General practice is on a cliff edge - and ACOs could tip it over

The latest acronym to hit the NHS is ACO – Accountable Care Organisations. You would be forgiven for sighing with disbelief at yet another change to the way the NHS operates. It wasn’t enough for the Conservative led coalition to push through the single biggest reorganisation of the NHS with the Health and Social Care Act 2012 – a change so big you could ‘see it from space’ according to the then NHS chief executive David Nicholson.

ACOs are the latest reorganisation by NHS England which Simon Stevens expects to “deliver fast-track improvements, such as fewer emergency hospitalisations and better care in people’s homes”. On the face of it that sounds like a good plan but the potential seismic shift in how the NHS runs under an ACO is frightening.

ACOs will seek to bring together all organisations (providers and commissioners) offering health and social care under ‘one roof’ in a geographical area. Social care is now based on means testing so you have to pay if you have some savings. There is a risk health care will go down a similar route within an ACO. All those in an ACO will be jointly responsible for care – and crucially jointly responsible for the multi million pound deficits run up by hospital trusts due to government underfunding. GPs beware…. you could also be responsible for sorting out that deficit within the ACO.

Another concern is that an ACO will be very much driven by secondary care given the large budgets they have and offices full of lawyers, accountants and managers. General practice is already in such a bad place with wholly inadequate funding, inability to retain or recruit GPs and a workforce so ground down with work and stress they haven’t got the time to speak out or stand up to such proposals. LMCs have a vital role to play as the true advocate for GPs and they must be central to any discussions on reconfiguration of services.

ACOs have the potential to remove the list based general practice that has served our patients well since 1948 and consume all patients into the ACO with the role of the GP as yet being unclear. It may be that the GPs become salaried in their ‘ACO practice’ or salaried to the local hospital trust. It is hard to see the independent contractor model surviving such a shift in ethos of how the NHS is configured. Private companies and insurance firms will be watching this change with interest as they will see a big opportunity to profit by working with ACOs by taking on lucrative contracts or offering insurance products to patients in such a large health organisation. Government legislation will allow this to happen.

Practices who are very large or have strong voices may be able to ride this storm but the threats are clear. The NHS is in such a mess with massive underfunding, a demoralised profession and politicians with no interest in preserving what was once the jewel in the crown that was general practice.

There may be some hope heading our way though. The government have singularly failed to explain these changes or consult on them and this has angered many people. Health professionals including Professor Allyson Pollock and Dr Ben White (who has already taken Jeremy Hunt to court over the junior doctor dispute) have launched a crowdfunding appeal to take the government to the high court for a judicial review over the ACO changes. It might make the government think twice and I urge you to support them.


General practice is on a cliff edge. ACOs pose significant threats and it is vital we inform ourselves on these huge changes to the NHS and speak out about them before it is too late.


This article first appeared in gponline.com

Comments

  1. Thanks for sharing the valuable information. Your article gave me a lot of information. We at Techno Data Group would like to introduce to you about our organization. We are the leading database providers for b2b marketing across the globe. we provide you with the readymade as well as the personalized email list and connect you with the right client or decision-makers. Please refer our General Practice Email List for further details.

    ReplyDelete
  2. My wife was so smooth at hiding her infidelity and I had no proof for months, I saw a recommendation about a Private investigator and decided to give him a try.. the result was incredible because all my cheating wife’s text messages, whatsapp, facebook and her phone conversations was sent directly to my Personal computer. Mr James helped me put a round-the-clock monitoring on her and I got concrete evidence and gave it to my lawyer..I feel so bad about infidelity,if your wife is an expert at hiding her cheating adventures contact him through Gmail he will help you(Worldcyberhackers) or WhatsApp : +12678773020

