Tom Mackrell

#First5 in #TeamGP. Salaried GP in West Leeds PCN/WLFP
Interested in #meded, health equity
Own views. He/him

[@DrKatie.BSky.Social @doctor_katie]

Editor:

I’m so proud of our 6,200 GP practices nationwide who delivered 388,000,000 appointments in the past year on record tiny proportion of NHS budget where 0.02% interactions result in a complaint.

I hope @wesstreeting @SKinnock would also decry this reporting.

@BMA_GP

[Dr Dave Triska @dave_dlt]

🧵A Monday morning in general practice. Real numbers from one small rural GP surgery
By 9am this morning, our practice had already processed 240 clinical tasks. That's 4 a minute. 80 consultations, 125 prescriptions, 22 documents, 13 results. Before most people had started work.

[@DrKatie.BSky.Social @doctor_katie]

Letter to The Guardian
31 December 2025

@TheBMA @theguardianfeed @guardian @guardianletters

[@DrKatie.BSky.Social @doctor_katie]

To quote my colleague James Booth, regarding the Resident Doctors’ action this week:

“Lots of MPs hitting social media.
I was a junior doctor (as we were called then) just over twenty years ago. I worked hard: long, stressful hours…

1/x

@TheBMA
@BMA_GP
@BMAResidents

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

This is delibratley misleading from @wesstreeting and @DHSCgovuk

Online bookings do not increase access. If anything they swamp the system and make clinical prioritisation harder - with delays to patients with urgent clinical need

GPs have been seeing increasing numbers of patients online and in person in the last 5 years without the resources or funding they need.

Soundbites from Wes and DHSC don't improve care or fund the NHS.

@DrSteveTaylor @TheBMA @BMAResidents @DrNeenaJha @RobLaurensonD4P @thomasdolphin @mattster

[Dr Dave Triska @dave_dlt]

A tale of a Monday morning in a GP surgery (mine).

The waiting room looked calm.

Calm isn’t quiet. It’s control.

A look behind the scenes of a “quiet” GP morning in this Substack:

https://t.co/1rlrjVPB0K

@Parody_RCGP @DrSteveTaylor @doctor_katie @DrSelvarajah

[Ankit Kant @ankitkant]

Imagine creating a system where hospitals are paid to do less, meanwhile GPs get paid less to do more…with patients ultimately losing.

Oh wait, that is the system.

And the government then post Drake memes implying they are on the side of patients.

[@DrKatie.BSky.Social @doctor_katie]

@NHSEngland According to this data

💥5,967 (over 96%) of practices in England have at least one online consultation system

💥5.1 million patient online submissions occurred in August

💥3.5 million clinical, the rest admin

(For context every A&E nationwide offers 67,000/day)

3/x

[@DrKatie.BSky.Social @doctor_katie]

@BMA_GP have articulated our concerns professionally & in good faith

GPs have been labelled “laggards” & “blockers of progress” despite eRS; EPS; GPSoC; GPC-UR read access; 99% surgeries on cloud-based telephony; & access higher than any point in 77 yr Hx of NHS: 1.5m pts/day

[Dr David Wrigley @DavidGWrigley]

GPs are being asked to open up online consultation software from 8am-630pm Mon-Fri from 1/10/25. No flexibility from @NHSEngland @DHSCgovuk @wesstreeting around suspending it if completely overwhelmed or staff sickness limits capacity. Patient safety will be compromised by this..

[RTW parkrun @RTWparkrun]

It’s parkrun day!
Come and join us for 5k of running, walking, jogging or volunteering among friends you’ve not yet met.
All are welcome and parkrun is free of charge. Simply sign up for a barcode on our website (& bring it!) then turn up for briefings at 8.50am.
See you soon.

[Tom Mackrell @TMackrell]

some talk of difficulties following referral in accessing diagnostic services at #WYLeDeR. Is the shift from 2ww to 28 days to diagnosis target an opportunity to facilitate more reasonable adjustments and make that first hospital appointment a better experience/reduce DNA rate.

[Leeds GP Confederation @LeedsGp]

🎗️ We’re encouraging more people in Leeds to take part in cancer screening. Read our Cancer Care Coordinator, Claire’s experience with cervical screening and understand the importance of early detection.

👉 Read Claire’s Story Here - https://t.co/7Vl5HVPN9t

#CervicalScreening

[Andrew Giles @giles_home]

A post on unfunded, and underfunded work in primary care.

Last year I did some analysis on LES schemes and freebies practices do, it wasn't exhaustive. 10 non-core things like phlebotomy, ECG, B12 etc that aren't funded in our area.

I revisited it today, some rough searches and maths suggests around 270,000 appointments worth a year of unfunded work, across a 350k population.

That's around 50% of all outpatient appointments per year, for the same population.

For FREE.

Except its not free, it's paid for by late nights and stress or by diverting time funded from contractual income to cross subsidise commissioning gaps, at a time when patients are expecting more and more.

Is that sustainable?

No one wants to stop, as it will be awful for patients, hospitals certainly can't do 50% extra, for free, but in practices it is taking care away from patients, either today, or in the future when the practice folds.

If you work in an NHS org, and the free work practices do is not on your risk register, flashing, with bells on, I think 2024 might be more painful than it already will be.

[Tom Mackrell @TMackrell]

@AiLyn_Runner @WfldHospice @UKRunChat You flew past me going up one of the hills! Well done. Looks like the marathon training miles are paying dividends!

[David Oliver @mancunianmedic]

take note
people on here who say "there are no GP appointments"

more than there have ever been, with fewer GPs than a decade ago and UK GPs seeing twice as many patients as counterparts in other high income nations

And average patient on GP list having 6 appointments a year

[@DrKatie.BSky.Social @doctor_katie]

The @Conservatives, @DHSCgovuk & @NHSEngland have decided, rather than being the ‘stepping stone’ year to signal safety, stability, and hope - 2024 will instead signal reduced patient access to GP services as well as likely closures of GP practices across the country.

🧵👇

[lizzie sweeting @lizziesweeting]

Join @ali_cracknell @Annawinf and other team members talking about our experience of supporting care homes with QI. Please share with colleagues who may be interested @alison_iliff @AlecTinkerPH @sarahdebiase

[Ai Lyn Tan @AiLyn_Runner]

parkrunners inspire each other!😀

🤝Pass it on!

Thank you @ndosie for your sponsorship
Here's the message you sent 5 years ago about #parkrun!

If, like Mwidimi, you #loveparkrun & would like to sponsor me, you'll get a shout out too!
👉🏼https://t.co/GKrjl3lXZx

#ukrunchat #runr

[Andrew Lee is heading to @andrewleedr.bsky.social @andrewleedr]

Unsurprisingly, these same ICBs have the highest concentration of GP surgeries serving mostly socioeconomically disadvantaged patients.

2/