A (junior) minister speaks.

You would think that a minister would have learned the expression engage brain before opening mouth but this assumes that ministers have brains and not just mouths. You also have to admire how they can come up with crap ideas to try and cover up the fact that there are not enough GPs. 

Pulse magazine reports once such idea as a success in one minister’s opinion but is it or merely an expensive waste of money on something that is already available albeit for a small consideration?

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f you look at the comments some others have also seen how useless this scheme is despite the headline of saving 40,000 GP appointments a year. Figures suggest that there are 340 million GP appointments a year so this scheme will have reduced general practice work load by a massive 0.01176470588 %. To any NHS commissar that will be a big number worthy of reporting to their minister possibly in the billions so it will be a worthwhile scheme to shout about.

Now it gets even better when you read further so have a look at this website regarding the long set of initials NUMSAS (NHS Urgent Medicines Supply Advanced Service) referred to in the Pulse article. 

A true masterpiece of Party speak and NHS redardocracy but hidden amongst this smouldering pile of NHS dung is the cost which you can eventually find as the last question in the funding and payment claims section.

So if we do a highly advanced piece of maffs that no NHS commisar could do called a share by then 2,000,000/38,900 or 2,000,000/29,177 based on number treated in the first year (and the total funding used runs until September 2018) depending which NUMSAS figure you choose from the article then each GP appointment saved costs a mere £ 51.41 or £ 68.55 versus the average cost of a GP appointment of £ 146 per year for an average 6 consults year means a GP consult costs just £ 24.33.

If you are an optimist and assume a total of 70,000 appointments by the end of the scheme the cost per patient becomes £ 28.57 per patient.

Now pharmacists can already dispense medicines in an emergency although it may cost the punter but if you are stupid enough to run out of medicine or to forget to order your medicines or lose it etc. then the expense incurred may provide a useful reminder not to do it again as any GP who has listened to a patient taking advantage of the scheme moan about being charged for their ignorance will know for it has usually cost the patient dear. They don’t like that hence the demand on more than one occasion for an emergency consultation when the surgery is next open to check that this is right. 

And how many patients per GP did a £ 2 million pound scheme save? Again depending on which figure you use then the number of appointments saved per GP might be as little as 0.85 or as much as 1.13 appointments per year or put another way this scheme will save each GP either 0.016 or 0.02 of an appointment per week – more than enough time to get a few extra rounds of golf in while avoiding all those patients attending the pharmacy. Maybe even enough time to see all the extras? 

And finally who is the minister involved? None other than Steve Brine MP the Parliamentary Under Secretary for Public Health and Primary Care. Good to know he knows so much about Primary Care and the difference this scheme will make to all those idle, overpaid, underworked GPs out there and such good value. If all GPs got what the pharmacists are getting from this scheme per patient contact he will solve the GP crisis over night. 

Now if a GP say sees 10,000 patients per year at £ 51.41 (choose your own figure from the above) per consultation how much would that be per year . . .?

Praise be to the Party for once again paying more than the cost of a normal GP consult to reduce GP workload by a massive 0.01176470588 %. An outstanding efficiency gain comrade commissar minister surely worthy of a commendation or knighthood for this one?

Too little, too late?

As all good comrade patients know the Party is all wise and so for years will have been planning centrally via good old 5 year plans to address all NHS deficiencies except their own inepitutude which cannot exist for they are perfect.

So comrades the Party announces another increase in NHS productivity. There must be a multitude of praises be due to Jeremy for delivering the “largest ever” increase in something via this scheme an extra 1500 doctors. However this is not the case. All that glitters is not gold. Study and think about the details.

Only 630 will start basic first year pre clinical medical training this year 2018 which means in say 6 years’ time there will be in in August 2024 less than 630 new doctors due to wastage say 10% a year as new house officers the most junior of doctors now known as foundation doctors (trainees) or F1s. By our maffs that means only possibly 334 new house officers, sorry comrades, F1 doctors will come out of this first new medical school sausage machine.

Assuming that all of these last the course and that they all decide to become GPs with no wastage this will only generate at best 334 new GPs in the year 2029. If you read this article and assume that only 2 in 5 doctors go on to further training with none taking time out and returning later this figure could be as high as 134 at best by 2029 although others may appear later. 

Of course the others in the full cohort will start training in 2019 and 2020 so doing a similar exercise there will if, and this is a very big if, they all became GPs they will come on stream as raw recruits in 2030-31 but nowhere near 1500 new doctors possibly as few as 795 using the above methodology possibly less as we have assumed no wastage during GP training. 

The 1500 are doctors to be not doctors now.

The shortage of doctors has been known about for years indeed decades, the increasing and aging population ditto but only now does part of the TriPartite alliance take some limited action which is merely an atom in the deep ocean of NHS healthcare need. Too little, too late?

Praise be to the Party for at long last realizing there is a problem which it has denied for decades and for taking important action to address the situation and crossing their fingers while doing so. Your new GP may see you in 2029-31 long after a large number of your current GPs have left and Jeremy’s 5000 extra GPs have failed to materialize in 2020.

Tales from the pharmacy 003.

 

We revisit this item after one of the team went to collect a prescription from a pharmacy and while waiting listened to the words of wisdom dispensed there by the soon to be saviours of UK General Practice the army of pharmacists to come. 

The Party view is here.

This has nothing to do with the fact that they are (not) brighter than doctors just that they there is an oversupply and the Party has bigged up their (limited) abilities to pacify the populous for the Party’s decades long failure to provide enough doctors or nurses and other front line staff to provide hands on medical care for patients.

So we were in shock and awe when we listened to advice provided by the pharmacist that we as general practitioners would have been incapable of providing.

NHS (dumb, dumb, dumb) 111 would have tossed their coin of incompetence of either an A&E attendance/999 ambulance or urgent GP consult had they been consulted but we were in awe of what followed when a patient asked of the pharmacy staff: 

“My relative is on dialysis is there anything they can take for a cold?”

They were “advised” after the query was escalated to the almighty Party god pharmacist: 

Take paracetamol and drink plenty of fluids.

Outstanding advice from that highly trained saviour of NHS general practice which led some in the pharmacy to smirk while the dumbstruck relative realizing how useless it was said they would ring the renal local unit instead.

Praise be to the Party whose ideas of improving NHS healthcare always involves dumbing down and paying peanuts to get idiots to deliver healthcare. Unleash an army of such morons nationwide and do costs go up or down and ditto standards of care? Ultimately quality costs and so do medical indemnity fees that will be borne by the NHS = the tax payers for such unbridled incompetence to come.