    ReplyDelete
  3. ⚡️✅MEET THE REAL HACKERS✅⚡️

    It Tears me Up Whenever we receive complaints from Clients About Their Experience With the Hackers They Met Before They Heard about us.
    These Days There Are alot of Hackers Online, You Just Have to Be Careful about who you meet for help, because many people now don't know who to ask for help anymore but there's really an actual solution to that which I am giving you for free, Don't go for the incompetent ones which I know you understand what I'm saying like hackers using gmail, yahoomail and other cheaper email accounts that could be easily hacked ⚠️🚷, come to think of it, why the fuck would a REAL HACKER want to use a Mailing Service that brings out his vulnerabilities? ❌❌ ❌ so can you see they are really not who they say they're, they are just here to Rip people Off, You Can Always Identify Them With Their False Write Ups and False Testimonies Trying To Lure you Into their Arms.❌❌❌ and my advice really goes out to you looking for a Real Hacker that's a heads up so that you would fall deep into their trap no more.🚷⚠️⚠️⚠️

    ✅COMPOSITE HACKS is here to Provide you with The Best Hackers, So you can get saved from The Arms of the Fake Hackers❌❌

    ✅We have Legit Hackers and Private investigators at your service. 💻 Every member of our team is well experienced in their various niches with Great Skills, Technical Hacking Strategies And Positive Online Reviews And Recommendations💻🛠

    ✅We have Digital Forensic Specialists, Certified Ethical Hackers, Computer Engineers, Cyber Security Experts, Private investigators and more on our team. Our Goal is to make your digital life secure, safe and hassle-free.
    Some Of The Services we render includes:
    * Website hacking 💻
    * Facebook and social media hacking 📲
    * Database hacking, & Blog Cleaning🛠
    * Phone and Gadget Hacking 📲
    • CREDIT CARD MISHAPS 💳 💥
    * Clearing Of Criminal Records ❌
    * RECOVERY OF LOST FUNDS ON BINARY OPTIONS & CAPITAL INVESTMENTS💰
    * Location Tracking 📲
    and many More

    ✅We have a team of seasoned PROFESSIONALS under various skillsets when it comes to online hacking services. Our company in fact houses a separate group of specialists who are productively focussed and established authorities in different platforms. They hail from a proven track record Called “HackerOne” and have cracked even the toughest of barriers to intrude and capture or recapture all relevant data needed by our Clients. Some Of These Specialist Includes ⭐️ PETER YAWORSKI ⭐️FRANS ROSEN⭐️ JACK CABLE ⭐️JOBERT ABMA⭐️ ARNE SWINNEN ⭐️And More. All you Need To do is To Write us a Mail Then We’ll Assigned any of These Hackers To You Instantly.

    Feel Free To Mail Us Anytime

    ✅CONTACT:
    * Email:
    compositehacks@protonmail.com
    * Wickr: compositehacks


    ★CONTACT US AND GET YOUR PROBLEMS SOLVED IN THE TWINKLING OF AN EYE

    ReplyDelete
  4. My husband was so smooth at hiding her infidelity and I had no proof for months, I saw a recommendation about a Private investigator and decided to give him a try.. the result was incredible because all my cheating husbands text messages, whatsapp, facebook and his phone conversations was sent directly to my Personal computer. Mr James helped me put a round-the-clock monitoring on him and I got concrete evidence and gave it to my lawyer..I say no to infidelity if your husband is an expert at hiding his cheating adventures contact him through Gmail he will help you(Worldcyberhackers) or WhatsApp : +12678773020

