I (@CraigNikolic) often post about the NHS's "Same day" plans for in-hours general practice hubs being dangerous, and why ICBs are misusing them to fill an unfunded gap, I rarely take time to explain WHY. So, here we go

They forgot to ask what patients really need. 1/28 If you were to take the NHS of a quieter time, with low waits and no decade of year-on-year cuts to services downstream of general practice, it may be something to consider.

We're not there though, and austerity general practice patients need GPs, not quantity of appts. 2/28

PCN DES Thread time trail!

Over the next few days, I will explain the PCN DES in General Practice.

Buckle up for an education.... 1/x🧵 ⤵️ The PCN DES (Primary Care Network Direct Enhanced Service) is a funding program aimed at improving primary care services in England.

It was introduced in 2019 as part of the NHS Long-Term Plan, which outlines the government's vision for the future of the NHS. 2/x

Hospital colleagues, community care, and wider.

Are you aware from 1st Nov most patients will have access to their GP records and see all communications & letters you send automatically?

Follow these 7 steps to make your's, the GP practice, and your patient's lives easier 🧵⤵️ 1. Assume the patient can see everything you have written.

This should be the norm, and applicable if the patient had requested a subject access request (SAR) anyway.

This is good medical practice anyway.

Welcome to #GPTriageTuesday #5 will you choose wisely?

Three consultation types but only one of each to use and you must use each one:

✉️ Online (text/photo only)
📱 Phone/video
😷 F2F can be clinic or visit.

Justify your answers if you can...

Your cases are below🧵⤵️ 1️⃣ 25y old ♀️ asking for the morning-after pill. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay.

2️⃣ 29y ♂️ asking for a nasal spray for hay fever. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay. 🧵⤵️

If you think seeing a GP is tough, unfortunately it is about to get so much worse...

Here is a thread why, and spoilers, it is going to be controversial as it goes along 🧵⤵️

1/x Firstly, General Practice was in a difficult place before COVID happened and pivoted overnight to create remote access to keep patients safe.

It then delivered the majority of the national 'World beating' vaccination scheme. 2/x

How to keep cool and healthy in a heatwave. 🌞

Some key tips to share with your friends, family and patients.

Enjoy the thread🧵⤵️ 1. Stop the heat getting in.

🪟 Close your doors and curtains/blinds. The sunlight brings the heat.

😎Shade is cooler so stop the sunlight and you will feel cooler.

Who advances to the final of #GPBattle for the greatest fictional TV 'GP' of all time?

Will it be the resilient Dr Martin Ellingham from Doc Martin or the finesse of Dr Gemma Foster from Doctor Foster to face Dr Karl Kennedy in the final

Vote below by Thurs morning... Vote for your finalist of #GPBattle for the greatest fictional TV 'GP' of all time?

Will it be the resilient Dr Martin Ellingham from Doc Martin or the finesse of Dr Gemma Foster from Doctor Foster?

You decide....

#medtwitter

So we know this winter is going to be terrible, and General Practice will take the brunt of it outside of hospital so here are some tips to help you survive.

A top ten General Practice reflective tips I guess.

1/x 1. Times will be uncertain.

Few places understand the level of risk General Practice manages but try to not go home worried about a plan you have made (insomnia test).

Talk it over with someone in your practice, team or network.

2/x