No.

311

August 2017 Flu Vaccines

The LMC Buying Group are just in the middle of our annual round
of negotiations with flu vaccine suppliers to get the best discounts
we can and deliver best profit per dose to practices (letter to come
out in next month/two months to confirm our preferred suppliers for
2018).

They have been round the table with three of the flu vaccine
suppliers and we asked this very question of why it isnt a level
playing field regards delivery of vaccines. They were told that the
Cornwall & Isles of Scilly

pharmacies often get deliveries earlier because the suppliers want

to shift their single dose packs first before the big packs of multiple
vaccines and many practices do not want these (due to lack of
fridge space). So, if a practice is happy to receive some/all of their
flu vaccines in single packs, they can and just need to ask their flu
supplier to do this and therefore get an earlier date. This is the
response they were given by Pfizer so itd be helpful for practices
happy to take the single doses earlier to let us know if they
encounter any problems.

Deadline for the September issue is

29th September 2017
LMC Newsletter

Inside this issue: Indemnity

Your Chairman writes
Sessional GP Newsletter
General; Data Protection
Regulation
Medical Performance Advisory
Group.
NHS Property Services
Update.
Verification of death policy
Cornwall Health
111 and OOH new Service
Hep B vaccine supplies
New PGDs
Improving access for all.
BMA guidancetraining
Cornwall 111
Events
2 Indemnity fees are kill-
ing our profession
3
4
Please sign at the bottom of
the article which is to be
passed to Jeremy Hunt.
5
Items for the Newsletter should be
6 sent to the Editor, Dawn Molenkamp
at Victoria Beacon Place, Room
B313, Station Approach, Victoria,
Roche, St Austell, PL26 8LG
7 Tel :01726 210141

Vacancies 8-12 e-mail dawn@kernowlmc.co.uk

Dr Basil Bile 13
Your Chairman writes ..
The summer has seen no let up in the rounds of meeting which we, as your representatives, attend. Most
of these have a routine feel to them with information and views being exchanged. Some are about building
relationships and some are about saving them. We review ideas both local and national, some sensible
and some completely barking. We hope either that we keep the worst of these away from ever entering
the General Practice consciousness and try and fine tune the others that are either worth preserving or
are coming our way no matter what we do or say. Recently I have been engaged with discussions at CCG
level about the contracts held by the CCG with secondary care providers. New national contracts were
introduced earlier this year and we have been looking at ways of evidencing whether or not providers are
keeping to agreed parameters. This is not as easy as you might think. Its fair to say that most of us are
battle weary of trying to knock back GP to do lists and please make sure that commands that we do not
list many of the very frequent transgressions.

Indeed, the sum total of the CCGs three months of evidence would not fill a week of that from my practice
if I were to collate it properly. So it was back to the drawing board for the evidence gathering and a redou-
bling of efforts to hold providers to account. Phew, I hear you say, at least the LMC as got our backs (I
hope you think that) - providers have had nearly six months to sort this out. Exactly, how hard can that
be ?

How disappointing therefore to find that although practices have had since 2004 to get used to their con-
tracted hours and responsibilities that some still dont seem to understand them. Our core hours are 0800-
1830. We MUST be available during those times. That means having a process whereby your phone is
answered at 0800 hrs either by the practice or by an intermediary, not 111. It also means that work that
flows into the practice during core hours must be dealt with EVEN if this means doing a visit after 1830 or
seeing a patient after 1830. It does not mean telling someone to phone back after 1830 for the OOH ser-
vice. This sort of practice undermines all of us, increases pressure on the OOH service (which we as GPs
own) and is actually a breach of contract. It makes our job at the LMC very difficult when we are faced
with evidence of this sort of behaviour. We cannot defend practices who do such things and it makes our
job very difficult at the top level trying to bring providers to account. Reasonably they ask for a quid pro
quo, so please dont do it.

if you are struggling for whatever reason, please let us know so we can help.

