Polyclinics ‘will harm trust in GPs’

October 13th, 2008

Polyclinics and walk-in health centres are likely to undermine the relationship between GPs and their patients, researchers said yesterday.

The Government has launched a drive to introduce the clinics and centres. They offer a wider range of medical services than a traditional GP surgery but patients may see a different doctor each time.

After interviewing 243 patients, the researchers found that those who felt confident about receiving good follow-up care were more likely to trust their GP.

Patients were also more likely to trust their GP if the doctor has checked whether they had followed prevous treatment.

In their study, the Leicester University researchers concluded that the drive to introduce polyclinics and walk-in centres would cut the opportunities for doctors and patients to build trustine relationships.

One of the researchers, Carolyn Tarrant, said ‘I’m sure they will have various benefits for patients and GPs but they are bound to reduce continuity of care and our research shows that this may lead to s decline in patient trust.

‘If patient trust declines, then medical outcomes may be adversely affected’.

Daily Mail, 23 September 2008

Both sides insist they have the patients’ interests at heart. But is the public really unhappy with GP opening and, if not, what is this row all about?

June 23rd, 2008

From the BBC website:

Doctors and ministers are at loggerheads over extending GP hours.

On the face of it, longer GP opening sounds like a great idea. Who would not want to be able to pop into their local surgery on the way home from work in the evenings? But general practice is not like Tesco’s and cannot necessarily cater to the 24-hour consumer society that has emerged. Any extension needs to be achieved within a finite budget and this raises the question of cost-effectiveness.

The government has said it is pushing for longer hours to meet the demands of patients. As evidence, ministers point to a survey of over 2m patients last year.

Views

The poll by Mori, the largest-ever canvass of patient’s views, showed 84% were satisfied with access. But Professor Helen Lester, a GP expert from Manchester University’s National Primary Care Research and Development Centre, says the devil is in the detail.

“If you take a closer look at the figures only 4% of the 16% who are not satisfied want longer opening in the evening. So do we really need a new system, or just a bit more flexibility?”.

She points out that the group most likely to want evening surgeries is young men and this is the very group that is least likely to use GP services.

Nick Goodwin, of the King’s Fund says “There are 291m consultations a year or – in other words – 800,000 a day. And by far the most frequent users of these are the over 75s and under threes – both of which are largely free to attend during regular hours”.

By comparison, men aged 16 to 44 only have four consultations a year on average – half the number of the elderly.

Professor Lester says “Logic would say you design the service around the 84%, while taking into account the views of the others. Anything else, would not be the most appropriate use of resources.”

Top 10 facts about your NHS General Practice.

June 23rd, 2008
  • At most practices, the doctors, nurses and other clinical staff see approximately 300 patients per doctor in your practice per week.
  • We deal with 9 out of 10 problems that you bring to the practice- only a minority of patients are referred for further care. This saves the NHS millions of pounds that can be used to treat more patients and decreases waiting lists. Much of the decrease in hospital waiting lists has been a result of more work being undertaken at your GP surgery such as diabetic and rheuatology care which all used to be done in hospitals.
  • This care is provided at the lowest cost per contact for any Health care professional. Compare this to the cost of just one patient attending the A&E department at £75 per attendance, one visit to a walk in centre costing £37 or one visit to an Out Patients Dept at around £150.
  • Most surgeries are now so well organised that the number of patients who use our services has increased almost threefold in the past few years.
  • Practice staff are now trained to provide services which were never available in practices before – this means less patients having to attend hospitals – think of the inconvenience and cost of having to attend the hospital for many problems that can be handled at present at your local general practice.
  • The time you spend per consultation with your GP has trebled since the NHS was created. We would like it to be even longer.
  • Your clinical care has been shown to have improved in many areas- not only did we achieve the high standards the government set for us, we actually exceed their expectation! We would challenge any other public service to match, let alone exceed the standard of care we provide for you- our patients.
  • You have the right to be registered with the GP of your choice in your area- contrast this with other services such as dental services.
  • We make sure that hospital letters for your care, prescription requests by yourself, results of your blood and other tests are checked by the doctors to ensure your safety and best care.
  • Our patients rate and value our services highly. 9 out of 10 of you said that you were very happy with the services provided by your local GP practice.

GENERAL PRACTICE IS UNDER THREAT BECAUSE OF POLITICAL INTERFERENCE IN THE HEALTH SERVICE BY THE GOVERNMENT.

Thanks to Dr M Roshan of Leicester for the above.

Protect NHS General Practice Facebook Group

Over 1 million people sign the BMA’s petition against polyclinics!

June 12th, 2008

Over a million people have signed a BMA petition calling on the Government to support existing GP practices and urging it to stop encouraging large commercial companies into primary care in England. On the afternoon of 12 June Dr Buckman, chairman of the GPs committee, led a deputation to 10 Downing Street where he handed over the Support Your Surgery petition.

