Digital and Tech GP @drgandalf52 Twitter profile

Pinned Tweet

Digital and Tech GP

4 years

Resources to help with telephone & video consultations. Quick telephone consult tips: Best webcam for video consults: Video consultation tips for GPs: @AccuRx video in <5 mins:

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Digital and Tech GP

@drgandalf52

1 year

There is no such thing as a sick note for children. Please do NOT contact your GP for one of these. If your child's school has asked for one, then the school should put the request in writing to the practice with your written consent or it is NOT a genuine request.

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Digital and Tech GP

@drgandalf52

2 years

Hearing NHS 111 so overloaded tonight that they are closing calls and directing all online as no capacity. If true, how rundown does the NHS have to be until the public realise the impact our government had on our healthcare service? Good luck to our patients & tired workforce.

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Digital and Tech GP

@drgandalf52

1 year

My day in GP: Closed triage list as it was over 60 at 9am (never happened before) Finished morning clinic at 1342 (meant to finish at 1100). Afternoon clinic starts at 1330 Now finished PM clinic (practice closed at 1830) Oh and have a visit to do still... How was your Monday?

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Digital and Tech GP

@drgandalf52

3 years

There is a national shortage of: 👩‍⚕️GPs 👨‍⚕️Nurses 🚑Paramedics 🚛HGV drivers Only one of these gets government support and public action. The rest are told to work harder, longer, and for less pay while being vilified by the media. Why is that?

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Digital and Tech GP

@drgandalf52

5 years

Doctor: Don’t confuse your google search with my 6 years at medical school. Patient: Don’t confuse the 1-hour lecture you had on my condition with my 10 years of living with it. Common sense: stop claiming superiority and work together. #Health

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Digital and Tech GP

@drgandalf52

2 years

If a stadium has a capacity of 100k and 150k people want tickets, then 50k will miss out. It doesn’t mean that the match isn’t played. If a GP surgery can offer 200 appts a day and 500 people want them, then 300 people will not get seen. This does not mean your GP is not working

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Digital and Tech GP

@drgandalf52

1 year

A safe minimum staffing level for the NHS strikes is actually a great idea. However, it would require more staff than we currently have....

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Digital and Tech GP

@drgandalf52

1 year

Unpopular opinion. GPs and other doctors / clinicians shouldn't cover for nurses and paramedics going on strike. What do you think?

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Digital and Tech GP

@drgandalf52

2 years

The GP appointment paradox: Patient: 'I can NEVER get an appointment'. Saying while in the room with me for an appointment. 6th contact in past 2 months. 20th in the past year mix F2F and phone. And repeat....

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Digital and Tech GP

@drgandalf52

2 years

We do not have a GP access problem. We have a GP capacity problem

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Digital and Tech GP

@drgandalf52

2 years

If a supermarket has 100 loaves of bread and 150 people want them, 50 people will go without. It doesn’t mean the supermarket is shut. If a GP surgery can offer 200 appts a day and 500 people want them, then 300 people will not get seen. This does not mean your GP is not working

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Digital and Tech GP

@drgandalf52

3 years

Chris Whitty @CMO_England of England thanking General Practice for its efforts over the pandemic. That is why he came to conference. To say thank you! #RCGPAC

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Digital and Tech GP

@drgandalf52

3 years

The iceberg of General Practice #gpcrisis #nhs #medtwitter

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Digital and Tech GP

@drgandalf52

2 years

To be a GP you must have done some rotations in hospital medicine as part of the training. Therefore to appreciate the patient's journey and how healthcare works, should ALL hospital doctors do a rotation in General Practice?

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Digital and Tech GP

@drgandalf52

2 years

Right after a mental day in practice, I am finally going home. It 2124 and signing out my practice after dealing with all the work from today. Been here since 0750 am. Over 100 extra 'urgent' contacts, some were, several not. No capacity anywhere. NHS is broken

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Digital and Tech GP

@drgandalf52

24 days

If I see a patient in 10 minutes, it's because I spent over 10 years learning how to assess, reason, manage and support a patient in that 10 minutes. You owe me for the years, not the minutes. Something the NHS, @NHSEngland and our Government want to ignore.