Sessional GP Newsletter

Here is the link for this months newsletter from the Sessional GP Subcommittee - click here .

NO . 3 1 1 Page 2
 General Data Protection Regulation (GDPR)
The GDPR will apply in the UK from 25 May 2018. The government has confirmed that the UKs decision to
leave the EU will not affect the commencement of the GDPR.

The GDPR applies to controllers and processors. The definitions are broadly the same as under the DPA ie
the controller says how and why personal data is processed and the processor acts on the controllers behalf. If
you are currently subject to the DPA, it is likely that you will also be subject to the GDPR. If you are a proces-
sor, the GDPR places specific legal obligations on you; for example, you are required to maintain records of
personal data and processing activities. You will have significantly more legal liability if you are responsible for
a breach. These obligations for processors are a new requirement under the GDPR. However, if you are a con-
troller, you are not relieved of your obligations where a processor is involved the GDPR places further obliga-
tions on you to ensure your contracts with processors comply with the GDPR.

The GDPR applies to processing carried out by organisations operating within the EU. It also applies to organi-
sations outside the EU that offer goods or services to individuals in the EU.

The GDPR does not apply to certain activities including processing covered by the Law Enforcement Di-
rective, processing for national security purposes and processing carried out by individuals purely for personal/
household activities.

Personal data
Like the DPA, the GDPR applies to personal data. However, the GDPRs definition is more detailed and
makes it clear that information such as an online identifier eg an IP address can be personal data. The
more expansive definition provides for a wide range of personal identifiers to constitute personal data, reflect-
ing changes in technology and the way organisations collect information about people.

For most organisations, keeping HR records, customer lists, or contact details etc, the change to the definition
should make little practical difference. You can assume that if you hold information that falls within the scope of
the DPA, it will also fall within the scope of the GDPR.

The GDPR applies to both automated personal data and to manual filing systems where personal data are ac-
cessible according to specific criteria. This is wider than the DPAs definition and could include chronologically
ordered sets of manual records containing personal data.

Personal data that has been pseudonymised e.g. key-coded can fall within the scope of the GDPR depend-
ing on how difficult it is to attribute the pseudonym to a particular individual.
Sensitive personal data
The GDPR refers to sensitive personal data as special categories of personal data (see Article 9). These cat-
egories are broadly the same as those in the DPA, but there are some minor changes.

For example, the special categories specifically include genetic data, and biometric data where processed to
uniquely identify an individual.

Personal data relating to criminal convictions and offences are not included, but similar extra safeguards apply
to its processing (see Article 10).

As yet there is very little detail and as more is published we will include it in the newsletters and nearer the im-
plementation date we will be holding workshops for practice data controllers.
For further information please see the ICO website.

NO . 3 1 1 Page 3
 Medical Performance Advisory Group.

This statutory committee of NHS E meets to review performance issues across the GP spectrum in the
South West. It has a broad membership and an equally broad remit. You will have received emails from it
in the past. From time to time we identify important themes that need disseminating and I take it upon my-
self to highlight two recent issues.

Addisonian crisis: remember the possibility and impending threat in any patient taking steroids, including
high dose inhaled. Ensure compliance with oral medication, give patient/carer advice and information. All
patients on steroids taken at a level that could result in Addison's should be considered for a 'special pa-
tient note' for OOH.

If you were not aware, it is your responsibility to inform NHSE of any criminal convictions or GMC warn-
ings or restrictions.

NHS Property Services Update

Attached to this newsletter is an update for all practices in NHS Property Services premises from Dr Ian
Hume GPC.

Verification of death policy Cornwall Health

Cornwall Health has introduced a new verification of death policy on 1st August 2017 following discus-
sions with NHS Kernow and CPFT.

From now on Cornwall Health clinicians will no longer visit patients in nursing homes or community hospi-
tals to verify either expected or unexpected deaths. In these circumstances nursing staff will be expected
to verify death and in the case of unexpected deaths contact the coroner.

