NHS: Utter confusion

We are in a new world. Politicians have been replaced by NHS England. The CCGs are in charge. GPs rule the world.

grasping at straws

What did you say?

It’s not going particularly well?

Just a few teething problems, old chap. To be expected.

New people, new roles, it’s going to take time.

Give it a chance to settle down and then watch the world change for the better.

But we are SIX MONTHS into the new regime and I still get the impression of utter confusion. Endless pointless meetings and the same ambitions we have had since PCG days (anyone remember Primary Care Groups?).

What do we want?

• More community care.
• More resources diverted into primary care.
• Integration between services and seamless care.
• Better care for the elderly and those with chronic diseases.
• A better ‘educated’ population who are better equipped to look after themselves.

Pie in the sky.

We have an aging population, high expectations and the financial situation is difficult.

CCGs are not going to save the world. Sorry, but it’s just not going to work and when it all goes pear-shaped it will be US – the greedy, lazy, incompetent GPs – who will get the blame. Mark my words. Wait and see.

You can call me an old cynic.
I am an old cynic.
But I AM RIGHT.

Post Holiday Blues

Post Holiday Blues
I have them.
My patients have them.
My staff have them.
My partners have them.

Its dark outside, even at midday.
We had snow falling, on top of ice.
It is cold, grey, wet and miserable.

I want to be home in bed.
I wish I could hibernate.

Nigel Slater

Nigel Slater! Yum yum. What a great cook. Simple, wholesome food, lovingly prepared and simply served. The man is a cooking genius.

Yes, you need to WORK at talent

Listening to a couple of teenagers yesterday. The conversation went like this:

“Hey, what you gonna do?”
“Like, tomorrow?”
“Nuh. Like in life. Like what you wanna do?”
“I wanna win the X factor. I wanna be famous. I gonna be a celebrity.”
“Yeah?”
“Yeah.”
“Cool.”

Well, I got news for all you wannabe celebrities, those who think talent is something that just happens and for all who think fame just follows.

If you want to do something great – YOU HAVE GOT TO WORK AT IT!

Did you know you need to put in at least 10,000 hours of work? You need to work to practice your craft, hone your skill, rehearse until you are the best you can be and then continue rehearsing to get even better.

Yes, I know I used a four letter word – “work”.

Now, are you SURE you want to be famous?

Joy unconfined

BBC news people are on strike.

I woke up with my radio alarm playing and listened to a wonderful debate on the danger of believing anything in life is free. This was followed by a wonderful description of the Wash and its birdlife.

But the best news of all?

Carole Kirkwood is NOT on strike. Joy unconfined.

GPs rule the world

The consultation is over.
Too late, if you missed it: your chance to comment on Liberating the NHS has passed.

GPs are going to rule the world!

Heaven help the world.

We wait for the details to be published and for parliament to deliberate.
Then we will see if this revolution in healthcare commissioning will really come to pass.

A privilege and a responsibility

When you are in a job that consumes so much of your time, and almost 100% of your energy, it is hard to imagine life without work.

So, when I met up with an old friend the other day, a recently retired GP, I asked him how he was getting along.

“Wonderful,” he replied. “Best to stop while you are still enjoying it.”

He then added how truly privileged he felt to have been privy to so much of the intimate aspects of patients lives, to their ups and downs, their dramas, their most private thoughts. People tell you the most amazing things, share their stories and give you glimpses of the most personal parts of their lives. He missed that aspect of the job. But he did not the responsibility of having to assess the risks, weigh the consequences and make decisions. And he certainly did not miss the paperwork, the stress, the having too-much-to-do and not-enough-time.

“Now,” he added, “I am very busy with other things. You never know what is round the corner.”

I am thinking about it.

First day of Spring and QoF time

Nights are shorter, days are longer and the sun is shining. Yippee.

Swine flu has faded from our national consciousness; although our fridge is still well-stocked with the unwanted vaccines.

I am currently in the grip of the dreaded QoF (Quality and Outcome Framework). This is a complicated scoring system and, theoretically, rewards us for good practice and for good clinical care. All good in theory. In reality, I spend the last few days in March chasing points, mainly by ensuring the right codes have been applied to the right patients. All very tedious, time wasting, and nothing at all to do with good clinical care of patients.

This has led me to muse on retirement. I could take early retirement next year. Losing some pension seems a fair exchange for getting some of my life back. It is tempting ….

In the meantime, I have another 100 points to chase AND a massive folder of evidence to compile. Next week is the deadline for submission of the folder. No time to think, no time to dream, no time to enjoy this first glorious day of Spring. Yes, I am working over the weekend, again.

January is over – thank goodness!

January is drawing to a close.

Apart from remarking on how quickly the month has gone and “gosh I can’t believe it is nearly February”, January should pass un-mourned. The fact that I have a birthday in January, the least celebratory of all the months, only adds to the intrinsic misery of this time of year. The days are dull. Christmas and New Year celebrations are a distant memory. Resolutions, made with such optimism, have been broken and discarded. The promise of a New Year and the inherent promise of change the New Year brings, join the unfulfilled promises gathering dust in the dustbin of January.

January surgeries are full of depressed people. People who can’t seem to get going. People with no energy. People for whom everyday life has lost its zest.
“There must be something wrong with me,” they say.
“Yes” I say. “It’s January.”

As the saying goes, we can leave the old year behind us, but we can’t leave ourselves behind. Our hopes, fears and failings will pass with us from 2009 to 2010 and, almost certainly, into 2011 and beyond.

February is nearly here. February brings the whiff of spring. February brings Valentine’s day. February brings longer days and brighter mornings.

So January, farewell. Hello February!

Snow

Snow today, several inches deep, in flurries that brought traffic to a stop. Beautiful and deadly.

Morning surgery had a few people – only coughs and colds. People had struggled through the near blizzard and freezing temperatures to come and spread their germs. Of course, they MUST be better for Christmas. And its only a week away.

Afternoon clinic was empty. Just a few snotty nosed kids, dragged in by their mums, because they MUST be better for Christmas.

Evening surgery was dead as a doornail. People cancelled. Empty slots. Time for paperwork, writing reports, pondering QOF points, and having a chit-chat with the staff. Time to gossip and laugh. How wonderful.

I wish we had snow every day.

Isn’t snow wonderful.