Catterick out of hours

Back on blogging after a break!

Some of you may have seen the article in the D&S about the changes to Catterick out of hours. In essence, calls placed after 2300hrs will be passed on to the duty doctor based at Northallerton (rather than Catterick) to deal with. If a patient needs a home visit or to be seen face to face, this will still be done by the doctor in Catterick.

The only change is that the doctor on duty at Catterick will not make the initial telephone call. This allows the Primary Care Trust to classify the Overnight Catterick duty as a 'sleeping' shift and so reduce the overnight payment to the doctor. The change will make no difference to the patients needing a GP after 2300hrs. The only difference we may see is that less doctors will be keen to take a pay cut to work at Catterick, and so the PCT will find it difficult to man this shift. Whether or not this will happen remains to be seen. The PCT is heavily in debt and we must try to make savings wherever possible in order to protect our services. The current OOH changes will only affect the doctors at present and the patients should not see a difference in the level of service provided at present.

Diabetes screening

Long time since the last posting, what with the excitement of the election and the ensuing aprehension about what is going to happen next to the NHS. We have recently been looking again at diabetes screening. We already screen some people at risk (normally those with existing heart conditions, mental health problems and those on medication such as steroids which can increase the chance of developing diabetes) and we have looked again at whether we should run a widespread screening programme. Currently the evidence as well as the cost/benefit does not support this plan to screen everyone. There is good evidence that screening all at risk groups is more effective. Are you at risk? Diabetes UK has an excellent screening tool to assess your risks(http://www.diabetes.org.uk/measure-up/) - if you are at risk, please come and see either of the doctors or Kim for a further chat and testing.

More election stuff - Labour

As promised a further update. Good to see the 3 prospective candidates for health minister slugging it out on the BBC politics show yesterday. Labour have made promises of free health checks for everyone aged 40-74 and the right to see a GP at weekends/evenings. The promises are light on detail - in fact most practices offer health checks to their patients already, and people can already see 'a GP' 24/7 by using the out-of-hours service. This goes along the same lines as the recent guarantee that patients with suspected cancer will be seen by a specialist within two weeks (this has been the case for several years already). Labour do seem committed to improve and expand cancer care services to enable more palliative care at home- this policy would be much welcomed in the Dales, as nursing/carer support is often difficult to guarantee in rural areas. Labour will also scale down the doomed NHS IT project (which it invented), and re-invest the money in frontline services. There is no mention in the manifesto about abolishing car park charges at hospital (a pledge last year at the party conference).

Election Promises - Lib Dems

The current proposals from the Lib Dems are for local GPs to take back their out of hours care, scrapping practice boundaries and to create locally elected health boards.

The practice boundary issue is not really of much concern to us, as geographically our practice area is well defined although we would possibly consider taking on more patients further downstream towards Richmond. The health board shows promise to make sure that health solutions are applicable to the population they serve and any move away from NHS Whitehall and a one-size-fits-all approach is most welcome. Out of hours care is a real concern though. Being responsible for commissioning out of hours cover is one thing, but having to provide 24/7 cover is likely to be unsustainable for a single-GP practice. Not only are there safety issues, but also difficulties finding locum cover for holidays and training days. Such a policy may necessitate a practice merger or at least a change in the way we work.

General Election

During the election campaign, the blog will have a focus on the main health policies of each of the main parties. RMC is keen to remain apolitical, and so will be unable to display any election posters (we have been asked to have leaflets in the waiting room previously).

Foot Care

We are pleased to announce that we can now offer a private foot care service at the practice to run in conjunction with the existing NHS service. Sheila Hunter will be working from the practice, as we had quite a lot of demand for a private podiatry service. There will be no reduction in the NHS service and hopefully this extra capacity will reduce travelling costs and time. Sheila can be contacted directly (01748 835 732 or 07833 166 220) for appointments.

Happy Easter

As another day draws to a close, thoughts turn to the Bank Holiday Weekend! I'll be off to burn a few calories on some Wainwrights- I made the unfortunate discovery of a book of routes which enable you to cover all the Wainwrights in 32 walks, although there are some fairly taxing days- hopefully I'll meet the challenge in the next 6 months, so if you wonder where the weight has gone and why the dogs are so scrawny, you'll know!