Cornwall Health clinicians will continue to visit patients at home or in residential homes to verify death.

This new policy has been developed in conjunction with NHS Kernow and CPFT have made alterations to
their policy on verification of death to reflect the Cornwall Health policy. Nursing homes have been ad-
vised of the new policy and their responsibility to ensure their staff are trained appropriately.

Dean Marshall
Medical Director
Cornwall Health

NO . 3 1 1 Page 4
 111 and Out of Hours
new service from 1st December 2017
Last year Kernow Health asked practices to vote on whether they would support bidding for the brand new
Integrated Urgent Care Service for Cornwall that brings together 111 and OOH. Practices told us that
what happens out of hours affects in-hours and with extended access on the horizon, plus inevitable
changes to MIUs, you wanted General Practice locally to be in control of the new service.

We bid successfully for the service and it will launch on the 1st December under the brand name Cornwall
111.

Many of you will already work in the service and we will not impose major change. KH CIC want to make
the service a great place to work; a place where GPs feel supported, with roles that are rewarding and
where you are remunerated properly.

Kernow Health will very shortly open their rota for booking so that people can commit to working the shifts
that they want to work in December, over Christmas and the New Year, and in the first quarter of 2018.
This is our service and we need to make it work.

GPs will still be contacted by the Devon Doctors rota team over the next few weeks as they have a re-
sponsibility to fill the shifts up to 1st December. Any commitments to shifts beyond this date should be
made to Kernow Health and our new service.

Hepatitis B vaccine supplies

Please see the Public Health Englands letter attached to this newsletter concerning arrangements for pa-
tients (excluding neonates) who need Hepatitis B vaccinations.

New PGDs authorised for practices in the South West

Your team can now download new PGDs that have been authorised for the vaccination of patients regis-
tered with practices in the South West of England.
https://www.england.nhs.uk/south/info-professional/pgd/south-west/downloads/

These PGDs are authorised from national templates from Public Health England, are valid for use from
September onwards and include:

For the introduction of hexavalent vaccine

DTaP/IPV/Hib/HepB v01.00
DTaP/IPV/Hib Booster v01.00
For the seasonal influenza vaccination programme
LAIV PGD v05.00
IM Influenza PGD v03.00
ID Influenza v03.00

Page 5 C O R NWA LL & I S LE S O F S C I LL Y LM C NE WS LE T TE R

 Improving access for all: reducing inequalities in access to
general practice services

Ensuring everyone can access services on an equal footing is a key priority for the NHS. One of the seven
core requirements for implementing improved access, as set out in the NHS Operational Planning and Con-
tracting Guidance 2017-19, is to address issues of inequalities in patients experience of accessing general
practice, identified by local evidence, and put actions in place to resolve this.

To support commissioners and providers of general practice services to address this, NHS England has pro-
duced a practical resource Improving Access for All: reducing inequalities in access to general practice ser-
vices - which aims to promote understanding of groups in the community who are experiencing barriers in ac-
cessing services and help to address those barriers as improvements in access to general practice services
are implemented.

The resource is intended to provide:

a guide to assessing local issues, supporting local equality analyses and providing examples of how barri-
ers arise at different points on the patient pathway journey, starting at the point where the patient identifies a
health problem through to getting appointments and the experience of attending general practice services;

practical tips on a wide range of issues related to protected characteristics and other groups who experi-
ence barriers to healthcare, for example through homelessness;
quick links to video clips, learning materials for practice staff, case studies, examples of good practice and a
wealth of information on NHS Englands website.

For further information please contact england.gpaccess@nhs.net

BMA guidance - Helping you meet your training obligations

This is mainly aimed at practices in England due to the specific issues they have faced with inappropriate
training demands/requests from CCGs and CQC, but it should be of interest to all practices.

The advice can be found here.

Cornwall 111 ROTA news for our OOH service starting

1st December 2017

About 2 weeks ago Kernow Health CIC emailed details about taking over the new integrated 111 / Out Of
Hours Service from 1st December 2017 and how important it was for Cornwall to be in control of these vital
services at a time of immense change.

