# general practitioners (blogs) — RSS Amplifier Recent posts from the 2 feeds in the RSS Amplifier directory that cover general practitioners. Page: Feed: --- ## [Advice and Guidance as a rationing model.](https://nhsreality.wordpress.com/2026/08/19/advice-and-guidance-as-a-rationing-model/) _2026-08-19 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ When there are not enough people with enough knowledge and skills, action needs to be taken. In the UK this is always short term approaches which a superficial media and body politic fail to delve more deeply into. Long term solutions are indigestible and unpalatable, and cannot even be discussed. Matthew Syed is correct when \[…\] ## [Downgrading mothers and babies in Barnstable will be followed by strokes, as in Hywel Dda, thus increasing the “health divide”. Dumbing down of life expectancy will apply equally in Wales to parts of England.](https://nhsreality.wordpress.com/2026/08/17/maternity-deserts-and-the-dumbing-down-of-life-expectancy-apply-equally-in-wales-to-england-downgrading-in-barnstable-will-be-followed-by-strokes-as-in-hywel-dda-thus-increasing-the-health-divi/) _2026-08-17 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ Barnstable and Haverfordwest share a need. They have up until now had hospitals with maternity and neonatal care, but gradual reductions have disillusioned the public. Those with the means and a good reason will leave, and those who cannot or who want to embrace the higher risk and lower life expectancy will stay. These are \[…\] ## [Managers and sludge make sure that many cancer and other deserving patients never reach the consultant in time. Rationing referrals….](https://nhsreality.wordpress.com/2026/08/17/managers-and-sludge-make-sure-that-many-cancer-patients-never-reach-the-consultant-in-time/) _2026-08-17 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ The rationing of money people and resources into General Practice and Primary Care is well documented. Despite a 2 decade political promise to put more money into primary care, the opposite has happened. The attitude off management, influenced much more by hospital doctors, is to respond short term. Primary care and General Practice is “long \[…\] ## [Staff feeling invisible and unimportant. External exit interviews might really help expose the “invisible” people …](https://nhsreality.wordpress.com/2026/08/17/staff-feeling-invisible-and-unimportant-external-exit-interviews-might-really-help-expose-the-invisible-people/) _2026-08-17 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ NHSreality has opined on the lack of “Exit Interviews” before, but I particularly like this method of expression and exposure. Not that anyone will listen. Staff feeling invisible and unimportant. External exit interviews might really help expose the “invisible” people …This is something that Trust Boards and politicians have to find money for. Doing without \[…\] ## [The current situation regarding the rationing and uneven post coded distribution of social care is explained in part 1. Listen to part 2 to be fully informed.](https://nhsreality.wordpress.com/2026/08/17/the-current-situation-regarding-the-rationing-and-uneven-post-coded-distribution-of-social-care-is-explained-in-part-1-listen-to-part-2-to-be-fully-informed/) _2026-08-17 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ Listen to the podcasts. Reflect on why we have always failed …I have a few Premium Bonds and my number came up the other day. I won £25 and am pleased that this went into my bank account. If my number comes up on the lottery of life, and I have a long term illness \[…\] ## [In most respects, especially fiscally, devolution has failed its children, especially in Wales where more parochial behaviour is encouraged and choices and opportunities are limited. We are in a “national multi-issue denial…](https://nhsreality.wordpress.com/2026/08/14/in-most-respects-especially-fiscally-devolution-has-failed-its-children-especially-in-wales-where-more-parochial-behaviour-is-encouraged-and-choices-and-opportunities-are-limited-we-are-in-a-nat/) _2026-08-14 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ I have lived in Wales for 46 years now, and bought up 3 children in Pembrokeshire. The little England beyond Wales had no problem with its identity and although the Welsh Nationalists were committing arson in Cardigan, it rarely came south. The signposting was deliberately destroyed, but intelligent visitors used maps. The Pembrokeshire Yeomanry and \[ \] ## [Politicians are sighting on GP pay in their desire to cut costs.. And the spectre of a 10 year course to be a consultant GP](https://nhsreality.wordpress.com/2026/08/13/politicians-are-sighting-on-gp-pay-in-their-desire-to-cut-costs-and-the-spectre-of-a-10-year-course-to-be-a-consultant-gp/) _2026-08-13 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ Is making a profit a vice ? ( It is time for Labour to grow up. Profit is not a vice This reflects a distorted market. The high profits of a few practices are probably because they can employ cheap labour in city centres and suburbia. In these locations good transport means that part time doctors can \[ \] ## [My local rationing . An example and a challenge for local politicians to admit that Enoch Powell was right…](https://nhsreality.wordpress.com/2026/08/10/my-local-rationing-an-example-and-a-challenge-for-local-politicians-to-admit-that-enoch-powell-was-right/) _2026-08-10 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ Hywel Dda had correspondence with a citizen under the FOI rules. This is the response to their reply posted on Facebook in the Save Withybush Campaign. My response is below and relates to how we are going to ration overtly. Every local person wants the greatest number and choice of services local to them. Enoch \[ \] ## [Running out of food? Not impossible in a warming world where nations are not prepared to act together…. A strategic food supply plan is needed… for the UK](https://nhsreality.wordpress.com/2026/08/09/running-out-of-food-not-impossible-in-a-warming-world-where-nations-are-not-prepared-to-act-together-a-strategic-food-supply-plan-is-needed/) _2026-08-09 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ The Global Food Security Index ( see below ) web page was last complete 2022. The 11th Global Food Security Index shows a deterioration in the global food environment for the third year, threatening food security. But in 2025 the insights at economist enterprise