Many of the points are not evidence based – esp access, e.g. text message consultations – we may end up doing more with little benefit to patients and actually creating more work for ourselves. The ForwardView recommends touch typing and speed reading to release time to care – move upstream – needs less nonsense to be typing/speed reading in the first place! More access is not necessarily a good thing – continuity of care generally means higher quality and less need for resources later on.
The overdiagnosis group is invited to write up a list of non evidence based things that are proposed/we are already doing.
It will be a long list….
2. Forward view (again)
What actually will the money be spent on : and is it right that the Trustee board made the decision to welcome the report rather than questioning it/ directing it back to Council for discussion especially regarding the cost of ‘ambassador’ roles
3. Multi morbidity paper
Need to be clear that fear is often a reason for overtreatment (legal or accusations of ageism etc)- this is really important. If the college was to explicitly endorse ‘non guideline’ choices as valid it might help others
Reference saying that we can cut admissions via reducing polypharmacy – not aware of any RCTs showing this and is linked to a text book not a paper
Geriatric assessments – why are GPs being asked to do this – it’s either GP work or needs resourced from elsewhere – we can’t keep taking on more work without it impacting negatively on everything else we do!
4. Care planning
in Scotland has been used as a means to reduce hospital admissions as the quality measure: when it should be about helping people get the best of what they want out of their healthcare. We need (again) support to step off guidelines and choose what is best for individuals
5. more people to do GP!
there is a lot of joy to be had in GP – but it is in a mess because of all the other rubbish we are loaded in on our days: we need to take out all the nonsense and really concentrate on providing our service – which is not a popularity contest given to the people who shout loudest – but to people whose needs come first.
6. Grassroots, ordinary GP is vital GP – to be honest, I think this is the hardest part of any portfolio career.