As part of the transfer, we have urgently developed the rota that will initially cover the period 1st December to
Monday 2nd April at 0800 hrs; this rota will be broadly the same as it is currently with additional shifts added
to meet the predicted demand. Our new rota team are in place and will be working from Cudmore House.
The Rota Manager, Michelle Brassington, can be contacted on 01872 221109 or by email ro-
tateam.kernowcic@nhs.net

If you currently work in OOH in a regular work pattern or pick up shifts ad-hoc, or do not currently work OOH
and would like to, can you please contact Michelle as soon as possible to discuss your requirements for the
new service. Michelle will be unavailable from 4/9-13/9 due to annual leave, but will respond to your email or

Page 6 C O R NWA LL & I S LE S O F S C I LL Y LM C NE WS LE T TE R

 LARC UPDATE 12th October - Summercourt

I have had numerous requests for updating sessions for the two contraception enhanced services.
In response to this we have arranged to offer both on 12th October 2017 at the Carvynick Country Club
near Summercourt (TR8 5AF)
MORNING - IUD provision
AFTERNOON - Implant provision and overview of hormonal methods
Lunch will be provided for those attending both sessions
These are suitable for
Existing fitters needing to refresh and update
New fitters who need a knowledge base prior to practical training
Clinicians who counsel women regarding their contraceptive choices
Each half day session will provide 3 hours of education suitable for FSRH and local reaccreditation
Further information, programme and an application form can be found on the website
www.crescetis.com
Dr Sarah Gray - sarah@drsarahgray.co.uk

SNOMED COURSES

Now completely booked up we are running a total of 5 sessions and although you may not have heard
from me yet as I am waiting to arrange a 5th session, we have been able to accommodate you all but we
have now reached the limit.

Thank you everybody for your support and glad we have been able to help.

Emergency First Aid Tuesday 10th October 2017

We have planned to run the above course as part of our training programme, however for this course to
run we need 10 delegates definite bookings. So far, we have 4 definite delegates.

If you wish to book your staff members on this course please can you complete the booking form and re-
turn it to me by 8th September at the latest and I will then let you know if the course if running.

The booking form is attached at the back of the Newsletter.

NO . 3 1 1 Page 7
 The Stennack Surgery, St Ives, Cornwall
Fantastic GP opportunity in St Ives, Cornwall

Salaried GP or GP Partner 4-8 sessions per week Start date flexible

We would like to welcome two enthusiastic, energetic, dynamic, committed and forward thinking GPs into our
team. We are a progressive practice providing an extended range of high quality services, working from our
inspiring Victorian grade 2 listed premises in this picturesque seaside town.

6 partners and 6 salaried GPs, 2 Nurse Practitioners and large nursing team
Pro-active, supportive & harmonious team with Pharmacist and Clinical Admin Team committed to re-
ducing GP workload
12,500 patients
Outstanding CQC Rating
100% QOF performance & committed to high quality patient care
Strong commitment to postgraduate and undergraduate training
Growing Research Practice
Extended range of services on site: MIU, minor surgery, pharmacy, physiotherapy, counsellors, shared
care substance misuse and anticoagulation monitoring
Active Patient Participation Group & Friends of Stennack Surgery
Opportunities for GPs with special interest.
Spectacular sea views guaranteed with all home visits!

For further information & any queries please contact a member of our Executive Management Team:

Dr Dan Rainbow (GP Partner) dan.rainbow@nhs.net

Dr Rupert Morrall (GP Partner) rupert.morrall@nhs.net
Lydia Hale (Practice Manager) lydia.hale@nhs.net

Partner- Looe, Cornwall

Situated in the beautiful Cornish seaside town of Looe, we are a friendly and supportive semi-rural 4 WTE part-
ner practice serving circa 9500 patients. With a partner owned harbour side surgery, plus two smaller surgeries
nearby (one dispensing), we are looking for a partner to join our team.

