GP TechLead

Introduction   As the landscape of general practice continues to evolve, many GPs are exploring portfolio careers, allowing them to diversify their professional experience. One such avenue is occupational health, a field that focuses on the relationship between health and work. Here’s a guide on how you can transition into occupational health as a portfolio GP. 

The recent unveiling of the revised GP contract by NHS England has sent shockwaves through the healthcare community, igniting a fierce debate. While some elements of the contract have garnered cautious acceptance, the British Medical Association's General Practitioners Committee (BMA GPC) has expressed strong disapproval of several key points, raising concerns about the potential impact on patient care, workload management, and the overall sustainability of primary care.

Beneath the apparent calm of the UK's National Health Service, a low rumble of discontent vibrates between two pillars of primary care: general practitioners (GPs) and the wave of new roles funded by the Additional Roles Reimbursement Scheme (ARRS). While both share the noble goal of serving patients, they find themselves on opposing sides of an evolving landscape, where questions of territory, training, and the very definition of "good care" spark ongoing skirmishes.

The global sum for GP practices in England has been increased from £102.28 to £104.73 per patient, in order to finance a 6% staff uplift. This is roughly a 2.4% increase. Negotiations between the Department of Health and Social Care and the British Medical Association (BMA) concluded last week, and the BMA's GP Committee said they had done so 'satisfactorily'. The global sum is a fixed amount of money that GP practices receive per patient registered with them. It makes up the majority of a practice's income, and is used to fund all aspects of primary care, including staff costs, premises, and equipment.

Has the season of strikes ended? In the news, many professions have now ceased their strike action. Teachers have now accepted a 6.5% pay deal meaning they will not strike anymore. Nurses, paramedics and 999 call handlers accepted a 5% pay increase as well as a one off payment to end the strikes. The nurses were actually in favour of continuing to strike but the turn out for their ballot was too low to legally allow more striking. Firefighters didn't strike but they accepted a 7% backdated pay increase and 5% pay increase this year. 

Going back to my previous introductory  NHS pension post , employee contribution to the NHS pension was tiered dependant on your earnings. Below was the previous banding and employee contribution rates. 

I briefly mentioned the proposed 1% pay rise for NHS workers in the maternity pay post but now the government has actually come out that there will be a 3% rise for NHS workers  in England. This will include consultants, dentists, nurses, paramedics and salaried GPs. This will not include doctors in training or GP partners however. This is actually more than I thought it would be, but for some, they want more. Consultants are being balloted to see if strike action is warranted as they didn't get the 5% they were looking for. Nurses will get roughly £1000 extra annually on average but they wanted 12.5% (which would be £4000 extra) and may strike as well. Other union NHS staff may also stage a strike if they don't get the pay rise they want.  Seems a bit ungrateful this sign A lot of their arguments are that it's still a below inflation pay rise (which is predicted to go reach near  4% this year ) and wont make up for the years of below inflation or non-existent pay rise...

As a GP Trainee, I took a call from a middle-aged lady from Eastern Europe who had some problems urinating for several days, associated with some lower abdominal pain and back pain. She spoke very little English so she had made her young teenage daughter call in and translate over the phone. This is one of the issues of phone consultations, how can things like this be kept confidential? GPs don't have an easy way to get translation services for phone consults, and not one that would be quick to get. Asking about vaginal discharge is bad enough for a male GP, let alone getting a young daughter to ask her mum. 

Like most primary care doctors around the country now, we're all working towards the vaccine effort of vaccinating our local populations. Some are actively giving out the vaccinations, some in a supervising role, some doing the very important task of organising everyone and everything. Uptake of the vaccine has been good with most people very keen on receiving it in with many others who are not eligible yet, calling up wondering when they will get it. One is the hard parts has been calling patients up to consent and inform them about the vaccine. The cohort of patients currently that area being called in are over 80, and may have issues with hearing that can make phone calls hard. Most of these patients have been done now, and we're moving down the age groups. People who cannot leave their home in my area have been able to get free transport to the vaccine hubs which will greatly improved uptake.

The NHS pension is often a mis-understood financial benefit that many employees generally just forget about. They know a lot of money gets taken from their payslips with the assumption they'll get it back later when they retire. I recently decided to look into it further so I thought it'd be useful for me to break it down as easily as I can. First this to say is that the NHS pension is a defined-benefit (DB) scheme, not a defined-contribution (DC) scheme. What you pay in is not added to some pot of money; it's better thinking of it as a membership fee. There are two NHS pension schemes, the old 1995 final salary scheme and the newer 2015 Career Average Revalued Earnings scheme (CARE). I'll go over the 2015 scheme as it is applicable to most people now (and what I am mostly in). The NHS pension is a guaranteed income for life upon retirement. It is index-linked, meaning that it will increase with inflation (Consumer Price Inflation) every year. This sort of scheme is r...

Flu season starting and people are calling up to try get them done. Normal winters, most people can't be bothered but with Covid as well floating around, people are desperate to get it (in fear that they'll be a shortage). Nursing home residents usually get top priority as just like any transmittable disease, it can spread like wild fire in an enclosed space like a home. It usually is a given that most residents will get it but one relative of a resident did not want his dad to have it.

Doctors have to make difficult decisions. GPs generally don’t have to do so as much but occasionally a hard one comes our way. On my ward round at the nursing home, an old 110 year old man was nearing the end of his life. He lived a storied and interesting life, in the army, seen the wars and was an actual rocket scientist. He had seen better days however. He had many comorbidities and had a poor quality of life for several months now. We were treating him for a chest infection, and he had 4 days worth of his second course of antibiotics. His daughter, herself an elderly woman, was concerned about his well-being, he looked unwell, barely conscious and breathless. She asked what we should do once the antibiotic course was finished. I explained that we could either try a third course of antibiotics which may clear up his chest or we could decide that antibiotics aren’t working for this infection and let nature take its course.