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Anish K Patel

@anishkpatel.bsky.social

470 followers 110 following 260 posts

‘Just a GP’ posting about general practice and healthcare

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Anish K Patel @anishkpatel.bsky.social · Dec 14

It’s hard to describe what it feels like to be a GP. Sitting in a room alone, with patients rotating in and out, tackling a never-ending list—there’s no space to breathe. It can be relentless.

🧵

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Anish K Patel @anishkpatel.bsky.social · 9h

Be careful what we build. Efficiency is good. Connection is better. We should design for both.

It is coming to healthcare too. Triage portals, templated scripts, fewer real voices. Services that work yet feel empty.

We have to protect the human touch.

6/6

Anish K Patel @anishkpatel.bsky.social · 9h

This pattern is everywhere now. Self checkouts, scripted helplines, standardised messages. Faster, tidier, thinner as an experience.

The positives are waved in our faces. The downsides are rarely counted, measured or designed for.

5/6

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Anish K Patel @anishkpatel.bsky.social · 9h

On the surface both options get you from A to B. Only one brings a human quality we are losing: connection.

We lose the small frictions that make us see each other.

4/6

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Anish K Patel @anishkpatel.bsky.social · 9h

Both moments bind a carriage. For a minute, strangers share the same story.

When did you last hear a real voice over the tannoy? Most days it is the automated list of stops. One train of many. No individual character.

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Anish K Patel @anishkpatel.bsky.social · 9h

Then there are the days when the voice on the mic sounds tired, sharp, clearly having a bad day. Uncomfortable, yes. Still human.

2/6

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Anish K Patel @anishkpatel.bsky.social · 9h

Have you ever been on a train where a real person announces the stops, says Charlie in carriage 3 is celebrating his sixth birthday and asks everyone to sing, then throws in a random fact about the next station?

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Anish K Patel @anishkpatel.bsky.social · 1d

I speak to retired GPs and the pattern is obvious. They miss the patients, not the job. Not the grind, the tick boxes, or holding a service together on a shoestring.

Most stayed as long as they could, then hit eject for their own sanity. There is a warning here for all of us.

Anish K Patel @anishkpatel.bsky.social · 10d

I speak with GPs nationwide. Two camps keep coming up:

1) recruit more GPs

2) grow the wider team and protect GP time for complex care.

Which camp are you in?

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Anish K Patel @anishkpatel.bsky.social · 12d

Oct 1 contract changes: online REQUESTS not online BOOKING. Gov says one thing, media go off and writes what they want.

When headlines promise booking, GPs get the heat, patients feel misled, and the bar for Wes jumps higher than he intended. 😬

Anish K Patel @anishkpatel.bsky.social · Jul 24

Everyone thinks they are on the side of good.

Anish K Patel @anishkpatel.bsky.social · Jun 13

Doing docs the other day. So many letters addressed to GPs that have not worked at my practice for 10+ years.

Would this be accepted in any other profession? 🤔

Anish K Patel @anishkpatel.bsky.social · May 16

Incentives matter.

And right now, the NHS is still paying people to build bigger spreadsheets, not better systems.

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typeshare.co/anishkpatel/...

Incentivised to Hold On: Why NHS CEOs Resist Letting Go

The NHS says it wants care closer to home, but its pay structure rewards holding on, not letting go.

typeshare.co

Anish K Patel @anishkpatel.bsky.social · May 16

The new 2025 NHS very senior managers pay framework (yes it is called that) tries to shift that.

But it’s still layered on top of a structure that pays for scale, not sense.

Until that changes, the incentives won’t.

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Anish K Patel @anishkpatel.bsky.social · May 16

NHS Trust CEOs aren’t rewarded for collaboration.
They’re rewarded for control.

Bigger budget = bigger band = bigger pay.

Even if that means holding on when they should let go.

1/3

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Anish K Patel @anishkpatel.bsky.social · May 15

Good piece on how it all came about 👇

Give you a clue. The Carr-hill formula.

www.nuffieldtrust.org.uk/resource/fai...

Fairer funding for general practice in England: what’s the problem, why is it so hard to fix, and what should the government do?

General practice funding is inequitable: the Carr-Hill formula, which decides the distribution of funding, is outdated and fails to take account of socioeconomic deprivation. This briefing, produced i...

www.nuffieldtrust.org.uk

Anish K Patel @anishkpatel.bsky.social · May 15

I spoke with someone from the voluntary sector while at an ICB event this week. He saw firsthand the gaps in our health and social fabric.

I explained how GP practices in poorer areas actually receive less funding than those in richer ones. His eyes widened. 😳He had no idea.

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Anish K Patel @anishkpatel.bsky.social · May 9

The hills (that currently feel like mountains) will keep coming.

But remembering the wind at our backs might just make them a little easier to climb.

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typeshare.co/anishkpatel/...

The Hills We Climb and the Winds We Forget

Headwinds, tailwinds and why progress rarely feels like progress in the NHS and in life.

typeshare.co

Anish K Patel @anishkpatel.bsky.social · May 9

Psychologists call it the headwinds/tailwinds asymmetry.

We notice what holds us back more than what helps us forward.

A problem fixed is quickly forgotten.

We are experts as tracking hardship.

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Anish K Patel @anishkpatel.bsky.social · May 9

We talk a lot about what’s going wrong in the NHS. What’s broken. What’s missing.

That’s fair. There’s plenty.

But the danger is we only ever feel the climb.

1/3

Anish K Patel @anishkpatel.bsky.social · May 8

The NHS isn’t a machine. General practice isn’t a factory. When we treat it like one, we end up solving the wrong problems. AND create new ones.

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typeshare.co/anishkpatel/...

What Gets Measured Gets Misunderstood

I’ve been looking at practice data for years, especially triage and call figures across GP surgeries

typeshare.co

Anish K Patel @anishkpatel.bsky.social · May 8

Data strips out context. It becomes sterile, rigid, and dangerously clean. It flattens messy, human work into neat numbers that are easy to misinterpret and weaponise.

Especially when those at the coal face aren’t the ones holding the spreadsheets.

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Anish K Patel @anishkpatel.bsky.social · May 8

Everyone keeps saying better data will fix the NHS. But after years digging into triage and call stats across practices, I’ve realised the opposite is often true.

What gets measured gets misunderstood.

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Anish K Patel @anishkpatel.bsky.social · May 2

So we triage. We sort. We see those most in need.

And today, that means you must go elsewhere.

I am sorry. 😔

Anish K Patel @anishkpatel.bsky.social · May 2

All I want to do is bring you in.

To sit you down.

To help you—the way we are trained to.

As a team, we handle most of what walks through our doors.

But there aren’t enough of us to go around.

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Anish K Patel @anishkpatel.bsky.social · May 2

All I can offer now is advice:

• Visit the local chemist, with their rigid list of conditions they’re allowed to treat, or

• Head to the urgent care centre, where you will be seen—but you may wait for hours.

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