This live event has finished
- We ask Andy Davies, chairman of the Warrington Clinical Commissioning Group, about burning NHS topics from our readers
- Whether it is appointments, delays or the future of the NHS, he will be answering all your questions for the next hour
- Join in using hashtag #AskAndy
That's all from us blog fans.
Thanks to everyone who got involved, including a number of tennis fans who inadvertently joined in with our Ask Andy hashtag, and thanks to Dr Andy Davies for taking time out of his busy day to chat with our readers.
There is a lot to learn from the private sector and my views are in no way that private companies are bad but I do have an issue with companies who have shares that will raise dividend profit for shareholders that takes money out of the NHS.
The NHS has tough financial targets to meet and I'm not convinced it will be able to do so with the small losses to shareholder dividends that will come from increasing privitisation.
There may be ways around these problems to get the benefits of smarter working processes that private companies often have without the need to risk our core NHS values and investment.
After a number of tweets earlier, we're going to finish on Andy's view of the privitisation of the NHS
I think direct charging of patients would be against the prinicples of the NHS which promises to be free at the point of need.
I think it's right to look at appropriate use of healthcare services but it's difficult to think of penalising people for conditions arising from life choices which may not fit with our own personal values.
Particularly with the rising demand related to acute intoxication with alcohol or drugs we perhaps need to think as a society whether we're prepared to support those choices or whether there needs to be sanctions in place for those who repeatedly drink to excess.
But that's not something we can change from the NHS, quite right and proper clinicians see and treat people with health needs irrespective of why those needs have arisen.
Do you think patients should ever be charged? (Northern Ireland's health minister warned earlier this week he is considering charging drunk patients)
Asks Jeanette Ball.
Andy says: For the older doctors out there, there were wet films and dry films.
A wet film you got to see the x-ray before it was reported, modern x-rays don't even have film!
In A&E as dr you get to see the image and have tto make the interpretation yourself to help with your clinical decision making this makes sense as most problems going to A&E need a rapid decision.
These films would be reported by a radiologist, specialist doctor, as a second check on the A&E pictures.
When we order an x-ray, the patient books a time to go to the department and has the image taken by a radiographer that image is then passed through for reporting and then sent back to the practice after it's been checked an authorised by radiologists.
That means as a GP don't get to see pictures when they're aken, I get to see the report after it's been quality-controlled.
Tom Hallett asks:
Can you tell me why x-rays take so long to reach your doctors surgery but if you attend A&E you get the results the same day?
We're going live now with the next answer.
Alex James, from Bewsey, said:
Would it make more sense for every practice in Warrington to have the same appointment system?
I think argument has been made that it is safe.
22 practices in the town entered into the shared care agreement which are signed up to between the prescribing doctors in the practice and the consultant who supervise the care of the patient. With those drugs they are on an amber list which means they shouldn't be prescribed without consultant supervision in primary care.
The decision whether or not to prescribe a medicine lies with the person who signs the prescription.
The practices who haven't yet taken on the shared care agreements for anti-dementia drugs and the atypical anti-psychotics do not feel they have sufficient time to supervise the prescriptions properly.
We have had lots of conversations with those practices and prescribers.
We don't share their assesment of the workload or risk and have tried to convince them it is fine to do but have remained unable to convince them.
They may reflect over time this group of patients will be able to take on prescribing of these medications and help them have more convenient access to the treatment they need.
The CCG's position is the shared care agreement represent high-quality pathway for prescribing these drugs.
David Hayes, from Cinnamon Brow, wants to know:
Why are some practices ‘not comfortable’ with prescribing Alzheimer’s drugs?
Mr Hayes’ story highlighting the problems he has faced getting his nearest surgery to prescribe Alzheimer’s drug aricept will be in tomorrow’s paper
Andy is here until 5.30pm.
Apologies to confused tennis fans looking for Andy Murray #AskAndy
Andy says: Burnout and fatigue because we're still running on system of care developed in the 30s and 40s yet the volume of work has gone up and up.
Complexity has also gone up and you need more time to think through options than we did 20 years ago because you have got more options.
Workload has gone up 62 per cent and there are roughly the same number of GPs.
we need a more multi-disciplinary approach to sort that out.
It takes a cultural change from people and their expectations, 30 to 40 per cent of problems patients bring to GPs could have been managed by other healthcare professionals like pharmacists or self-care.
Get that bit right and you have probably got enough GPs.
What is the biggest problem doctors face at the moment?
asks Jan Unsworth, from Orford
Andy Davies gets to work answering your questions.
Andy says: I think there is a role for video consultations either directly with patients from primary care or alternative to outpatient appointments with consultants.
There is benefit to being able to see and speak to somebody to make sure communication is clearer.
There are also some visual cues you get as a doctor that are also important.
In terms of general future of health care need to get better at describing service offers for different patient groups with different needs eg. minor illness clinics which usually work well with nurse clinicians, complex case management clinics with more varied input from nurses and doctors alongside the standard GP appointments.
Tom Ferguson, from Great Sankey, asks:
How do you see things changing in the future? Will we be able to Skype doctors soon?
Andy says: An ageing demographic in Warrington is a challenge.
A lot of our work and discussion with clinicians and the public has been around that question.
We have a dedicated work stream to work on provision of care for elderly people with long term conditions and the frail elderly.
It is also big part of the work we do in redesigning primary care as part of Prime Minister's challenge fund work this year.
We regularly involve older person's engagement group (OPEG) or representatives in our discussions.
First question this afternoon is:
Marjorie Jones, from Lymm, wants to know:
How do you plan to care for a growing elderly population in Warrington?
WELCOME to our live blog with Warrington CCG chairman Andy Davies.
He will be here for the next hour answering your questions