For the full story visit the BMA’s web site.

King’s Fund Report – Under One Roof: Will Polyclinics Deliver Integrated Care?

June 10th, 2008

The King’s Fund have published a report on polyclinics which identifies and explores both opportunities and risks in relation to quality of care, accessibility of services and cost.

Unsurprisingly, it supports our view.

Yorkshire Evening Post links to SOS!

June 6th, 2008

Thanks to all at the Yorkshire evening Post for their support of Save Our Surgeries. It seems as if Leeds are having a revolt over the plans for polyclinics too. Good for you, Leeds! Keep it up 🙂

The same opinions are being repeated over and over by GPs and LMCs (Local Medical Committees) across the country, yet the Government still refuses to acknowledge that these proposed changes are neither needed nor wanted, and are intent on privatising our NHS.

In fact, they are no longer just proposed changes. They are now becoming a reality. My home city (Worcester) is having one forced upon it despite protests from the Worcestershire LMC and local GPs (see previous blog entry on 25th May 2008).

You can read the article in the Yorkshire Evening Post here

John Humphrys interviews Lord Darzi on BBC Radio 4’s “Today” programme on 9th May 2008.

May 25th, 2008

Here is the transcript of a section of the above interview and a press release from the Worcestershire LMC following it. Whilst I cannot call Darzi a liar (I do not wish to be sued), I think that the following highlights some contradictions of his claims.

START TRANSCRIPT

JH: If somebody, if a large enough group of people, in a given town or given area, say “”we don’t want our hospital to close, we don’t want a polyclinic” (or whatever it happens to be), then they will not only be listened to, but their wishes will be acted upon? Is that what you are saying?

LD: Absolutely, and these are the pledges and these are the safeguards that I have published well ahead of the nine different reports which we expect to start next Monday.

JH: Well that could be done on a strictly numerical basis couldn’t it? So if you were serious about this, what you have to do presumably is to send out a little polling form or something to everybody in the area, and say tick box A or tick box B? That’s not what you are proposing is it?

LD: No I’m not. What I’m suggesting, any local change has to have a purpose. That purpose has to be based on outcomes – saving lives, whatever that quality happens to be. And then, that needs a consultation with the users of the service: the patients, the public. If there is a dispute, then that dispute, you could bring in an arbitrator, a clinical arbitrator, to resolve that local dispute.

JH: right, so in the end, the decision will still be taken by either the clinicians who run the hospital or the service, or by the local politicians. In other words, I am struggling a bit to discover what’s changed.

LD: What’s changed, we need to be, as clinicians, we need to stand up there on the platform, engage the patients, explain why changes need to occur, if it’s based on quality. Maybe we haven’t done it before; we need to do more of it in the future. John, I’ve been in clinical practice for 20 years, I have yet to meet a patient, in whom you describe what change you might be making in your practice, what you may be offering as a treatment which will compromise their care, for them to accept it. That is not the world we are living in. We are living in a world in which quality matters and healthcare quality should matter to all of us.

END TRANSCRIPT

START LMC PRESS RELEASE

Worcestershire Local Medical Committee Ltd

­­­­­­­­­­­­­­­________________________________________________­­­­­­­­__________

St. Stephens Surgery • Adelaide Street • Redditch • Worcs. B97 4AL

Tel: 01527 65082 Fax: 01527 61211

Email: info@worcslmc.co.uk Web: www.worcslmc.co.uk

Secretary: Dr. Simon Parkinson – sparkinson@worcslmc.co.uk

Executive Officer: Michelle Hallahan – mhallahan@worcslmc.co.uk

PRESS RELEASE

For immediate release: Thursday 15th May 2008

The LMC seeks public consultation on GP Led Health Centre

In the light of Lord Darzi’s clear comments on BBC Radio 4’s “Today” programme about public consultation, Worcestershire’s Local Medical Committee has written to the PCT and the Strategic Health Authority today asking if they will indeed consult on the GP Led Health Centre that is planned for Worcester City. Apparently adverts have been placed already and we believe that this is inappropriate as the limited discussion that has taken place has not led to this proposal receiving support. The Local Medical Committee remains of the view that £1.2m per annum is being spent unwisely on a service that is inappropriate for this county. We are urging the PCT and the Strategic Health Authority to think again in the light of the comments from the Health Minister.

True consultation has not occurred in this case.

Notes to Editors:

For further information, and to request an interview, please contact Dr Simon Parkinson on 01527 65082.

END PRESS RELEASE

What a load of waffle Lord Darzi spouts. As you can see from the above WLMC press release, no consultation has occurred whatsoever.

I’d like to draw your attention to the last line of the transcript; “We are living in a world in which quality matters and healthcare quality should matter to all of us.” I couldn’t agree more. I hope you do too.

New SaveOurSurgeries blog

May 4th, 2008

We’ve created a new blog to compliment the main web site.  Watch out for new entries on it from time to time!