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 […]
Category: NHS
Ferelith Gaze: The NHS is a duty to uphold, not just a function to devolve
The 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 […]
Michael Devlin: Duty of candour—make apologising easy
Seven 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 […]
Andrew Moscrop: Would it be a good idea to charge for missed appointments at the doctors surgery?
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,” […]
Tom Moberly: Showing patients what they are worth
Printing 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 […]
Samir Dawlatly: When is a deal not a deal?
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 […]
Juliet Dobson: Cutting support services for new mothers is a false economy
I 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 […]
Martin Marshall: The travesty of the 10 minute consultation
“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, […]
Barbara Harpham: CCGs are not adopting new technologies quickly enough
In 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 […]
David Eedy: What lessons can be learned from the collapse of dermatology services in Nottingham?
The 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 […]