As ever @craig.nikolic.co.uk summarises the key issue to me here. Trusts running General Practice hasn’t worked - a square pegs and round holes experiment (not my words - a GP trying it in one area) and the money doesn’t work. My worry - go to LinkedIn and read the threads that ignore this

No apologies, I believe in the #NHS, make sure sure that facts are shared, that politicians remain accountable & all have a responsibility to share factual information I have no vested interests, other than making sure we all have access to healthcare free at the point of need

Workforce Planning – the biggest expense for #GP Have you done a workforce budget for 2025/26? Have you thought about the skills and people you have and whether the right people are in the right roles doing the right tasks? Are you making best use of the ARRS roles in your PCN?

“left shift” it’s the new NHS management phrase. If attending a conference I think it should be mandatory for everyone to sing “let’s do the time warp again” every time it’s mentioned (with full moves) . You’ll thank me for that !

That wraps things up for this year’s #AISMAconference. A big thank you to all our speakers, conference organisers and delegates who’ve made it such a successful event. Our newly appointed leadership team wish you all a safe journey home and look forward to seeing everyone at next year’s event!

Yesterday was the last day on the #AISMA board for James Gransby and Andy Pow. They step down after bringing incomparable expertise, energy and enthusiasm to the association over the years. We thank them for their amazing contribution and wish them all the best for the future.

GP contract threatens ‘vast gaps’ between practices and ARRS shortfall, @medicaccountant.bsky.social warns www.gponline.com/gp-contract-...

Welcome to Pow and Thomas. A new venture from @medicaccountant and Melanie Thomas bring 50 years of combined expertise to provide a tailored support package for GP practices, PCN's, Federations and other healthcare businesses. Follow us to see what we are up to

1 day to go until we launch - something new in the financial world for General Practice, PCN's, Federations and other medical organisations

Sunny Sunday 🌞

1995-2025 done ! Many happy memories and leaving a great team behind. Next week Mel and I start our new venture @powandthomas.bsky.social . We spent ages on the name 😂 Supporting General Practice and doctors finances in a different way.

So the final week has arrived as I close a large chapter of my career. Easy ride in ? 🫣 No five talks to do - 25/26 GP contract, finance for doctors, annual allowance 😡 , running a GP practice better and today a 🧠 dump for the team . Ill need that 🍻on Friday. 30 years has gone quickly

Glorious day up north 🌞

Our response to the 2025-26 GP contract announcements: aisma.org.uk/2025/02/28/r...

Next week we're bringing our members a finance update from Andy Pow from AISMA. If you're a member, pop over to the Facebook group to sign up. Not a member and want to join? It's only £50 for the year, sign up here www.igpm.org.uk/membership

Whilst I didn’t contribute as much as usual 31 January doctors tax deadlines have been a constant for the past 27 years. Made worse recently by annual allowance issues. But for me no more ! The baton is well & truly passed on. On to new things this year. Watch this space !

Who has asked you to attend a meeting? Do contact your MDO or BMA for support. Remember you have Human Rights Act entitlements to both freedom of speech and a private life.

If you're in a meeting with me and you say you can see how to save millions in costs, I will ask you every single time where that cash will come from. Sacked staff? Cut estates? What? Saying "saving future costs" in a system that's not funding future costs is going to get challenged.

🌞🏰

Snowy fells . More stunning views this time from the North Lakes 🌞😀

A cold but clear day. No heat in the sun !

It’s beautiful out there but lots of black ice on the back roads. Cars, ice and stonewalls are not a great combination so slow down !

Let it snow let it snow let it snow 🌨️🗻🎄

It’s not so grim up north today @craig.nikolic.co.uk Cold , quiet up a fell & stunning !

The National Insurance bill is out and as suspected there is no exemption for anyone. So hospitals like all other health & care providers will just have to hope additional funding at the right level comes their way. Politicians & press need to grasp this publications.parliament.uk/pa/bills/cbi...

In October 2024, the GP practices of Barking & Dagenham saw 131,412 patients from a list size of 254,704, with an average offering of 515.94 appointment per 1000 list size. Enough appts for over half the borough's entire population in a month. This is not sustainable.

