GP TechLead

 We had a new resident this week at the care home, a 90 year old man who seemed pleasant enough but with quite advanced dementia. Hadn't met him before but was on the round for an initial meetup to see what his baseline was and to go over a few housekeeping things. Due to covid, we have to gown up, face visor and glove up for every resident, which I normally I find very laborious but in this instance, I was glad got the extra use of PPE.

So in NHS pension news, there has been talk about the McCloud judgement. This relates to two different cases made against the government by a judge and firefighters in regards to public service pensions. They won their case against the government on age-discrimination basis and therefore the government will be forced to act. Here is the very simplified break down of this ruling.

Maternity pay is something I have found quite confusing, especially in the NHS. With a spate of new pregnancies in my friendship group, I thought it'd be something I'd revisit. I find it easier to think of it as weeks in the pregnancy so you will notice the fractions, which mean the week of the pregnancy (10th week of pregnancy is equal to 10/40) - hope that makes sense. Also bare in mind this is the standard NHS / BMA maternity leave, if you are employed by a GP surgery then depending on your contract, it may differ from what is down below. 

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. 

As a parent, there are several topical parenting questions. One such popular question is “Will you give your child a smartphone?”. When I was young the old Nokias that could play snake was very popular, but I never got a phone until I was in 6 th form (and it was not a snazzy Nokia). I guess parents back then did not have the dilemma they have now.

Headaches are a common symptom in GP land. They ironically can be a bit of a headache for a GP to manage. There are a number serious headaches that need proper attention and during this remote consulting era, it takes a lot of clinical confidence to manage them over the phone only. 

Due to the chat about 1% pay rises for NHS staff, a discussion amongst friends brought up the NHS pension again. One thing not mentioned previously, was the illness and death benefits that it brings. This document outlines a lot about the 2015 pension scheme and also talks about what would happen if you were too ill to work. This is only applicable to the 2015 scheme; given the recent McCloud judgement, I am unsure if we have all reverted back to the legacy schemes. However, come April 2022, everyone should be on the career-average 2015 (maybe renamed to 2022) NHS pension scheme so hopefully this should still be applicable then. 

The UK has been through a tough economic year, given people have lost jobs, people have been been put on furlough and there has been massive government spending. There has been a lot of money being pumped into the (successful) vaccination drive that will hopefully kick-start our recovery. A lot has been talked about the 'national debt' but given this is a fiat currency, this will always be the case... (possibly discussed at a later date). Rishi Sunak was given the unenviable job of creating a budget plan to try help the recovery which he reveal 2 days ago. Below are what I feel are the biggest changes in the coming tax years.

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.

Last post I discussed the intricacies of the annual allowance, how earning above a certain amount or being stung by changing CPI's can cause you to be foul of the annual allowance. This post I will go over the lifetime allowance and how it applies to the 2015 scheme.

In my first post I explained how the NHS pension is calculated and it's more obvious benefits - I suggest reading that first otherwise it this may not make too much sense. The main reason I actually wanted to look into it was to calculate the annual allowance and to see if it was worth topping up a personal allowance. What I found was, that it was very complicated so hopefully I will be able to break it down for you in a easy to follow manner. Again, I am only talking about the 2015 NHS pension.

Covid has really been tough for older people, being constantly reminded that this disease is a death sentence for them and having to isolate at home. What has been even tougher is older people in the care homes. They've heard through out the pandemic that Covid has been racing through the homes and a lot of the deaths have been in them. In the care home I help look after, the social isolation has really been getting to a lot of the residents. 

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...

Never expected big numbers with my first app, its quite a niche market and I've done no advertising for it. I haven't put it on the App Store on iOS (no point for £99 a year) but eventually I will. There is a separate app called play developer console which gives you some analytics about the app. It's been roughly 3 months on the Google Play Store, below are the numbers.

Thus ends this short journey. I still have one to do, but isn't quite a matched bet, more of a money-back gamble. In the end it was too time-consuming for me for not enough pay off and it always was quite boring to do. In total I made £957.67 tax free which ain't bad. 

