Martin McShane: Nietzsche and commissioning

As part of the development of our Clinical Commissioning Groups (CCGs) the seven GP CCG chairs now have a place at the NHS Lincolnshire Board meetings.  The agenda was not particularly unusual. We were required to approve the Equality and Diversity Strategy. We had a couple of papers dealing with our legacy document and the […]

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Richard Smith: In the goldfish bowl with GPs

Two weeks ago I spent 90 minutes in a goldfish bowl with about 30 GPs. The goldfish bowl is a process to encourage reflection, and it certainly caused me to reflect. The goldfish bowl features in the leadership course of the Royal General College of Practitioners. Somebody with some pretensions to having been a leader […]

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Domhnall MacAuley: Northern Ireland general practice

Last night Clare Gerada, chair of the RCGP, spoke in Northern Ireland about the Future of General Practice. This morning she meets our new Minister of Health. She described her vision and what she would like to achieve. She was, perhaps, trying to encourage the wrong audience – those present already believe in her values.  But, […]

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Guy Rughani: A waist of money?

“Cash for blubber” is how the Twitter community have dubbed the UK government’s latest bid to tackle obesity. As revealed in the Sunday Telegraph, plans have been made to pay GPs extra for giving their patients “weight management advice” and referring them to publicly financed dieting clubs. But will this nudge fatten wallets or slim […]

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Martin McShane: Development through delivery and delivery through development.

Almost all our emergent consortia have completed their elections. Chairs are being identified and the process of change and transition is accelerating. Someone asked me last week whether the process we were embarking on was irreversible. Psychologically, I think it would be very hard to reverse it but, more importantly, across the country the clustering […]

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Tiago Villanueva: GPs are specialists too

In Portugal, general practitioners (GPs) are considered “specialists,” as general practice/family medicine is considered a specialty like any other hospital specialty. This is also the case in many other European Union/European Economic Area (EU/EEA) countries. If there’s a more satisfying moment than qualifying from medical school, it must be finishing specialist training. Becoming a “specialist” […]

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Tom Nolan: New pandemic flu guidelines – don’t forget your oximeter

New guidelines on the management of pandemic H1N1 influenza were published recently by the Department of Health. They include guidelines on when to refer patients to hospital (see below) and an update on the epidemiology of the disease: fewer than 1% of cases are admitted to hospital; 12-15% of patients admitted to hospital go on […]

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Tauseef Mehrali on war and medicine

My practice recently revamped its provision of short-notice medical appointments by transforming the Emergency Surgery into the (so far so good) Rapid Access Surgery. In essence, patients can now no longer pitch up to the practice between 11 am and 12 noon and definitely see a doctor regardless of their complaint, or lack thereof. […]

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Tauseef Mehrali on the universal strategy

With the month of fasting behind me and afternoon blood sugar levels now soaring above 3mmol/l, I’m really quite getting into the swing of general practice. It’s the Russian roulette of the medical world. Your fate is simultaneously within and way beyond your control. After all, it was you that called that patient in during […]

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