MSCP Supertanker without a compass

When I was young the MSCP was a Multi-Storey Car Park, a blot on the landscape but at least my mum could park close to the shops.  Now it’s a Multi Specialty Community Provider and NHS England has a plan for it. Unfortunately it’s a plan with values on the front page, and the trouble […]

Is bigger better – for patients?

This week saw the release of the Nuffield Trust’s study of 4 large GP practice organisations, headed “Is bigger better?”.  The conclusion after 111 pages is roughly that although practices are being nudged in this direction, “we have not been able to provide evidence about improving quality”. The question arises, why is NHS England nudging […]

Only respect for patients will make digital work

I was at a couple of events this week which put forward grand ideas about the future of healthcare.  Visionary, aspirational and of course digital.  So why is it not happening? This simple test I did with the audience at King’s Fund illustrates:  Stand up if you have flown this year.  Two thirds rise.  Sit […]

The essentials of General Practice

I’ve been thinking very hard about how we support GPs in the essentials of their work, and been inspired by a couple of things this week.  One is the best single page summary of GP work I’ve ever seen, to which I’ll return, the other perhaps surprisingly is the GMS contract which covers the vast […]

King Canute, eat your heart out

Have you noticed that everyone talks about MANAGING demand, but no-one wants to hear about managing DEMAND? Same words, but the meanings are polar opposites.  MANAGING demand has a long, high profile history.  Recall the court of King Canute telling him he could hold back the tide by his command.  A bit like all those […]

A paperless NHS and quill-free Dept of Health

Do you, like me, wonder what all the fuss is about over a paperless NHS by 2020?  I did try to find out whether there was a similar drive to eliminate the quill pen in Whitehall:  it was the invention of steel nibs in 1822 rather than a lack of geese apparently. The danger posed […]

So what is an e-consultation?

Well I was right about the bombardment of doom ceasing for just one day.  They are at it again, and  NHS England’s £2.4 bn GP Forward View is “not nearly enough, not the right stuff and not soon enough.”  Never mind, it is what it is. Though not one of the 1700 words Shakespeare coined,  “e-consultation” […]

GP Forward View: be careful what you wish for

For one day at least the bombardment of doom is silenced:  GP leaders have lined up to say that the NHS England’s GP Forward View is largely what they wanted.  (The same can’t be said of  GP forums of course, but we know many of them would make a tabloid editor blush.  First comment on […]

Failure hurts, thankfully

askmyGP has been operating for over a year now, long enough to have clocked up a couple of failed practices.  That hurts, obviously, and I’m not going to name or blame anyone, but try to draw out what we have learned. The strange thing in both was not that it didn’t work, but that it […]

Doing what, officially, cannot be done

A couple of things this week have given us great joy at GP Access, and I make no apology for talking about them because we need to turn around the prevailing wind of moans. The first was talking to Rupert Bankart about his practice in Peterborough.  For all the reasons which bedevil general practice at […]