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Digital and Tech GP

@drgandalf52

2 years

To all those who find 'It's Going to Hurt' uncomfortable viewing. Is that because it shows the dark side of working in the NHS? It shows what many clinicians do and behave to survive both an amazing organisation, but also a cruel and under funded one in the NHS IMHO.

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Digital and Tech GP

@drgandalf52

1 year

A myth of General Practice: Myth: 'My GP can see what happens to me when I get seen in the NHS hospital as I have one health record' Reality: no unified records. Example: Patient seen in clinic ~20th Oct, a letter typed early Nov. Arrived GP 24.11.22 This is the reality...

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Digital and Tech GP

@drgandalf52

2 years

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

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Digital and Tech GP

@drgandalf52

3 years

'It's not a covid cough' 'Great, but I can't tell a COVID cough from another cough and I have an equal responsibility to you as my patient and my other patients, so you need a PCR test as well.' This conversation x10 a day at present....😒😷

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Digital and Tech GP

@drgandalf52

2 years

Why is it so hard to see a doctor or nurse in the UK any more? Is it because they are lazy? Or is it because the UK has fewer than any other OECD country?

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Digital and Tech GP

@drgandalf52

2 years

The NHS is free at the point of need. Not want. A hard message for many to accept.

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Digital and Tech GP

@drgandalf52

2 years

How to make a GP happy without really trying. On discharge summaries, list the medications in alphabetical order. A simple, but significant time-saving tip to help your neighbourhood GP.

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Digital and Tech GP

@drgandalf52

2 years

Maybe this is a major reason you can not see a GP! ⬆️ Near 10% growth in population. ⬆️ Over 25% growth in population >65 years old ⬇️ Near 10% reduction in GPs Duh... image from the @FT

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Digital and Tech GP

@drgandalf52

2 years

Myth vs Fact. Myth: Your GP can expedite your outpatient hospital appointment. Fact: Your GP can't. Only the hospital team managing the outpatient clinic can.

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Digital and Tech GP

@drgandalf52

3 years

So @sajidjavid says the NHS is sustainable? Yesterday I had 35 consultations in my morning clinic, 10 more than is deemed safe in a whole day! In practice 7.30am-6pm. Working hours 8am-1230pm. If not for my amazing team I could have walked out yesterday. Is that sustainable?

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Digital and Tech GP

@drgandalf52

2 years

The NHS is an amazing organisation. It is also an awful employer.

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Digital and Tech GP

@drgandalf52

2 years

A patient is surprised I called them at 1930 to sort out their urgent issue after the practice is closed over an hour ago. Commented they are halfway down my list and not going home anytime soon. At least this patient didn't shout at me like most the others today.

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Digital and Tech GP

@drgandalf52

2 years

The craziness of our prescription system in England Hypothyroid - ALL scripts free for 'life'. Contraception is free but the morning after pill is ~£30 unless you contact practice (costing the NHS >£35) Asthma needing inhalers not free despite poor compliance can kill you.

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Digital and Tech GP

@drgandalf52

2 years

Anyone anxious about going back to work In General Practice tomorrow? I won't log on early tonight, but know many of my colleagues will to try and 'clear the decks'. Look after yourself, tomorrow will come and go.

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Digital and Tech GP

@drgandalf52

2 years

After 3 and a half months. Dad is home. Thank you NHS for bringing him back home.

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Digital and Tech GP

@drgandalf52

1 year

Please note not all sore throats are Strep A. In fact most are not. I need this to be shared for the safety of all patients and the sanity of our primary care workforce.

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Digital and Tech GP

@drgandalf52

2 years

Refer patient to IAPT for support with mental health. Response: Too complex, refer to local mental health team (LMHT) Refer to LMHT, not complex enough. Refer to IAPT. Refer to both copying in replies. Declined to see as referred to another provider GP blamed for doing nothing!

