caroline rayment 💙

@drlukeevans @DrSteveTaylor It’s shocking - this just imposes increased waits for patients. If myself, as a GP of 25 years, feel they need seeing f2f because I’ve reached the limit of my competence and need them seen Happy to use a and g in addition - it’s very useful for medication queries

The Government is mandating GP referrals have to go to a Single Point of Access (SPoA) - with a stated aim of 1 in 4 being bounced back to the GP to manage. It is now confirmed in writing that those patients will not be on official waiting lists. 1/2

@annalouisedixon @_RobbieMoore @doctor_katie @wesstreeting I am a GP partner. It is the 25 th March and I have no idea what our practice will receive as income from April - this is not good enough

The last 28 years have been fantastic! Ups and downs as life flows along but 2 great kids, great jobs and fab friends x

@JoePJRobertson We do offer same day urgent care - however the thing now suffering is routine care delayed by having to have open digital referrals all day despite capacity

GPs are more than capable of delivering same-day urgent care. What they cannot do is absorb another mandate without the workforce and estates funding to support it. Access improves when capacity improves. It’s that simple. theguardian.com/society/2026/f…

@medicaccountant We have £20 k as access and capacity money - so we need over and above that to pay for more sessions or employ new Dr otherwise it’s a loss …. It’s not new money

The 26/27 GP contract is not good news. I expected the uplift wouldn’t be high (no money) - it’s at a level for breaking even. But there is more access requirements. And the big kick will be the loss of capacity and access monies. Practices & PCNs are going to have to adjust

@doctor_oxford @LucyGoBag Excellent article. How can we even contemplate funding assisted dying when we don’t fund palliative care fully - not really a choice then is it?

"The hard truth about underfunding palliative care is that people who are at their most vulnerable – the dying – suffer more pain, more indignity, less choice & less autonomy than they might have." Incredibly, only 30% of hospice care is NHS funded - a national travesty. Please read my piece in today’s @guardian.

@dchnet @annalouisedixon Frustrating!

@RaymentCaroline @annalouisedixon It was a great question that got the usual waffle of an answer 🤯

Thank you @annalouisedixon for bringing this question. The answer was not reassuring

Sir Jim Mackey keeps talking frameworks, compliance, and vague incentives, but offers no real solution. ✖️Endless policy talk ✖️Zero action ✖️Words over patients ✖️Bureaucracy over care Routine waits are rising, frail patients miss out, frontline care suffers.

@medicaccountant @annalouisedixon He didn’t seem to understand the point ….? That doesn’t bode well

@RaymentCaroline @annalouisedixon I’ve no idea what the answer actually meant ! Certainly had no relevance to General Practice

This is true but then how will they allow us to increase our capacity - they hold the purse strings

Dear @wesstreeting @SKinnock - I now have at least 25% less face to face appointments with my patients due to your enforced all day online requests I have to deal with. I’m sat in front of a screen for hrs & hrs typing away-I became a GP to see patients in my surgery. @pulsetoday

I know many GP teams have been struggling with this. We want to see our patients. But instead we are having to lose capacity so that politicians can deliver a soundbite. I am not sure how much more we can take.

@bookingcom we have just arrived at our cottage booked through you. It’s impossible to get hold of someone other than an AI voice - we are not happy - please help

our practice used to have great access. Same day urgents, 1-2 weeks routine. Since digital access imposition in October a routine appt is 3 weeks as we’ve had to reduce F2F appts to triage all the online appts @wesstreeting @SKinnock @annalouisedixon @_RobbieMoore @doctor_katie

@hannahapexfit Apex

A reminder to start building muscle now.

The NHS survived this year because staff absorbed the consequences of decisions they didn’t make,chaos they didn’t create. The blunt message from this year is the NHS is led by someone who isn’t clever enough, experienced enough and is too cocky by half. myemail.constantcontact.com/Downing-Street…

I've written this open letter to @Keir_Starmer & @wesstreeting because, though I am desperately worried about NHS patients over the next 5 days, I know this strike by resident doctors is a desperate act of last resort. Please read.

@RoyLilley I’ve been qualified for almost 30 years - every year there is a ‘winter crisis’ but no government of either colour has been prepared to tackle the lack of beds and staff compared to comparable countries. Def. Of insanity - doing the same thing and expecting different outcome

The NHS prepares for winter every single year. What it can’t do is what Santa can do… rely on fairy dust and magic, to conjure up some help… in the NHS there’s no magic that can create capacity... ... that no longer exists. myemail.constantcontact.com/Crisis.html?so…