession, which is, so sadly not remunerated so, as care workers are not seen as being important as they should be and are in urgent need of much greater remuneration, much more so than GPs.

Source: GPs must not be allowed to hold patients to ransom over working hours – Jayne Dowle | Yorkshire Post

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Huge rise in GP expenses could make some practices unviable within two years | The BMJ

It is well-known that the NHS is in crisis and little is being done to remedy it, lack of staff, abundance of patients, lack of funding and a major crisis in Social Care for similar reasons, but the Social Care crisis could be much more serious than that in the NHS. However, while the Government and all previous Government have been prepared to look at the NHS, but by doing so, they have in some respects added to the crisis, the Social care crisis is totally with the Governments due their  considerable inactions and apparent indifference to Social Care.

But, while Social Care is a major factor in the NHS, lets just look at Primary Care and GP practices.

I should mention that Dentistry is also a problem and could well be as bad, if not more so than GP practices for trying to find a NHS Dentist is like ‘looking for a needle in a Haystack’, which could well be so for GP practices if the problems can’t be sorted.

There is a major shortage of GPs and newly qualified doctors are reluctant to become GPs, in fact many, while qualifying in the UK, leave the UK when qualified. This is due to the finance of GP salaries and GP surgeries and the stresses caused within practices.

Trying to obtain GP appointment even virtually by telephone, let alone face to face are very difficult and this is causing a massing of patients for GPs attending A&E instead, causing even more lengthy delays in A&Es making it impossible to meet ‘targets’, especially the 4 hour wait and thereby creating problems for ambulances having to wait outside hospitals as they are unable to transfer their patients into A&E.

But GPs in short supply in GP practices are not the only problems as obtaining other staff are also problems, as there are insufficient receptionists, practice nurses and others. So major stresses for all concerned.

Then with practice expenses increasing, not only staff salaries, but there are also energy price increases and price increases for products used in the surgery, such as cleaning and PPE and others.

In fact, instead of stating the problems, it could be easier to state what is going right or not a problem.

Well, just the NHS, as with all the problems the NHS is still better than health services in other countries, especially as it is, mostly free at the point of delivery, with the exceptions of Dentists, Opticians and prescriptions, but they are still heavily subsidised.

The NHS was and still is a great concept and one that we need to maintain and have much less privatisation, which is creeping into the NHS.

But the Government, when we eventually have one, needs to sort out the finances, before the NHS and also Social Care disintegrates into nothing.

Source: Huge rise in GP expenses could make some practices unviable within two years | The BMJ

GPs offered teenage patients with learning disabilities ‘do not resuscitate’ orders | Daily Mail Online

This is disgraceful as DNRs should never be given without a persons or persons family authorisation and to even mention them is very insensitive.. The GPs who did mention the DNRs should be ashamed because I believe it goes against their code of ethics for I doubt it is not what they mention to all their patients.

The MPS are right the DNRs should be withdrawn, but wrong to say by the end of the year for they should be withdrawn immediately as they should never have been placed or asked about in the first place.

 

Source: GPs offered teenage patients with learning disabilities ‘do not resuscitate’ orders | Daily Mail Online

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

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

English care homes ‘sitting ducks’ as GPs refuse Covid vaccine at infected sites | Coronavirus | The Guardian

So, according to this article some GPs are ignoring a NHS directive to provide COVID-19 vaccinations to all residents and staff in care homes, if there are any positive COVID-19 residents there.

Unfortunately the NHS can only advise GPs to enter and not insist, as all GPs and their practices are independent  organisations and run their own practices how they wish.

The practices undertake to do work for the NHS, but all persons in the practice are employed by the practice and not the NHS.

This is a throwback to when the NHS was created in 1948 as then, GPs and Dentists were refusing to enter the NHS as they were reluctant to lose their private status. To this the Government of the day, stated that their private status could be maintained, if they did contract to do NHS work and this remains the status quo.

Now, of course the current GPs are stalwarts of the NHS and are against any forms of privatisation, when they are acting, in some way, as a private organisation themselves.

This, in practice, normally works well, but can bring anomalies as with GPs refusing to enter Care Homes.

However, there are other instances were this comes into conflict with NHS directives, one being the delivery of Annual Health Checks to persons with Learning Disabilities, where some practice do them in a fashion while others to a good standard. This is but one another instance, but there will be others.

Source: English care homes ‘sitting ducks’ as GPs refuse Covid vaccine at infected sites | Coronavirus | The Guardian

GPs in England will scale back care to deliver Covid vaccines | World news | The Guardian

When COVID-19 arrived hospitals scaled back their services to cope with the expected demand for COVID-19 admissions, which meant that many routine services were not available and we now find that due to this, the death rate of patients who were denied consultations and treatments, could well be in the region of COVID-19 related deaths. Now they are attempting to continue with these services during the COVID-19 second wave.

Now the authorities are putting something similar in place with respect to GP services and while it is important for persons to receive the vaccines should this be to the detriment of patients requiring usual GP Services.

Of course, the answer should be no, but this is down to lack of spending in health services for too many years as Governments after Governments have been forcing the health service, by limiting their budgets to control spending, to reduce what appeared to be slack, thereby making costs savings.

So, the cost savings were made to some extent, but these cost savings have now caused the opposite in lives lost and a multitude of pain and suffering for those who managed to stay alive.

Surely, we do not wish the same or similar within GP surgeries.

Why did the Government not plan for the introduction of vaccines in training people to administer injections for this eventuality, but again this Government has fallen short and it is the population of the UK who will suffer! For either GP services will be cut back, or the vaccine implementation will be curtailed. Neither of which is what is required or wished for.

 

Source: GPs in England will scale back care to deliver Covid vaccines | World news | The Guardian

NHS asked care homes to place ‘Do Not Resuscitate’ orders on all residents at height of pandemic : The Telegraph : The Learning Disabilities Daily

Care homes were asked by NHS managers and GPs to place blanket ‘Do not resuscitate’ (DNR) orders on all their residents at the height of the coronavirus pandemic to keep hospital beds free, a new report has found.

The Queen’s Nursing Institute (QNI) – the world’s oldest nursing charity – discovered one in 10 care home staff surveyed was ordered to change DNR plans without discussion with family members, nursing staff, or with the residents themselves.

Half of staff members who said they had been asked to change DNRs worked in homes for the elderly, while half worked in homes for younger people with learning or cognitive disabilities.

Staff also warned that some hospitals were operating a ‘no admissions’ policy for care home residents – even for non-Covid-19 conditions such as heart attacks – and some said they had struggled to make appointments with GPs for elderly people.

 

Source: NHS asked care homes to place ‘Do Not Resuscitate’ orders on all residents at height of pandemic : The Telegraph : The Learning Disabilities Daily

NHS England proposes fortnightly GP care home visits – 61chrissterry

GPs will be required to visit care homes at least every fortnight from September under new requirements revealed by NHS England.

Source: NHS England proposes fortnightly GP care home visits – 61chrissterry