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Digital and Tech GP

@drgandalf52

2 years

Having to say this again. General Practice access is not the issue. General Practice capacity is the issue.

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Digital and Tech GP

@drgandalf52

2 years

Over the weekend saw people I have not seen in a while. Every single one asked me if I was seeing patients F2F yet! All seemed surprised when I said I had seen patients F2F since day 1 of lockdown and through the COVID pandemic. I hate this narrative that GPs have been shut!

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Digital and Tech GP

@drgandalf52

2 years

Keen to know how seeing your GP in the next 2 weeks will change the 22-week + wait to be seen for most outpatient hospital services....

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Digital and Tech GP

@drgandalf52

3 years

Schrodinger's cough - simultaneously so bad that you need antibiotics, whilst not being bad enough to self-isolate and do a PCR. By @tonihazellgp 😁

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Digital and Tech GP

@drgandalf52

2 years

Was asked by a patient how I was getting on as they hadn't seen me in a while. I gave my standard answer: 'ticking along'. Their response: 'like a time bomb?' Some patients know how strained we are in General Practice...

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Digital and Tech GP

@drgandalf52

2 years

So after 40 days, I have managed to have a 2-way conversation with my Dad. This is after over 2 weeks in ICU being intubated and ventilated, a trach and now moving to rehab phase. Thank you to the teams at @nottmhospitals @NUHCriticalCare and wider.

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Digital and Tech GP

@drgandalf52

9 months

Ask yourself this? If GPs are: 'Overpaid' 'Not busy' 'Take long lunches' 'Do an easy job' 'play golf all the time' Then why are they all leaving the job? Why can't the NHS retain GPs?

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Digital and Tech GP

@drgandalf52

2 years

Omicron Covid testing - a guide on which test to do and when Available to share and use (unofficial guide)

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Digital and Tech GP

@drgandalf52

2 years

Boris has announced massive vaccination plans. Please do not ring your GP to ask about them. Please give us at least 24 hours to work out the latest dictat from @BorisJohnson or it will just block the lines for us to say we don't know yet.... #vaccination #BorisJohnson

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Digital and Tech GP

@drgandalf52

3 years

To make General Practice a career people will stay in: 🕒 Minimum 15min appointment ⚖️ 3:1 balance clinical to admin time to do the work. 🚫 Max 25 contacts a day (like Europe) 🥗 30min lunch break (pref with the team ⛔ stop the vilification in the media How difficult is it?

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Digital and Tech GP

@drgandalf52

1 year

Dear @SteveBarclay this 'achievement' has didly squat to do with your work or policies. It due to the staff in General Practice breaking themselves for patients. Staff you do not value at all as shown by the new GP contract details:

GP Contract update 2023/24

Join Andy and Gandhi for our first impressions on the GP contract for 2023/2400:00 GP contract review 23/2401:12 GP contract still awaited02:35 PCN DES08:33 ...

www.youtube.com

Steve Barclay

@SteveBarclay

1 year

We’re making real progress in getting patients to see their GP quicker. ✅ Almost 2 million more appointments were delivered this February vs. February last year. 🗓️ That’s 100,000 more appointments each working day. 📈 With more GPs and primary care staff to come.

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Digital and Tech GP

@drgandalf52

1 year

Just to point out it is the end of 28th March. New Enforced GP contract comes into effect in 3 days. The full details have not been published by @NHSEngland Is there any other business where details of a national contract are still not provided 3 days before it starts?

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Digital and Tech GP

@drgandalf52

2 years

Did you know it costs almost twice as much to the NHS (and therefore the taxpayer) when a patient goes to A&E than it does to use a GP practice? Imagine if General Practice was funded to try to meet the demand, how much we could save.....

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Digital and Tech GP

@drgandalf52

2 years

Accused by a patient for making them lose their job. They wanted me to sign a covid exemption certificate. 🚫 No allergy to vaccine contents 🚫 Not had a reaction to first dose 🚫 No health issues to prevent use/impact understanding I didn't make the rules I won't lie though

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Digital and Tech GP

@drgandalf52

1 year

Yesterday was one of the worst days I have had in practice in a long time. Today looks worse. WTF is going on...

