NHS: GP surgeries and privatisation

interesting thread from Keith Geraghty

https://twitter.com/user/status/1638655905448247299

 

Panorama from June 2022
Panorama investigates Britain's biggest GP network. US owned Operose Health provides GP services to the NHS, with 70 surgeries from Leeds to London and more than half a million registered patients. Reporter Jacqui Wakefield reveals a shortage of GPs, some less qualified medical staff working without adequate supervision and a backlog of important patient paperwork.

BBC iPlayer - Panorama - Undercover: Britain’s Biggest GP Chain

shocking.

 

My GP surgery was taken over by Centene / Operose and it’s been horrendous (my whole care is pretty much managed by pharmacists / “clinicians” who turn out not to be doctors, and even when a doctor does manage it, things keep going wrong). I was contacted by a journalist who wanted to interview me for this BBC programme (they found me through a Google review I left for my GP surgery), and I gave them details of what it’s been like, but I didn’t want to appear on TV because of my health.

 

they're called 'Physician Associates' and their use is becoming more widespread.
(in particular for patients with LTCs).

https://www.healthcareers.nhs.uk/ex...cal-associate-professions/physician-associate

 

One of the worrying thing about this is how good they will be in knowing when to pass patients back to doctors, particularly in patients with long term conditions where there is already a dangerous assumption in many professionals that taking patients symptoms seriously promotes ‘false illness beliefs’. Also one wonders why there is a need to create this new professional group rather than extending the role of practice and community nurses. We already have such as diabetic nurses, why not add other nurse specialisms.

I suppose there is already a shortage of nurses, but would these physician associates also have less training and cost less than nurses. I do not rule out the potential value of such a role, but worry that if not developed carefully would [correction] result in a diminution of care for such groups as ourselves, people with ME. I suspect with people with ME, such a role would only have value if it was in addition to current medical care rather than instead of medical care.

[added - There is a danger that this group would end up with the jobs that no one else liked doing, that are not necessarily the most appropriate to delegate to the least skilled. Hopefully things have changed over the last twenty five years plus, but when I worked with people in nursing homes and care homes often it was the newest and least experienced staff that ended up feeding people, with little or no training in recognising silent aspiration and the risks of aspiration pneumonia.]

 

lol when i was about 19 my grandmother was in hospital after a severe stroke, was pretty much only able to move her eyes. I fed her, i was given no advice just a bowl of slop which i gave her with a teaspoon.

 

Because GP practices are private businesses, on1y the GP's have an NHS contract. Other staff's pay varies from practice to practice. My very experienced (graduate) nurse practitioner sister (35 years of experience in A&E and Minor Injuries in the Navy and NHS, inc1uding as a c1inica1 manager running a who1e service in P1ymouth) was made redundant in the NHS 'restructuring' about 10 years ago (read austerity cuts). After a coup1e of years working in a 1oca1 sma11 hospita1's minor injury unit, where she was the on1y qua1ifed nurse practitioner (with no doctors in the unit) and was expected to work a fu11 shift without even a tea break, she worked for about 18 months in a GP surgery (initia11y thinking it wou1d be a better work environment).

Her pay was ha1f what she was earning under her NHS 'Agenda for Change' contract, the GP practice wou1dn't even pay her as a Nurse Practitioner. For this pittance she was expected to work 12 hour days and supervise inexperienced nurses and practice staff, despite her pay/contract being for on1y 8 hour days. She decided it wasn't worth the damage to her own hea1th and took ear1y retirement in her 1ate 50s.

So I don't see why any graduate wou1d want to work in this sort of environment for even 1ess pay than a qua1ified nurse! It must be even worse now than it was when my sister was working.

 

The bigger picture
https://twitter.com/user/status/1471796744455397379

 

Actress, 30, died after her blood clot symptoms were dismissed as 'anxiety' by associate doctor

Actress, 30, died after her blood clot symptoms were dismissed as 'anxiety' by associate doctor (msn.com)

 

To be fair i dont think this is about it being a PA, but about that particular PA being useless! A patient's leg being swollen & hot isnt anxiety is it!? Prat.
I'm not at all medically qualified & even i know that those symptoms in addition to shortness of breath = go to A&E it might be a clot, so i dont think the issue is that they were underqualified, I'd imagine even an experienced but unqualified HCA could have identified it.