UK’s biggest GP chain replacing doctors with less qualified
Discussion
https://www.bbc.co.uk/news/health-61759643
Never heard the term Physician Associate before. So someone with 2 years of study + a science degree can see patients instead of a real doctor? That really is a race to the bottom.
edit: subject line got truncated - should say 'UK’s biggest GP chain replacing doctors with less qualified staff'
Never heard the term Physician Associate before. So someone with 2 years of study + a science degree can see patients instead of a real doctor? That really is a race to the bottom.
edit: subject line got truncated - should say 'UK’s biggest GP chain replacing doctors with less qualified staff'
Edited by s1962a on Monday 13th June 11:49
pavarotti1980 said:
What about nurse practitioners or other independent/supplementary prescribers? Are they also a race to the bottom?
No. If you want to see a nurse or other practitioner that is your choice. Getting a 'doctors appointment' and then seen by someone who is not a doctor is poor form.pavarotti1980 said:
Also don't use a private GP if you don't like their staffing structure
We don't have a choice of which GP practice we get assigned to - you have to pick from the ones in your catchment area.I can see both sides of the argument here. The simple fact is that we don't have enough doctors. They are expensive to train, expensive to employ, and hard to retain because frankly a lot of the time they have a s
tty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.
That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
tty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
s1962a said:
https://www.bbc.co.uk/news/health-61759643
Never heard the term Physician Associate before. So someone with 2 years of study + a science degree can see patients instead of a real doctor? That really is a race to the bottom.
edit: subject line got truncated - should say 'UK’s biggest GP chain replacing doctors with less qualified staff'
Pretty much no one wants to be a GP these day, I wonder why Never heard the term Physician Associate before. So someone with 2 years of study + a science degree can see patients instead of a real doctor? That really is a race to the bottom.
edit: subject line got truncated - should say 'UK’s biggest GP chain replacing doctors with less qualified staff'
Edited by s1962a on Monday 13th June 11:49
TX.
deckster said:
I can see both sides of the argument here. The simple fact is that we don't have enough doctors. They are expensive to train, expensive to employ, and hard to retain because frankly a lot of the time they have a stty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.
That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
Would agree with this and just to add I have been seen twice by the practice nurse of the GP surgery I am registered with and both times it seemed appropriate to see her rather than a GP (blood pressure test and heart functioning test). tty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
GPs would probably work better if many people saw a practice nurse first and then be referred to see a GP if needed.
JagLover said:
deckster said:
I can see both sides of the argument here. The simple fact is that we don't have enough doctors. They are expensive to train, expensive to employ, and hard to retain because frankly a lot of the time they have a stty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.
That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
Would agree with this and just to add I have been seen twice by the practice nurse of the GP surgery I am registered with and both times it seemed appropriate to see her rather than a GP (blood pressure test and heart functioning test). tty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
GPs would probably work better if many people saw a practice nurse first and then be referred to see a GP if needed.
How about offering the patient the choice: you can make an appointment with the nurse/"associate" staff or you can wait much longer and get an appointment with the GP (because they are far and few between)?
If you know you have a lesser issue which can easily be dealt with by a nurse then you can get your appointment sooner.
This seems very sensible as long as it is managed correctly. I once had to see a GP for 15 minutes to get cream for eczema. In the same way that teaching assistants can support teachers, it seems obvious that lower severity items (which still need a prescription) could be managed by somebody with less training.
There have been Nurse Practitioners for years. They are highly competent nurses who are considered able to take on minor ailments.
These mini doctors are the opposite. It remains to be seen how long it takes for the practice concerned to get sued out of existence.
The idea that you should take the morning off work to see the nurse to get triaged and then wait another few days to see the Dr is ludicrous.
The only reason this particular branch of the NHS is in such a poor state that they are forced to hire such people is because the Treasury refuse to allocate the money to do it properly.
These mini doctors are the opposite. It remains to be seen how long it takes for the practice concerned to get sued out of existence.
The idea that you should take the morning off work to see the nurse to get triaged and then wait another few days to see the Dr is ludicrous.