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Digital and Tech GP

@drgandalf52

2 years

On a chaotic busy day 10% of my consultations have been patients contacting the practice to urgently sort out their delayed appointments with outpatients/ surgery. Some accept there is a back log. Some do not 😔 None contacted the hospital team first. This needs to change.

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Digital and Tech GP

@drgandalf52

4 years

GP pet peeve: when the ED tells my patient to see a specialist and I 'have' to refer them Many do not know what primary care is capable of: the resources we can use and the skills we have (or the hoops to go through). A highly trained GP can do infinitely more than you realise.

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Digital and Tech GP

@drgandalf52

2 years

How much does NHS care cost?

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Digital and Tech GP

@drgandalf52

2 years

Do you agree or disagree? Medicine is no longer a vocation. It is servitude.

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Digital and Tech GP

@drgandalf52

4 years

GP basing on twitter has not made a hard day any easier. Few points: 1. GPs didn't 'close', we adapted to the biggest healthcare nightmare of this generation 2. Need vs Want is a complexity few understand- especially the media and 'righteous'. 3. Without GP the NHS couldn't exist

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Digital and Tech GP

@drgandalf52

2 years

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 🧵⤵️

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Digital and Tech GP

@drgandalf52

2 years

So I am creating a twitter community. Healthtech in UK Primary Care. If you want to join, let me know and il send an invite.

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Digital and Tech GP

@drgandalf52

1 year

Thank you to all who vote in Medical personality of the year 2022, but there was one clear winner. Congratulations @parody_RCGP for being voted #MPOTY22 by the #Twitterverse after over 500 votes! See below for our mega runner up

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Digital and Tech GP

@drgandalf52

2 years

Unfortunately, our local pharmacy is telling everyone to go see the GP for hay fever treatment. Going to have a word later after this triage clinic of which 30% is now hayfever symptoms....

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Digital and Tech GP

@drgandalf52

2 years

My advice to all doctors is do General Practice. But only if you want to, not as a back up. Otherwise you will hate it. I love it. Love the patients, my team and the variability and innovation. But it is so damn hard at times it that it may break you. Selling it?

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Digital and Tech GP

@drgandalf52

4 years

Are GPs the hobbits of the NHS? ➡️Steadfast ➡️loyal to a fault ➡️source of ridicule and blame ➡️need more resources than you think ➡️often mocked by others for their abilities ➡️but without them the world would have ended ➡️only the fellowship know their true worth?

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Digital and Tech GP

@drgandalf52

2 years

Dear colleague. Stating it is 'obviously' not condition X after arranging blood tests, scans I can't request in primary care and invasive testing doesn't really help anyone. Your retrospectoscope may be perfect, but your communication skills clearly are not.

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Digital and Tech GP

@drgandalf52

1 year

Why you can't see a GP. The reality in the NHS. Are you next?

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Digital and Tech GP

@drgandalf52

2 years

GPs are the hobbits of the NHS 🧝‍♂️ ▶️Steadfast ▶️Loyal to a fault ▶️Source of ridicule and blame ▶️Need more help than you think ▶️Often mocked by others for their abilities ▶️But without them, our NHS would have ended ▶️Only the fellowship knows their true worth

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Digital and Tech GP

@drgandalf52

2 years

NHS GP practice: offering unlimited online, phone, f2f or visits based on need and capacity which receives ~£155 a year to deliver this. Private GP service: offering 2x f2f/phone consultations and 2x video consultations for £480 a year. Which is better value to you?

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Digital and Tech GP

@drgandalf52

2 years

So @sajidjavid is going ahead with plan #GPnationalise He doesn't acknowledge it will double the cost of primary care as GP partners & their teams will stop doing all their extra work for free. Trusts will then ask for more money to do the same work. Answer then to sell it off

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Digital and Tech GP

@drgandalf52

1 year

Our PM @RishiSunak uses a private GP service which charges £250 per use. Your GP gets just over half (ave ~£156) of that for providing a year's worth of care regardless of how many times you use the practice (online, phone, video, or F2F). NHS General Practice is underfunded.

