JD is currently bemoaning the state of affairs in general practice, but it's no better in hospitals either. I've recently been talking to a friend & colleague. He specialises in a condition that is refractory and chronic and many of his patients have seen him many times over several years. His patients, on average require eight follow up appointments before he either achieves some sort of objective, or runs out of ideas. Until recently no one told him how often he could see patients or keep them on his books. He, as the professional made the decision as to whether or not to get them back.
All that has changed. He has now been instructed that he can see a patient for a maximum of three appointments only, and then they MUST be discharged back to primary care. And the appointments they do have will have to be with a specialist nurse in an increasing proportion. That means that many of his patients he will have to discharge before he can achieve anything, and they will return to their GP in effect untreated. The management don't give a shit. They are only interested in "processing" the patients through the system so they can get their money from the PCT. The fact that these peoples' medical problem will not have been addressed does not matter to them. The idea is that if the patient still requires specialist care he will have to be referred again and the Trust can then charge the PCT again, for the patient just to be seen by some overfed harpie who calls herself a consultant but knows fuck all about it.
So what is he going to do about it. He's taking early retirement.