This time last month it would have been merely a dream, but today, it was my reality

Look, people on the rest of the mainland get sunlight, alright?

someone looking forward to mowing a lawn seriously ive heard it all now

how dare you pcernie, had 11 degrees sun all week

Hopefully my new ultrabook should be here tomorrow

Especially happy since it means my infected laptop can just lie there until I need to burn a CD or a portable hard drive

Going back to work tomorrow - hopefully things are calmer than they have been and we can get some movement on doing things in order... Rather than relying on telepathic communication

Last day in the office until after Easter - yay

Will be doing a virtual course from home on US time so until 8.30/9.30 at night - boo!

Oh it was!

It's just an endless lot of sh1t in here.

Meetings, timesheets, needless tension, office moves, new things to learn and remember, courses... And on top of it all I have a delivery of five years worth of accumulated kit from my previous location coming.

Signing up for a 5k run in May - not that far distance wise, I know, but it's a good starting point with just enough time to train. I'm determined to run next years half marathon again so training starts now!

Add to that the fact I've got a couple of fights coming up this year (K1) after losing my last one at the start of this month and some weight to cut, my eating and water in-take is being improved as we speak

Victoria Coren. Wrote a poorly researched article on General Practice in the Guardian. She has gone down in my opinion of her.

Saw that, but I wouldn't know the difference!

http://www.theguardian.com/commentisfre ... ard-to-get

It seems to start promisingly as a review of what the Govt promised. So I thought it would be a look at things from a political view.


It wasn't.

Two things here. Being on the combined contraceptive pill slightly increases your risk of a stroke. This gets worse with a single risk factor eg age, smoking, BMI etc but when you start to combine them, the risk goes up dramatically. Whilst VCM might be a professional gambler, someone has calculated the risks and put up rules (UKMEC) about where there's an absolute contraindication (ie do not prescribe) and where there's a reasonable risk or "safe" risk. VCM might be happy to gamble about the risk of stroke. But the GP won't be happy to gamble with their license to practice or imprisonment. The other thing is just because a patient wants something doesn't mean a GP should prescribe it. If someone comes asking for morphine, I'm not going to prescribe it just because they've asked for it.

If it's an emergency at 10pm, VCM should probably have headed down to A&E. If it wasn't an emergency, she could have contacted the out-of-hours doctors. They're staffed by GPs (and nurses).


Sounds reasonable - should have been able to change it. We prefer proof of address at our surgery eg bill.


Not sure about other surgeries but vaccinations are routinely handled by the nurses. I still fail to see how a vaccination is urgent (it very rarely is).


Yes that was rubbish but sometimes stuff happens. Doctors and nurses (and other healthcare professionals) get sick now and again. But not actually changing GP is just lazy - either spend some time doing it or stop whingeing.


Services are so stretched that in some areas, they've stopped offering pre-bookable appointments. A true emergency is often a retrospective comment. This morning I saw five people who thought they were "emergency" and couldn't wait to be seen. Three were kids who just had colds for 24 hours. One was someone who thought they were asthmatic but didn't want to wait (they didn't have symptoms there and then). One was somebody who needed a sick note. None of them in my book were emergency.


That's fine. In that case, stop all prescribing rules and let everything be available over the counter. Who's gonna pick up the pieces? What if VCM had a stroke because she decided to take a combined contraceptive pill (instead of a mini pill, implant, injection or coil as other contraceptive choices)? Should the state pay for it? What about people who start buying morphine and similar over the counter?

But that stopped because it was unsustainable. Where before it was a case of "don't bother the doctor", it's very much "me, me, me, now, now, now". Consequently, demand went up and doctors couldn't cope with it.


Everyone calls it botched without looking at what the problem was and what the solutions were. Demand was up. Doctors couldn't cope with doing out-of-hours and routine surgery. Daytime workload had rocketed. It was becoming unsafe both for the doctors in terms of mental and physical well being, as well as for patient's in terms of clinical safety. Morale was low. Retention and recruitment were big problems. Nobody wanted to be a GP and those that were towards retirement were just leaving. The Govt offered a choice - keep the out of hours, or they would take it over with a drop of £6000 per GP (this is the annual supplement GPs were paid for doing out of hours work). The GPs accepted this. The Govt has since found out it can't do it with a budget of something like 1.5x what they paid GPs. Private companies were paid to take over out-of-hours services and some are stopping it because it's not profitable.

In addition, more daytime work has been shifted from hospital to GP. In the "halcyon" days that VCM alludes to, a GP would diagnose a patient with diabetes and then send them to the hospital specialist who would then manage them. Now, a GP will manage a diabetic patient almost exclusively with those more difficult or requiring insulin to be seen by the specialist. That's one small example. There are hundreds of others. QoF was a way of paying GPs for some of the extra workload they were doing. Get more points for achieving xyz and get more money for it. Unsurprisingly most GPs hit the targets and got the money. There have been rumours it was designed as a pay increase through the backdoor but the idea was that GP pay needed to be increased in line with the rest of the medical workforce.

Now? We're back to a similar situation. Workload is high, demand is high. Morale is low. Recruitment and retention has become an issue. Doctors don't want to be GPs. GPs close to retirement are choosing to leave early.

I have no issue with your analysis. but the phrase 'pre-bookable' made me weep tears of blood .

Sick of my workplace - the entire place is paranoid cos of one control freak cow, me included. You're constantly being watched and asked what you're doing. One guy's almost certainly going off on the sick and he probably won't be the only one. This is even after we moved into a new office away from the bosses - they've even left the door open to hear who's talking. Place is unreal.

Over here, I have to have a sick note on the first day of absence from work - so if I am ill and can't go to work, I have to go to the doctor's and get a sick note. Whether that is a cold, 'flu, appendicitis or whatever else.

That generally means sitting and waiting and hour or so without an appointment - if you turn up at the surgery, they have to see you. I generally call in advance and they have managed to see me every time so far.

On the other side, the hassle usually means that I don't bother "being" sick. If it is a heavy cold or something, I'll snuffle my way through the day at the office... Last month I had a heavy cold for 8 days, before I went to the doctor on a Friday, because I had started wheezing the night before and I was worried it was going across to my lungs (asthma). Luckily it wasn't and with a different cough syrup from the doctor, it cleared up over the weekend.

If I make an appointment for something other than me being unfit to go to work, it generally takes a week. Annoying when the condition results in pain.

3 weeks ago I had neck pains, again, worked through it the first few days, because it wasn't too bad and I didn't want to hassle the doctor. In the end I did go, I had a slipped disc in the neck! I received 6 lots of physio and a muscle relaxant.