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Digital and Tech GP

@drgandalf52

3 years

Is the @DailyMailUK prejudicial against General Practice? Explain No Yes 👇🏽 👇🏽 👇🏽

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Digital and Tech GP

@drgandalf52

1 year

A quick win for @Jeremy_Hunt to increase the number of doctors and GPs is fix the pension/tax farce stopping doctors working. Over 3 months in and nothing yet. It really is simple

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Digital and Tech GP

@drgandalf52

2 years

About to sit down to the first Christmas meal without dad. He is stable but still with amazing nurses, doctors and the team in hospital. Miss him so much. Hold your family close and be sensible this holiday period all.

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Digital and Tech GP

@drgandalf52

4 years

If @BorisJohnson justification for #Lockdown2 is to 'save Christmas' rather than purely for the safety & health of our nation then I personally will be offended. Many gave up Eid and Diwali for public safety during #COVID19 & as we are repeatedly told: We are in this together.

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Digital and Tech GP

@drgandalf52

2 years

Tips for great outpatient clinic letters: 1️⃣ Copy the patient in 2️⃣ Write without jargon or abbreviations 3️⃣ Clear section at top for GP actions/info 4️⃣ Don't ask GP to do something you can do just as easily 5️⃣ Section on what to do if things don't work (pref not just 'see GP')

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Digital and Tech GP

@drgandalf52

2 years

Appraisal 2023....

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Digital and Tech GP

@drgandalf52

11 months

We are preparing the next generation of GPs for a job that existed 10-20 years ago, rather than the job that exists today. Apt and true words.

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Digital and Tech GP

@drgandalf52

3 years

I still carry and wear my mask when I go indoors (and really crowded outdoor places like the marathon today). Please retweet if you do the same as it feels like I'm the only one sometimes.

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Digital and Tech GP

@drgandalf52

2 years

P: Why won't you prescribe my medication? Me: What medication is that? I have no medical details as you just joined the practice. P: I don't know. My medicine. Me: What do you take it for? What health issues do you have? P: I don't know just give me my medication. And repeat

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Digital and Tech GP

@drgandalf52

2 years

Which covid test should you do explained in one graphic Feel free to use/share

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Digital and Tech GP

@drgandalf52

2 years

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

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Digital and Tech GP

@drgandalf52

3 years

These are not the fault of GP receptionists: 🚫 No appointments ⌛You missed your appointment 💊 Your medication review is overdue 🚛 Medicines out of supply 🧪 Your sample is lost in the lab ☎️ The number of people waiting in front of you 😭 The state of the #NHS #GPcrisis

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Digital and Tech GP

@drgandalf52

2 years

Writing 'GP to kindly do' is not kind when it is the 6th item in a row on the same letter! Please do not do this.... Kindly

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Digital and Tech GP

@drgandalf52

3 years

Me: 'Hello, I believe you requested an urgent call back from the practice?' Patient: 'Yes' (privacy and ID check) Me: 'How can I help with your urgent issue?' Patient: 'I have had this now for 2 years....' Every day in one way or another. The system is broken.

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Digital and Tech GP

@drgandalf52

2 years

What is the 'real' problem with GP appointments?

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Digital and Tech GP

@drgandalf52

2 years

Dear pharmacists, I love you, really I do. And I know the supply lines are frazzling us all. But even I am not telepathic as to what you do stock. Please please please have the courtesy to give that information, or anticipate a frustrated call.

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Digital and Tech GP

@drgandalf52

2 years

Dear @NHSEngland . You have made some bonkers decisions in the past. Extending the @CapitaPlc contract for PCSE services takes the cake and shows either: ➡️ Incompetence ➡️ Nepotism ➡️ Sadistic pleasure in punishing primary care ➡️ A combo of some/ all.