published In 2025, Finland ranks first in the Global Food Security \[ \] ## [Still using paper notes – after all this time!](https://nhsreality.wordpress.com/2026/08/08/still-using-paper-notes-after-all-this-time/) _2026-08-08 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ NHSreality has suggested integrated IT systems in every trust, and recommended that any of the GP systems available should be chosen in each Trust. Since this has not happened, probably because GPs were never allowed to influence trusts ( we are self employed businessmen who make a profit and this is a vice ) no \[ \] ## [Ship everywhere from one CLI (Sponsored)](https://crawlproof.com/a/hSXH13S3rxt9) _2026-08-08 · **Sponsored**_ One codebase, hosted runners, encrypted credentials, and automated submissions across stores ## [A possible template for a plan for the future of General Practice – who wants to be the fall guy?](https://nhsreality.wordpress.com/2026/08/08/a-possible-template-for-a-plan-for-the-future-of-general-practice-who-wants-to-be-the-fall-guy/) _2026-08-08 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ Is the Descriptor below inevitable? I can see that Prof Hay be predicting correctly. I personally would probably not have chosen GP as a career under such a plan but who knows? Medical school training courses to be extended to add an MBA for all aspiring GP Team leaders? Think of the increased cost, and personal \[ \] ## [The management of the crumbling NHS Estate… Mistakes compounded on mistakes](https://nhsreality.wordpress.com/2026/08/08/the-management-of-the-crumbling-nhs-estate-mistakes-compounded-on-mistakes/) _2026-08-08 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ NHSreality has opined on the RAAC ( Reinforced Autoclaved Aeriated Concrete ) scandal and it being swept under the radar .. The lack of an Honest Debate means that structures are failing, and service failures will have to follow. In my own part of the country, and an example that follows through in many other \[ \] ## [Equitable funding of social care – and the choices we all have to make. “Denying nursing home residents equitable access to NHS community services increases pressure on care providers and contributes to avoidable hospital admissions”.](https://nhsreality.wordpress.com/2026/08/08/equitable-funding-of-social-care-and-the-choices-we-make/) _2026-08-08 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ The big question is whether equitable funding of social care should be pre-planned and covered by insurance or not? If not I see no way to make it fair, because those who have saved and were thrifty are punished more than those who spent everything. If we take the risk that we will never need \[ \] ## [Is the unfair funding of GP practices ( And NHS Dentists ) a scandal yet to be exposed? Is the word profit unethical/ banned / a “vice”?](https://nhsreality.wordpress.com/2026/08/07/is-the-unfair-funding-of-gp-practices-and-nhs-dentists-a-scandal-yet-to-be-exposed-is-the-word-profit-unethical-banned-a-vice/) _2026-08-07 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ NHSreality has tried to explain the funding of the self employed businesses which have subcontracted to the 4 Health Services since inception. General Practice and Dentistry. The two groups have had their contracts imposed on them, and in Dentistry this has resulted in a complete breakdown, numerous citizens who do without a dentist, and a \[ \] ## [As access gets worse, and waits lengthen, referrals increase, and complaints rise, the waiting list could be solved especially in the rural areas where there will be the most excess deaths](https://nhsreality.wordpress.com/2026/08/03/as-access-gets-worse-and-waits-lengthen-referrals-increase-and-complaints-rise-the-waiting-list-could-be-solved-especially-in-the-rural-areas-where-there-will-be-the-most-excess-deaths/) _2026-08-03 · Roger Burns - retired GP · NHS reality. An NHS soapbox. Speakers' corner for the NHS._ A retired Medical Director, who I suspect never had an exit interview, has spoken out in Pembrokeshire. The reality of poor survival and outcomes due to distance from basic facilities is real. The golden hour is the time between presentation and treatment for a cardiovascular event (Heart or brain) and in left behind parts of \[ \] ## [General practitioners do not need to be certain; they need to be safe](https://vitualis.com/?p=14718) _2026-06-04 · Michael Tam · Michael Tam_ This was a professional paper on the expert management of uncertainty in general practice settings. Doust J, MacIsaac MB, Tam CWM, Knight A, King D. General practitioners do not need to be certain; they need to be safe. Australian Journal of General Practice 2026; 55(6): 334-339 DOI: 10.31128/AJGP-10-25-7854 PDF | URL Abstract Introduction General practitioners … Continue reading ## [A qualitative study of the influence of childcare on high antibiotic use in a multicultural, lower socioeconomic community](https://vitualis.com/?p=13608) _2025-05-12 · Michael Tam · Michael Tam_ This paper on a qualitative study that I’m very proud of, where we interviewed early childhood educators and parents/carers, including in local community language, on their perspectives of antibiotic use in the Fairfield Local Government Area. Knight AW, Hasan I, Tam CWM, Qummouh R, Shehata A. A qualitative study of the influence of childcare on … Continue reading ## [Integrated Care for People Living With Rare Disease: A Scoping Review on Primary Care Models in Organization for Economic Cooperation and Development Countries](https://vitualis.com/?p=13485) _2025-02-10 · Michael Tam · Michael Tam_ This paper is a scoping review of the models of integrated care for people living with rare diseases, in primary care settings in OECD countries. Vidic N, McGlynn A, Abdi F, Tam CWM, Cramptom RM, Lim K-S, Palmer EE, Taylor N, Harris-Roxas B. Integrated Care for People Living With Rare Disease: A Scoping Review on … Continue reading ## [Development and pilot testing of the Population And ContExt adaption of decision aids (PACE) framework](https://vitualis.com/?p=13356) _2024-10-09 · Michael Tam · Michael Tam_ This paper on a contextualisation framework for clinical decision support aids to local populations was published in PEC Innovation. \[Link : PDF\] Dolan H, Bateson D, Li M, Thompson R, Tam CWM, Bonner C, Trevena L. Development and pilot testing of the Population and ContExt adaption of decision aids (PACE) framework. PEC Innovation 2024;5: 100347 … Continue reading