What we offer
4-6 sessions a week with 8 weeks holiday, salaried applications also considered.
A high achieving environment 100% QOF and CQC Good
Encouragement in developing your medical interests
Established training practice at all grades
Stability with an average partner age of 43 years
GMS partnership actively engaged with shaping the future of general practice in Cornwall

What we need
Commitment, enthusiasm and a team orientated approach
A focus on clinical quality alongside business aptitude
A flexible and positive approach to forthcoming changes in General Practice

Contact our Practice Manager, Mark Allen, for more information: markallen3@nhs.net or 01503 266960 or
send your CV and covering letter to Old Bridge Surgery, Station Road, Looe, Cornwall PL13 1HA.
www.oldbridgesurgery.co.uk

NO . 3 1 1 Page 8
CORNWALL THE FALMOUTH HEALTH CENTRE PRACTICE

Replacement GP Partner or Salaried GP 6-8 sessions

Due to the retirement of our senior partner we are looking to recruit the right individual to complete our
team. We are one of the best surgeries in Cornwall; high achieving and forward thinking. We are a suc-
cessful and dynamic practice combining the best of the traditional qualities of General Practice with inno-
vation and aspiration. Our premises is a spacious purpose built Health Centre and as such there is no
capital buy in for new partners.
Falmouth is a vibrant university town and is the winner of the Sunday Times readers vote Best Place To
Live 2017 and also benefits from good access to high quality State and Private Schools.
Maximum QOF attainment
9000 patients
5 GP partners , nurse practitioner, 3 practice nurses , 2 HCAs and 2 phlebotomists
Pharmacy on site and also co-located with community nurses, health visitors, community matron, social
services care coordinator, community midwives, podiatry, dental services and out patients.
Protected Doctors meeting time daily and weekly MDT meetings
12 minute routine appointments
CQC Good or outstanding in all domains
Nurse led chronic disease management
Medical student and VTS training practice
Low home visit rate
EMIS Web, EPS, eConsult, paperless
GP interests include minor surgery, cycling, education, surfing, womens health, horse riding, open water
swimming and sexual health!
Want to join our team and find out the secret of combining the achievement of excellent clinical outcomes
with a great work/life balance? Send your CV and covering letter to Geoff Dennis, Practice Manger.
geoff.dennis@nhs.net or for more information call Geoff on 01326 310160 or 07921 240856 or visit our
web site www.faldoc.co.uk.
Our partners in the photo above (from left to right): Paul Davoren, Nick Rogers, Vicky Hartnell, Denise
Lasbury, Rachael Wilson

NO . 3 1 1 Page 9
 Partner/Salaried GP Vacancy
Bude, Cornwall
Bude Best Coastal Resort Sunniest place in the UK!

Our semi-rural coastal practice has 6 Partners and we are looking for an enthusiastic GP to join our friendly team
and can be flexible about sessions and start dates.
Our practice
GMS high QOF achiever providing excellent medical care with a wide range of LES & DES
11,000 patients
EMIS Web
Fully supported by nursing, & administrative teams with Nurse led Chronic Disease Management Clinics
Special interests encouraged, dedicated time for peer-review and clinical work to support revalidation and best
practice
Close working links with BASICS, RNLI, Probus Surgical Centre
Purpose built rented premises (no buy in)

We are committed to high clinical standards, good patient care and are looking for a forward-thinking GP to proac-
tively contribute to the development of the practice.

Please apply with CV and letter to

Miss Kathryn Pengelly, Practice Manager, Stratton Medical Centre, Hospital Road, Stratton, Bude, Cornwall EX23
9BP

Enquiries and informal visits welcome please telephone 01288 352133 or email: kathryn.pengelly@nhs.net

Visit our website at www.strattondocs.co.uk

NO . 3 1 1 Page 10
Are you a General Practitioner who is keen to develop a special
interest in the management of Orthopaedic Trauma?