Must admit, the grind of this is getting long and boring. Profit is down as I'm finishing the sign up offers and just relying on reload ones. I learnt how to do ACCA bets this month, but doing it is long... I think I will stop after my subscription ends this month, time spent is not worth the pay off... Here are the stats for this month.

Out of hours is a service that provides primary care when the normal GPs have closed, so is usually available after 18:30 on weekdays and all the weekends. It is also available on bank holidays if the GP surgeries are closed (which is most of the time but during Covid, GP surgeries have had to stay open for 2 of the bank holidays). Ideally issues that are dealt with are ones that are more urgent that can't wait until  you see your regular GP, not a long term issue that requires investigations or referrals. 

So one month in part-time Matched betting, I feel I've made an alright profit. It did take a bit of time near the start but I sped up nearer the end of the month, so it takes much less time making bets. I barely think about it now which does worry me that I'll make a mistake but I've only had a few slip ups (!) - these have actually been me not really reading the terms & conditions of the promotion, and not an issue of placing the bet. I've signed up to the monthly profit accumulator website which has a very useful oddsmatching tool which greatly speeds up finding the deals and finding the odds. You can sign up here  (referral link - both get £20 if you sign up!). 

After introducing this new scheme , there have been problems with new partners getting their payments. Hurdles that were put in the way had been that the probationary period of fixed-profit that a lot of practices put in place when a new partner joins. This period has new partners paid a fixed salary rather than a share of the profits for a short amount of time. When these partners have gone to apply to the scheme, they've been told that they are no eligible for the payment, as they are not profit sharing and also because when do become profit sharing after their probation then they will still not be eligible as they wont be 'new partners'. 

I created an app, very basic and first one on Flutter. I hope to develop more slick versions but it was said to just get your first one out so you know the process of creating, uploading and publishing an app to the App stores. I have only published it to the Google Play store as I don't plan on paying £99 a year just for the privilage of uploading to the Apple App store but if I do create another app, I likely will. It has very basic functions but I find it useful as a reference tool to see what are the current guidelines for cancer referrals in primary care. Give it a download and give it a review if you think its good! Please click here to check out the app!

Matched betting is a system of getting guaranteed profit from bookmakers. It’s been around for years but I’ve never got round to doing it as I thought it was too complicated and it would take too much of my time. Now we can't do much due to Covid, I thought I'd give it a go and will document my journey through this. Profits are likely low compared to time spent but it’s risk free, stress-free and tax-free.

The government and NHS have released their new Covid-19 app. After their disastrous trial on the Isle of Wight, it can be assumed that things have been ironed out enough to roll out for general release. It works via Apple's/Googles Covid-19 API which allows phones to handshake each other over Bluetooth. This API is only provided to healthcare authorities so other app developers aren't able to exploit it to make other apps. It takes the much talked about de-centralised approach to contact tracing, meaning that in theory, the app developer/government wont know which users have been in contact. Countries trying to do the centralised approach have been struggling as Apple refused to let app developers meddle with the Bluetooth settings so have had to adopt this de-centralised approach. Below is the rough blueprint of the two systems.

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.

I recently published my first Flutter app, and one of the hard parts as a newbie was signing and  creating the app bundle from Android studio. There is a good link here walking you through it but it didn't help with the details if you were having any issues. Here is my walkthrough on how to do create your app bundle and what to do if you had issues like me. This walkthrough is applicable to Windows. Once you're happy with your app and created a nice app icon, you're ready to sign it.  Copy and paste this command into the terminal, replacing USER_NAME with your particular username. This will create a key file. You do not need to store the key in that particular folder but just for ease of use and for finding it later. keytool -genkey -v -keystore c:\Users\USER_NAME\key.jks -storetype JKS -keyalg RSA -keysize 2048 -validity 10000 -alias key   Now for me, when I input that command, it did not recognise keytool as a command. The way I fixed it was to download the new...