That’s it for 2024. All free @medicsmoney.bsky.social sessions are full. Thanks for all the support and watch out for more in 2025

The usual way in the past few years has been an imposed contract on 31 March followed by backdated adjustments c October / November time. That will break many practices this time. The normal way is not good enough in a normal year. This is far from a normal year.

A grey day ! And wet !

The pros and cons of PCNs are often debated. On this one I’m 50:50. Many positive benefits but not sure I’d cope with everything it brings ! Still good to be given the opportunity so well done to all and good luck Laura - it’s almost December !!

And relax it’s the weekend #cataday

The joys of working at home when your home is here is the ability to get out for short walk whilst its light. Makes all the difference at this time of year

A sleepless night following an interesting meeting yesterday which meant my head kept buzzing. One question my head thought of last night was …. Does the NHS have more people working in associated think tanks than the army has working in actual tanks ?One for @craig.nikolic.co.uk to ponder !

New data on farms and inheritance tax: a third of farm estates over £1.5m aren’t farmers but wealthy people avoiding IHT by sinking money into farmland. The Budget hits farmers too hard and tax avoiders too lightly. It needs to change.

Some free courses coming up in the next couple of weeks for those working in the NHS on the new tax rebate system and tips around how to improve your general finances. Details below

Apparently it’s going to be wet , windy and maybe some snow today. Having researched this I have found that the main reason behind this is that it’s the 23rd November & these kind of things happen at this time of year. For more useful advice look out for more posts from me ☔️💨🌨️

That needs to start now - with a clear vision that we will fix the staff cost problem but as a stepping stone to a new funding mechanism. One that restores continuity, moves clinicians from conferences to clinics - puts GP expertise back at the heart of primary care - & trust (N)

I had hoped with a change in government we would start to rebuild these relationships. If we are to move from hospital to community the vision needs to be clear,the structures need to be clear,the trust needs to be there. Not designed in conferences designed in practices (4/N)

We have seen resource directed to PCNs and now probably INTs but no one has been clear on why that will work & no one has appraised whether PCNs offer value for money rather than investment in General Practice at practice level.Instead we get a policy of lack of investment (3/N)

I get why the NHS wants data and also why it needs it to model new contracts . But a data grab in return for core funding is not a way to lead. If you want people to engage then be clear with the vision and be clear why you need that data for that vision. (2/N)

NHSE willing to revisit global sum calculations 'if GP practices share payroll data ' - the problem with this approach is trust … and the lack of it . It’s not a way to build relationships with core General Practice. https://www.pulsetoday.co.uk/news/contract/nhse-willing-to-revisit-global-sum-calc…

This caused much amusement in the office today. 1. Everyone thought they were far to happy about pension admin 2. There was major calculator envy 😂

I asked it to add an accountant. What do you reckon?

Following a fantastic conference at @medicsmoney.bsky.social I followed @medicaccountant.bsky.social advice in one of the sessions on getting bits of my pension sorted. Just heard back that it all seems to have updated!

For an impartial view of the issues around the budget and GP funding then this podcast is excellent @nickbostock.bsky.social sets out the issues in a very clear way. Is worth a listen especially for those making decisions on funding.

Apparently the SoS said GPs should hold tight on funding …. Easy to say when it’s not your personal finances impacted

Hello @aismanewsline.bsky.social …

Todays farming protests are not just about inheritance tax. The press would have you believe that’s the only issue . Worth a read below about why it’s a lot more than that & a reminder to Barbour clad MPs who want to make IHT the news to hide what their party brought in 👇

Here's a useful tool for Bluesky Type your account name in and activate It will come up with a list of the accounts followed by the people you follow.. If you type in your password it will give that list with an optional follow button to make life easy. Try it 💙💙 bsky-follow-finder.theo.io

Brilliantly powerful writing from James Rebanks (@herdyshepherd.bsky.social) as ever. Given the media reporting you'd be forgiven for thinking farmers just want to keep their £millions from inheritance tax. The truth is far different. unherd.com/2024/11/a-fa...