The only reason this particular branch of the NHS is in such a poor state that they are forced to hire such people is because the Treasury refuse to allocate the money to do it properly.
richardxjr said:
Zumbruk said:
richardxjr said:
So in 2007 Winky Mcfknut sold all the surgeries as well as the gold 
GPs have always been private contractors. knut sold all the surgeries as well as the gold JagLover said:
deckster said:
I can see both sides of the argument here. The simple fact is that we don't have enough doctors. They are expensive to train, expensive to employ, and hard to retain because frankly a lot of the time they have a stty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.
That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
Would agree with this and just to add I have been seen twice by the practice nurse of the GP surgery I am registered with and both times it seemed appropriate to see her rather than a GP (blood pressure test and heart functioning test). tty, stressful job dealing with a public that doesn't respect them. We have an aging population, and older people take up proportionately more of their GP's time for routine stuff, meaning that there are fewer appointments left for everybody else, which means that it's getting harder and harder to actually see anybody, at all.That said, everybody is entitled to proper, skilled care from a qualified professional. But the key point is - what does qualified mean? Do you, actually, need ten years of training to look at Ethel's bunions for the third time this month, or to prescribe Bert his haemorrhoid cream? A lot of routine GP work is just that - routine. And I see no reason why there shouldn't be a graduated hierarchy of medical professional.
The flip side is that we don't want to miss the important stuff, and this is where it becomes a balancing act. I see from the article that the issue isn't in fact the use of less qualified staff - it's the lack of oversight. So let's fix that. Let's formalise things and set the standards that are enforced by a governing body (that even private practitioners have to abide by). Let's give people running GP practices options. Let's actually put in place something that will at least give us a chance of serving people appropriate to their needs.
I see nothing wrong with the principle, just the implementation. I think the NHS would be well served by looking dispassionately at what other health services are doing, and allow themselves to follow creative and cost-effective patterns that have already been proven to work.
GPs would probably work better if many people saw a practice nurse first and then be referred to see a GP if needed.
Operose has attracted attention because of its acquisition of the AT Medics chain of practices in London.
This acquisition was challenged in one commissioning area: North Central Commissioning Board. It was judicially reviewed and the review was dismissed - the acquisition was lawful.
In reality, buying the c40 practices from the AT Medics founders would have passed unnoticed by everyone if it wasn’t for this one judicial review. Operose has been running GP practices for some time and, in turn, has been owned by Centene (the US insurance company) for a while as well.
As stated more than once above: GP practices are - and always have been - private businesses providing a contracted service to the NHS. This is how the NHS works - always has. Why people are surprised at this, I have no idea.
On the whole there are not chains of GP practices offering services to the NHS (unlike, say, pharmacy or dentists), so Operose - being the biggest (even with only 70 practices) - is bound to attract attention, however ill informed.
I’m all for two things here:
1. Cost efficiency for the NHS - differential qualifications for service delivery means differential contract pricing (though GPs will resist this I’m sure - they are way better at negotiating with the NHS/Dept of Health than, say, pharmacy).
2. Right people/right service - we need the precious resource of our medical professionals (of all qualifications) to be operating at the top of their licence.
I’m no rabid PH level capitalist, but even I can see that none of this is anywhere near the shrieking “they’re privatising our precious NHS” that the media wants to whip us all into.
This acquisition was challenged in one commissioning area: North Central Commissioning Board. It was judicially reviewed and the review was dismissed - the acquisition was lawful.
In reality, buying the c40 practices from the AT Medics founders would have passed unnoticed by everyone if it wasn’t for this one judicial review. Operose has been running GP practices for some time and, in turn, has been owned by Centene (the US insurance company) for a while as well.
As stated more than once above: GP practices are - and always have been - private businesses providing a contracted service to the NHS. This is how the NHS works - always has. Why people are surprised at this, I have no idea.
On the whole there are not chains of GP practices offering services to the NHS (unlike, say, pharmacy or dentists), so Operose - being the biggest (even with only 70 practices) - is bound to attract attention, however ill informed.
I’m all for two things here:
1. Cost efficiency for the NHS - differential qualifications for service delivery means differential contract pricing (though GPs will resist this I’m sure - they are way better at negotiating with the NHS/Dept of Health than, say, pharmacy).
2. Right people/right service - we need the precious resource of our medical professionals (of all qualifications) to be operating at the top of their licence.
I’m no rabid PH level capitalist, but even I can see that none of this is anywhere near the shrieking “they’re privatising our precious NHS” that the media wants to whip us all into.
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