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Samir Dawlatly: Will general practice survive?

28 Jul, 15 | by BMJ Group

Just before I completed my training as a GP the 2012 Health and Social Care Act was passed. I had a sinking feeling that general practice wasn’t quite going to be what I thought it was. Up until that time I had been concentrating on passing my exams and assessments and not really taken much of an interest in medico-politics. At times I felt like there was little hope of stability and security in primary care.


Ferelith Gaze: The NHS is a duty to uphold, not just a function to devolve

17 Jul, 15 | by BMJ

Ferelith_gazeThe government is heralding the Cities and Local Government Devolution Bill—currently making its way through parliament, with broad cross party support for its intentions—as reversing 150 years of centralisation.

The bill opens up a number of exciting opportunities. Local partners—from Manchester to Cornwall, from Dorset to Hertfordshire—are making headway in their plans, with strategically aligned and integrated services at the top of the “to do” list. more…

Michael Devlin: Duty of candour—make apologising easy

16 Jul, 15 | by BMJ

mike_devlinSeven months ago a statutory duty of candour was introduced for hospitals in England, and four months later it was extended to all healthcare bodies registered with CQC. Are we likely to have seen a remarkable improvement in patient safety as a result? I suspect not, although to be scrupulously fair it will probably take years to establish what difference, if any, the new duty has made.

It has never been entirely clear what the statutory duty of candour would achieve that the existing professional duty would not. The difference is that the threshold of harm requiring action by healthcare bodies in the statutory duty is higher than the professional duty, which is confusing. more…

Andrew Moscrop: Would it be a good idea to charge for missed appointments at the doctors surgery?

14 Jul, 15 | by BMJ

The studio audience of BBC Question Time applauded and health secretary Jeremy Hunt appeared to wriggle with delight when a member of the public asked whether patients should be charged if they miss their appointment in general practice. “I don’t actually have a problem in principle with the idea of charging people for missed appointments,” the health secretary said.

His remarks were reported by news sources the next day. But a Downing Street spokesperson swiftly announced that the government had “no intention” of charging for missed appointments. “Bigmouth strikes again” decried the Mirror in its report of how “the millionaire Health Secretary” had been “slapped down by David Cameron” for his suggestion that “sick and vulnerable people should pay for any doctors’ appointments they miss.” more…

Tom Moberly: Showing patients what they are worth

3 Jul, 15 | by BMJ

tom_moberlyPrinting the cost of drugs on their packaging is one of Jeremy Hunt’s latest ideas for helping the health service save money.

Arguing that patients need to use NHS resources responsibly, the health secretary said that ministers “intend to publish the indicative medicine costs to the NHS on the packs of all medicines costing more than £20.” Alongside the price, the phrase “funded by the UK taxpayer” will be printed. “This will not just reduce waste by reminding people of the cost of medicine, but also improve patient care by boosting adherence to drug regimes,” he said. more…

Samir Dawlatly: When is a deal not a deal?

3 Jul, 15 | by BMJ

One of the questions I was taught to ask as a GP trainee when someone came to see me with symptoms that had been ongoing for a while was, “Why now?” What is it that has tipped the balance for the patient to make an appointment about something that has been bothering them for weeks and months?

The same question springs to mind with Jeremy Hunt’s latest “New Deal” for British general practice. Why now? Why make some big pronouncement weeks after the general election. I’m not sure I fully understand why he felt the need to make an announcement in the first place. After all the General Practitioners Committee of the British Medical Association negotiate the GP Contract with the Department of Health each year. Part of me wonders if this is the first sign that this is going to be more public than usual. more…

Juliet Dobson: Cutting support services for new mothers is a false economy

1 Jul, 15 | by BMJ

juliet_dobsonI was sad to hear that support services for new mothers are going to be cut across England. The Guardian reports that breastfeeding classes, home visits from midwives, and “babyfeeding cafes”—where mothers can drop in and talk to feeding advisers as well as other parents—are increasingly being scaled back or cut owing to pressures on local authority and NHS budgets.  more…

Martin Marshall: The travesty of the 10 minute consultation

29 Jun, 15 | by BMJ

martin_marshall“Perfunctory work by perfunctory men.” That’s how an eminent physician once described general practice. “A ridiculous claim” cried GPs, rising to the defence of their discipline, “specialists just don’t understand the nature of general practice. They don’t value our ability to make quick decisions based on a deep understanding of our patients and their context, our exceptional skill at managing risk and uncertainty, of using serial consultations to optimise the effectiveness of our diagnostic and therapeutic interventions.” more…

Barbara Harpham: CCGs are not adopting new technologies quickly enough

26 Jun, 15 | by BMJ

barbara_harphamIn December 2011, the NHS identified six ways technology could help patients and, ultimately, save money. A freedom of information request was sent to 211 clinical commissioning groups (CCGs) across England in October 2014 looking for a progress update; 189 (90%) responded.

How did they do? Well, it’s a mixed bag, with CCGs naturally opting to cherry-pick where to focus their efforts. But overall the picture is not healthy. more…

David Eedy: What lessons can be learned from the collapse of dermatology services in Nottingham?

23 Jun, 15 | by BMJ

david_eedy_picThe independent investigation into the near collapse of the acute and paediatric dermatology service in Nottingham has called the process an “unmitigated disaster.” This collapse was foreseeable and avoidable, and in the aftermath of the report it is important that clinical commissioning groups (CCGs), trusts, and private providers nationally take on-board what went wrong to prevent similar mistakes being made in the future.

The report found that no one organisation was to blame for the collapse of the service, which is not quite the same as saying the organisations are blameless. more…

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