It’s the shape of the GP’s job that needs to change. The pharmacist will see you now: overstretched GPs get help…The fundamental ideology of the Health Services’ provision. Funding of this type admits 30 years’ manpower planning failure

In a tacit admission of 30 years’ manpower planning failure, Simon Stevens/Mark Drakeford  have ridden to the rescue. But this is only a sticking plaster – and for England and Wales differently. There is no suggestion of how to make a GPs work less intense, and how the new resources will change the “shape of the job”. There is an ignorance of risk, and the risk management that GPs, trained completely differently to pharmacists, are performing each and every minute of every day. The litigation could be considerable. If there is one “nurse psychologist” (unrecognised in psychological training) per three practices, this needs to be 9 times as many with 3 for each practice. The money spent on pharmaceuticals need to be rationed overtly so that these therapists have to be used before drugs…. Recruiting overseas doctors  from 3rd world countries is unethical… The generations of rejected applicants for UK medical schools need an explanation and an apology. In North Wales Mr Drakeford is in even more denial.. (Rachel Flint 20th April in the Daily Post: Professor Mark Drakeford has sparked fury by dismissing claims that primary care services on the verge of collapse) but at the same time he is accused of not listening in Pembrokeshire, S Wales. (Amy Owen in the Herald 27th June 2015 Drakeford: ‘doesn’t listen, doesn’t read’). More recently, on April 15th the Herald reports Mr Drakeford as announcing “£43m to improve Wales’ primary care services”. Following Mr Stevens lead? Has he changed his mind?

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Maureen Baker missed her opportunity on Radio 4. She said GPs “salaries” averaged 96K. She did not say we were self employed. She did not talk about the intensity and the all day decision making. She did not mention rationing and autonomy, or exit interviews and cultural change. When asked if the announced proposals would be enough she evaded the question, when she could have said “no”, or unlikely. It seems obfuscation and denial are part of the RCGP Leadership team. (“We genuinely hope that today’s news marks a turning point.”) Lets hear what the BMA says for some semblance of reality….

Chris Smyth reports in The Times 21st April 2016: The pharmacist will see you now: overstretched GPs get help

Millions of patients will be seen by pharmacists, therapists and medical assistants instead of GPs in an effort to save the NHS from collapse.

Simon Stevens, head of NHS England, warns that the health service will fail without a £2.4 billion rescue package for the “fraying” GP system. Patients will be encouraged to diagnose illnesses online, GPs will be offered bonuses of £20,000 to work in unpopular parts of the country and 500 foreign doctors will be hired in the biggest overhaul of general practice for half a century.

Despite criticism from patients’ groups, which said that they did not want to be treated “on the cheap”, the plans received a rapturous reception from doctors’ leaders, who have repeatedly warned that GPs are in crisis.

“It’s critical — don’t think they’ve been crying wolf,” Mr Stevens said. “The number of GPs hasn’t kept up with population growth, ageing and treatment patterns. GPs’ backs are against the wall.”

He acknowledged that pressure was being piled on A&E units because patients were finding it harder to see a doctor and warned: “If general practice fails, the whole NHS fails.”

Mr Stevens is promising a 14 per cent real-terms increase in GP funding over the next five years, taking their budget to at least £12 billion from £9.6 billion today. In an acceptance that there are not enough family doctors, 1,500 more pharmacists will be stationed in surgeries to deal with routine appointments.

Blood pressure checks, treatment for minor ailments, routine follow-ups and medicine reviews for older people could all be done by in-surgery pharmacists, who have almost as much training as doctors and are in “bountiful supply”, according to Mr Stevens.

A thousand physician assistants — science graduates with two years’ intensive training — will examine patients. Three thousand more mental health therapists, or one for every three surgeries, will deal with anxiety, depression and other mental elements of physical problems, Mr Stevens said.

Katherine Murphy, chief executive of the Patients Association, said: “We welcome investment in primary care but we shouldn’t have to wait until GPs are in crisis and then look for a quick fix. Pharmacists have a huge role to play and are an untapped resource but I do have reservations about physician assistants because they are an unregulated profession and we must make sure that we aren’t just introducing new roles to make up the numbers.”

Joyce Robins, of Patient Concern, said: “Once again, the NHS is trying to get round problems on the cheap. When patients phone up their GP they expect to see a doctor, not a less qualified substitute.”

Inspections of the nine in ten surgeries rated good or outstanding will now happen every five years, instead of every three as planned, to cut red tape.

Maureen Baker, chairwoman of the Royal College of GPs, hailed the plans as a huge and important step in the right direction. “For too long GPs have been undervalued, underfunded and not recognised for the essential role we play in keeping the health service sustainable and safe for patients,” she said. “We genuinely hope that today’s news marks a turning point.”

GPs carry out about 370 million appointments a year, or 90 per cent of all NHS consultations, but get only 8.3 per cent of the funding. There are 37,000 family doctors in England, 1,000 more than five years ago.

Nick Triggle for BBC News 21st April 2016: NHS in £2.4bn funding boost for GP services in England and once again focusses on numbers rather than the shape of the job.

The shape of a jobGP Occupational Health – too little too late. Lack of trust may ensure the service is ignored.. Say goodbye to continuity of care…

The meltdown is here…. belt up, hold onto your hat, and make sure you have planned for what is not available….

 

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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