Capita secures three-year extension to deliver primary care support services

Capita has secured a three-year extension with NHS England and Improvement (NHSEI) to deliver primary care support until 2025.

www.pulsetoday.co.uk

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Digital and Tech GP

@drgandalf52

2 years

Did not know this, thank @BMA_GP New plan Private GP services asking patient GP practices to refer will be charged an admin fee for the used GP practice time and delaying the patient treatment time for all requested NHS referrals. template letter in the works....

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Digital and Tech GP

@drgandalf52

2 years

Have an idea for an infographic about the NHS which I think is cool but likely to cause some controversy. Should I do it?

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Digital and Tech GP

@drgandalf52

2 years

NHS activity data 2021-2021 from @NHSDigital data.

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Digital and Tech GP

@drgandalf52

2 years

Being a doctor is my job. It is not my life. Aware people in and around my life may feel different but seems I need to clarify this.

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Digital and Tech GP

@drgandalf52

2 years

So my GP update training today has suggested if you are tired for more than 4 weeks this could be due to: Diabetes Hypothyroidism Long covid CFS/ME Menopause CKD OSA Anaemia Heart failure Depression/anxiety Life That all they could cover in 6 hours. Easy being a GP right?

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Digital and Tech GP

@drgandalf52

2 years

Reflections on the NHS, Ramadan, probity and the state of General Practice. A thread 🧵⤵️1/x

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Digital and Tech GP

@drgandalf52

1 year

Shockingly, the @DHSCgovuk on behalf of @SteveBarclay confirms that some doctors have received a ~£20,000 pay cut over the terms of the current government. Would you accept that?

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Digital and Tech GP

@drgandalf52

2 years

There is a systemic lack of GP capacity that some vilify which is a national issue. Feeling so stressed that the only way a person sees out is suicide is a personal issue. One impacting potentially all healthcare professionals. Be kind to your GPs and healthcare team 😢

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Digital and Tech GP

@drgandalf52

3 years

Thank you Mr Wade. #voteWadeforGPC 😜

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Digital and Tech GP

@drgandalf52

2 years

After 4 months.... Dad has taken his first steps. Slow progress but progress is go.

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Digital and Tech GP

@drgandalf52

2 years

Why do practices use Physician associates? 📖 Knowledgeable and broad skill clinical workforce group 🤒 Ideal skills for acute care with deeper abilities with training 👋 Valued part of our team 📉 Not enough GPs to run modern General Practice 💷 ARRS funding #BBCPanorama

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Digital and Tech GP

@drgandalf52

3 years

So those that don't know, I'm currently off with covid 🤧 Day 7 of symptoms 😷 Cough and brain fog still here. Rest OK 🤯 Tried to help practice remotely 💻 Took me 2 hours to do work that normally takes me 20 mins ⏳ Had to tap out 🤕 I feel so guilty 😶 I hate this 😔

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Digital and Tech GP

@drgandalf52

2 years

General Practice appointment data May 2022 17% increase in all appointments from last year 35% increase in F2F appointments from last year General Practice is not now, nor has it ever been 'shut' Data:

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Digital and Tech GP

@drgandalf52

2 years

Covid might be mild for you. Omicron might like a cold for you. For someone else it could be a hospital admission, weeks on ICU or death sentence. Be safe, be sensible and show kindness for others. #WearAMask

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Digital and Tech GP

@drgandalf52

4 years

This video shows patients how to start a video consultation. With many practices using video consultations to provide care due to #coronavirus , sharing this video via SMS/text before starting a consultation may help to make the consultation easier.

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Digital and Tech GP

@drgandalf52

3 years

The government has failed to inform patients effectively about COVID testing. If you have a new cough/temp or loss of smell/taste you need to have a PCR test ✅ A Lateral flow is not accurate ❌ Had to explain this over 10 times today

7

24

103

Digital and Tech GP

@drgandalf52

1 year

Can you do this job or find anyone who can?

3

38

104