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Author Archives: Gavin Francis

For the last ten years GPs have been paid, by the taxpayer, to deliver ‘general medical services’ through a scheme based partly on incentives. ‘Quality of care’ is assessed using an ‘outcome framework’ known as QOF, whose parameters relate to expected best practice when treating various long-term diseases. Someone with diabetes, for example, should have his cholesterol checked regularly, his blood pressure kept below dangerous levels, and be given medication to keep his blood sugar acceptable. At least once a year, I see all my patients who’ve suffered a stroke to check that they’re on the right treatment to thin […]
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My first home visit of the day was to a 97-year-old woman who just ‘wasn’t right’. Her daughter had phoned around ten, while I was still doing the morning clinic. Between patients I’d noticed her name pop up on the screen. ‘What do you mean, “not right”?’ I asked Pearl, the receptionist, on my way to call someone from the waiting room. ‘Just that,’ she shrugged, ‘“not right”.’ I visit Betty Cruikshank every month or so. She lives with her disabled daughter, Norma, in a two-up two-down, and spends most of her day on a bed in the back room. […]
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