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£240m for online access to GPs. That’ll fix it.

The DH has announced £240m for online access to GP appointments, repeat prescriptions and patient records.  This will be match funded by other providers, so the figure could be doubled, but let’s stick to £240m for the sake of argument. Why?  Do we see marchers in the streets demanding online access to their GP?  Is […]

Why we don’t need rules on ward staffing levels

Point one:  you may not like this blog.  If this is you, read on. Point two:  I’m no expert on nurse staffing levels in hospitals. Cries of “Shame!” go up all over the media on the failure of Professor Don Berwick to state minimum nurse staffing levels on wards.  Here’s why I think he’s right. […]

NHS England reviews incentives, rewards and sanctions, but misses the point

  NHS England has released a discussion document on incentives, rewards and sanctions.  Here’s my open response: Dear NHS England review, Two contradictory messages shine through your document.  The first is that the system of incentives, rewards and sanctions is problematic, complicated, causing perverse outcomes and not fit for purpose.  The second is that the system […]

Hunt: good diagnosis, wrong treatment

There was something highly refreshing in Jeremy Hunt’s speech last week on primary care.  His diagnosis is well informed, and we know from a tweet that he spent time on the phones at Hurley practice in Kennington.  He talks about family doctors in terms of  strengthening relationships with patients.  This is a version of medicine […]

Let’s start with a conversation…

One of the first things I learned at medical school was that about 80% of diagnoses are made on the history (patient story) alone. Examination and diagnostic tests are often only used to confirm the initial clinical suspicion and both carry their own risks.We have accepted the need to undertake a clinical “telephone triage” of […]