If so, we are looking for you to join our enthusiastic and dynamic Trauma & Orthopaedic team at the Roy-
al Cornwall Hospitals NHS Trust. We are aiming to find one or more GPs to complement our team, work-
ing up to 3 flexible sessions a week, in our Fracture Clinic.

The successful appointees will be offered a period of close training in all aspects of the assessment, diag-
nosis and management of orthopaedic trauma. This will incorporate initial shadowing of senior clinicians
with a proven background in training and gradual clinical exposure leading to independent, but supervised
practice. You will be working alongside orthopaedic consultants and junior doctors, physiotherapists,
nurses and plaster technicians in a clinic setting based at the Royal Cornwall Hospital.

Our Fracture Clinics assess over 22,000 patients a year, with a range of upper and lower limb trauma in
an adult and paediatric population. This is a consultant led and delivered service; every Fracture Clinic
on the Royal Cornwall Hospital site has a minimum of one, but often two, consultants, as well as ortho-
paedic trainees. Our trauma service is at the forefront of innovation and surgical research and we will train
and supervise you in how we manage simple and complex trauma as well as gaining critical insights into
what can be treated without surgery, when surgery is required, as well as seeing and assessing the re-
sults of surgery. This will involve the clinical assessment of new and old injuries, the review and interpre-
tation of x-rays, and a collaborative role in the decision making process.

You would be joining a surgical department supported by a first class radiology service, providing patients
with immediate access to digital x-ray and often CT scanning, with ultrasound, MRI and Nuclear Medicine
scanning as necessary.

The successful candidates will be expected to cover a total of 3 morning sessions per week, with their ex-
act schedules being negotiable and mutually agreed. This is a very new initiative and we hope to develop
a collaborative and progressive approach to joint working and training in the management of orthopaedic
trauma. Our aspiration is to promote ever closer working relations and strengthened links between spe-
cialty services and primary care and in the long term we would like to develop closer links and encourage
GP trainees to pursue attachments with the long term goal of improving patient experience and orthopae-
dic knowledge in both primary and secondary care.

Interviews are likely to be in September.

If you require further information please contact Mike Butler or Mark Norton on 01872 252580 or
email michael.butler3@nhs.net or mark.norton1@nhs.net

NO . 3 1 1 Page 11
 The Stennack Surgery, St Ives, Cornwall
Experienced Practice Nurse
We are looking for an Experienced Practice Nurse to join our progressive and innovative General Practice and Minor
Injuries Unit (MIU) team in the beautiful seaside town of St Ives in Cornwall. We currently have a nursing team of
approx. 12 staff including: Healthcare Assistants, Assistant Practitioners, Practice Nurses, Research Nurses and
Nurse Practitioners providing the nursing expertise we need both for General Practice and our Minor Injuries Unit. If
you have the necessary experience, drive and enthusiasm to become both part of this team as an Experi-
enced Practice Nurse we would like to hear from you.
Qualified Practice Nurse (Essential)
2 years minimum working as Practice Nurse in General Practice (Essential)
Treatment Room Skills (Essential)
Evidence of further study/training in at least one of these Chronic Diseases: Diabetes, Asthma/COPD or Car-
diovascular Disease (Essential)
Cervical Screening Training (Desirable)
Childhood Immunisation Training (Desirable)
Aptitude to work towards Clinical Team Lead/Nurse Manager (Desirable)
Up to 37.5 hours per week (Applications for part-time hours welcome)
Competitive salary
Closing date for applications 30th September
If you require further information please email lydia.hale@nhs.net
Stennack Surgery Information:
6 partners and 6 salaried GPs, 2 Nurse Practitioners and large nursing team
Pro-active, supportive & harmonious team with Pharmacist and Clinical Admin Team
12,500 patients
Outstanding CQC Rating
100% QOF performance & committed to high quality patient care
Strong commitment to postgraduate and undergraduate training
Growing Research Practice
Extended range of services on site: MIU, minor surgery, pharmacy, physiotherapy, counsellors, shared care sub-
stance misuse and anticoagulation monitoring

