Adrian Fogarty wrote:
> To be fair Jel, Matt actually said "most general practice is not acute". 
> Your own figures (well, from "Julian") admits that of 1,000,000 GP 
> attendances, 1-200,000 are acute. So, simple mathematics should tell you 
> that over 80% of general practice is not acute. Hence, that would seem 
> to concur with Matt's viewpoint.
> 

I am not sure why names are in quotation marks - here is Julian's email 
address and he wrote the following, but I failed to include it.
'NB Pls feel free to copy to acad-ae-med, attributed, my email is 
[log in to unmask] if anyone from that list wishes to respond off 
list.'

And as for the mathematics, I don't think, and neither do you, I suspect, 
that that was the main thrust of the original posting.  If it were then I 
guess it might have read something like "GP's see a stack of work, both 
acute and non-acute, it's a good job that they share the workload with us 
or we would be more swamped than we are' ;-)


> And as for "Fay's" view, well clearly she must work in a parallel GP 
> universe to the one I'm used to seeing in central London. She suggests 
> that her GP practice is full of acute work on a Monday morning, but that 
> doesn't seem to fit with the patients pouring into my department on a 
> Monday who tell me they can't access their GP for days.

I don't think you really mean to be as silly as that statement might 
suggest :)   "I see lots of work so that means others aren't doing any????"


  She also
> mentions an OOH co-op on a Saturday evening as an example of "the acute 
> side [being] well covered elsewhere in the NHS". Fine, but how does 90% 
> of GPs giving up OOH work following the new contract constitute "the 
> acute side being well covered"? 

Well we can ask her - I will :)


And as Helen rightly points out, how do
> eight consultations with a GP OOH service which fail to identify serious 
> sepsis constitute "the acute side being well covered"?

So from silly to more silly?  Sounds like the sort of allegation made in a 
Statement of Claim that might be written about _anyone_ or any system - and 
indeed is likely to be, at some  point, if they are busy enough.

I don't think your level of understanding is really at the level portrayed.

  We're currently
> working with a co-located GP OOH pilot at the moment, and I'm shocked, 
> truly shocked, by what the GPs sometimes send back to us, claiming they 
> can't deal with.
> 
Yes, yes dear, and I have been shocked time and time again by stuff that 
bounces from A+E that is sick - or stuff that clearly isn't but gets 
investigated up the ying yang.  Name calling/generalisation based on the 
frustrations and busy-ness of our lives is unlikely to a)be based in 
reality b)show any of us in good light.

> Who knows, maybe Gordon Brown will see sense in all of this madness.

LOL :-)

Cheers - have a good weekend.  I am on-call - all via 'A+E'....uh oh!

Jel

> 
> AF
> 
> ----- Original Message ----- From: "Jel Coward" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, May 25, 2007 10:44 PM
> Subject: Re: EM- juniors future
> 
> 
>> Dunn Matthew (South Warwickshire General Hospitals NHS Trust) wrote:
>>> Most general practice is not acute. General Practice is changing as a 
>>> speciality, but it seems that what GPs do best and what has the most 
>>> impact on the health of the population are primary prevention, 
>>> secondary prevention and chronic disease management (in that order). 
>>> The acute side of a GPs work is usually a fairly minor part of the 
>>> workload and is well covered elsewhere in the NHS.
>>>
>>
>> So I had to ask about this on another jiscmail list - 2 replies below ;-)
>>
>>
>> Reply 1:
>> What is printed below is bollocks.
>>
>> We do about 50 - 80% of the acute care AFAIK, the vast majority of CDM 
>> (which includes secondary prevention), and are fit in a little primary 
>> prevention though that is basically the job of HVs, councils and 
>> national government (health not sickness management).
>>
>> The hospital point of view is simply so much narrower that it does 
>> not, and cannot, describe the reality.  The concern is that they do 
>> have significant influence.
>>
>> Locally the stats are roughly:
>>
>> A&E 70,000 attendances - about 50% minors, some of which could be 
>> dealt with elsewhere.
>> GP 1,000,000 attendances with GPs, some additional with practice 
>> nurses and others.
>> Of the 1m GP attendances 1-200,000 are for acute conditions - hence, 
>> roughly, GPs do 50-80% of acute care.
>> On top of that our OOH service has 35-50,000 contacts per annum, many 
>> at the far more serious end compared to WiCs, and especially to NHSD.
>>
>> Strangely GPs know quite a lot about what goes on in hospitals.
>>
>> Very asymmetric.
>>
>> Julian
>> NB Pls feel free to copy to acad-ae-med, attributed.
>>
>>
>> Reply 2:
>>
>>
>> "The acute side of a GPs work is usually a fairly minor part of the 
>> workload and is well covered elsewhere in the NHS. "
>>
>> Two incorrect statements there. He clearly has not seen what goes on 
>> in a GP practice on a Monday morning or an OOH co-op on a Saturday.
>> At least when I pontificate about A&E I can do so from the standpoint 
>> of having worked there both 2 decades ago and recently.
>>
>> Fay 
> 
>