    ReplyDelete
  5. Stop being scammed by fake hackers. Hire a Ethical Hacking group who are professional and real. You might be curious that what hacking group services can provide? .. If you hire a hacker, you always have worried of losing your money. We won't keep a cent if can't do our job. 100% refund if job is not completed. Hacking Services that you will find here at: ALEXGHACKLORD are custom to fit your hacking needs... A professional and experienced hacker providing hacking services for a variety of client needs. Specialize in many different Hacking Services some of my most popular hacking services are, Hack INTO ANY BANK WEBSITE Hack into any COMPANY WEBSITE HACK INTO ANY GOVERNMENT AGENCY WEBSITE HACK INTO SECURITY AGENCY WEBSITE AND ERASE CRIMINAL RECORDS Hack into CRAIGSLIST AND REMOVE FLAGGING HACK INTO ANY DATABASE SYSTEM HACK PAYPAL ACCOUNT HACK WORD-PRESS Blogs SERVER CRASHED hack HACK INTO ANY SCHOOL DATABASE AND CHANGE UNIVERSITY GRADES, no matter how secured HACK INTO CREDIT BUREAU DATABASE AND INCREASE YOUR CREDIT SCORE HACK ANY EMAIL OR SOCIAL NETWORK AND KNOW IF YOUR PARTNER IS CHEATING ON YOU HACK INTO YOUR PARTNER'S PHONE PICS, TEXT MESSAGE AND LISTEN TO CALLS TO KNOW IF HE IS CHEATING UNTRACEABLE INTERNET PROTOCOL HAVE YOU OR YOUR CHILD BEEN BULLIED ONLINE BEFORE AND WANT TO GET BACK AT THE PERSON, WE CAN HELP YOU TRACE THE ACTUAL LOCATION OF THE PERSON AND DO WHATEVER YOU REQUEST TO THE PERSONS COMPUTER IS ANYONE BLACKMAILING YOU ONLINE AND YOU WANT US TO GET INTO THEIR COMPUTER AND DESTROY DATA AND EVIDENCES AGAINST YOU? If you need a hacking service that is not listed, feel free to contact him at: ALEXGHACKLORD@GMAIL. COM


    ReplyDelete
  6. Oftentimes, it could seem unfair when you are unable to afford the basic things. not being able to acquire a home, car or loan. Simply because your credit score is low. I had suffered terribly due to a low credit score caused by eviction, late payments and hard inquiries. I had to contact LANX CREDIT SOLUTION a credit repair company. They literally saved me from my traumatizing experience. They increased my score and removed the negative and derogatory Items on my credit report. This review is in order to encourage you to do something about your bad credit. It took just 12 days for things to change everything.
    PHONE: (310) 879 2541
    Email: LANXCREDITSOLUTION@GMAIL.COM

    ReplyDelete
  7. Hi everyone,I’m so excited my husband is back after he left me for another woman. My husband was having an affair with a co-worker and i love my husband so much but he was cheating on me with his co-worker and this girl i think she use witchcraft or black magic on my husband to make him hate me and this was so critical and uncalled-for, I cry all day and night for God to send me a helper to bring back my husband! I was really upset and i needed help, so i searched for help online and I came across a website that suggested that Dr.Wealthy can help get ex-boyfriend back fast. So, I felt I should give him a try. I contacted him and he told me what to do and i did it, then he did a love spell for me. 22hours later, my husband really called me and told me that he miss me so much, Oh My God! i was so happy, and today i am happy with my man again and we are joyfully living together and i thank the powerful spell caster Dr.Wealthy, he is so powerful and i decided to share my story on the here. if you are here and your Lover is turning you down, or your husband moved to another woman, do not cry anymore, contact Dr.Wealthy for help now..Here’s his email, wealthylovespell@gmail.com
    He also do the following spell
    Pregnancy spell
    Love spell
    Penis enlargement spell
    herpes/hiv
    Winning spell
    His email, wealthylovespell@gmail.com
    Or his WhatsApp +2348105150446

    ReplyDelete
  8. Truthfully, taking the decision of contacting a credit repair company was not an easy one, I desperately needed a home, I couldn’t get one due to the evictions and Late payments on my credit, with a very low FICO, I was frustrated and had no choice but try one. Luckily for my I read some very good reviews on LANX CREDIT SOLUTION and decided to contact them. I have never been happier, my FICO was increased to 750 and the late payments and evictions were taken off my report. Superb service I must say!!! You can reach them on LANXCREDITSOLUTION@GMAIL.COM or (310) 879 2541. thanks

    ReplyDelete

Post a Comment

Popular posts from this blog

A Porsche or a Ventilator?

The serious implications of the case of Dr Bawa-Garba