FOWEY RIVER PRACTICE - CORNWALL

PRACTICE/RESEARCH NURSE
An opportunity has arisen for a motivated Practice/Research Nurse to join our patient centred friendly team.
We are a four Partner, semi-rural, three site GMS Practice with nearly 8,000 patients. We provide high quality, tradi-
tional patient centred care, in a beautiful part of Cornwall.
Practice nurse ideally for a minimum of 2 days a week (previous practice nursing skills advantageous) Asth-
ma/COPD trained would be desirable
Research nurse for a minimum of 1 day a week - research experience preferable, but not essential (all necessary
training will be provided in post)
Longstanding training practice (both GP & Nursing) with current ST3 in post
Supportive, friendly culture
Training would be encouraged/offered where necessary
Hours negotiable, pay dependent on experience and qualifications
Please contact paula.julian@nhs.net for a job description & application form, please enclose a copy of your CV.

NO . 3 1 1 Page 12
Dr Basil Bile

One hundred million smackeroos is serious dosh in any language. According to The Times
(London not Cornish version) that is precisely the sum that is to be paid to Recruiters charged with
finding enough doctors to plug the staffing gaps in the NHS with the advent of the much heralded
seven- day NHS. The lavish exercise will take place over the next three and a half years, with agen-
cies being paid twenty thousand quid for every GP found. Frankly, if they are prepared to split the
profit they can come and find me. I will be hiding under my consulting room desk as per bally usual.

Half of the doctors needed will have to be from beyond these shores, a process described in
painfully politically correct terms as ethically employing international medical professionals. This
manpower er sorry, personpower shortfall is all on account of some clever spark back in the nine-
teen eighties deciding to close down several London based medical schools without so much as a by-
your-leave or thank you, including my very own alma mater Charing Cross (the hospital not the sta-
tion before you ask.) Happy days, many of which were spent in the dissecting room trying desperately
to reconstruct the clumsily severed nerves in a cadavers arm by twisting strands of fascia together
before the anatomy demonstrator arrived to inspect our fledgling surgical skills. No doubt its all virtual
and digital nowadays. No more being knee deep in formalin. No more creative anatomy. Medical stu-
dents today dont know theyre born.

Meanwhile NHS Fruitcake has excelled itself with its latest looney suggestion, namely that al-
ready stretched Family Docs should review each others referrals at least once a week, to make sure
all options are explored and that patients are seen and treated in the right place, at the right time, and
as quickly as possible. With the greatest of respect, the best way to ensure those worthy objectives is
to stop putting irritating and time-wasting administrative obstacles between GPs and their patients,
including this thinly veiled attempt to subvert the referral process. Calling it Clinical Peer Review
fools nobody. Its all about putting pressure on GPs not to do the best for their patients in order to im-
prove NHS statistics. How dumb do they think we are? Very dumb obviously.

So dumb in fact that they have decided to make it easier to become a GP. Contestants strug-
gling to qualify as Family Docs will be given two more resits for the Royal College of Garrulous Practi-
tioners monumentally tedious membership exam, allowing six attempts in all.

A Health Education England review has unearthed the fact that many trainee quacks failed the
Emarseygeepee because of problems unrelated to clinical competence, ie spending too many nights
down the pub.

The eminently admirable queen bee of the Arseygeepee Helen Stoke-Lampoon quoth: We
desperately need more family doctors practicing in the UK, but not through the back door.

Quite right old fruit. We are a proud profession. Arriving via the tradesmans entrance must be
avoided at all costs. In my day we didnt have all this fuss and bother of having to embrace Royal Col-
legiacy. We could practice the noble art of Family Doctory on the basis of having passed the cycling
proficiency test, or at least you could if you described it on the headed notepaper as Cyc Prof after
the magical letters MB.BS

Page 13 C O R NWA LL & I S LE S O F S C I LL Y LM C NE WS LE T TE R