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How to Enhancing Bs From 0 to TET Full Process | Black Desert Online

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From Base To 15 We lose 340 Durability That’s mean 340 memory
if we dont use Artisn
From 15 to 4 try’s For TET we losed 604 Durability That’s mean 604 memory

Total 944 memory
Memory 944 x 3m = 2,832,000,000

feel free to ask anything ^^

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INTRO | 00:00
Explain the idea | 00:09
The material Needed | 01:31
Enhance From Base To +15 | 02:39
Enhance From +15 To TET | 06:59
Costing | 18:35
Outro | 20:16

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Join Andy and Gandhi for our Digital Primary Care update including discussing the dawn of a GP workload crisis, vaccination passports, PCN DES contract and more….

Is there still a workload crisis?

#GPworkload #workloadcrisis #vaccinationpassports

00:00 Welcome

The last few weeks is it busy?
Andy / Gandhi

The theme in the industry media around workload

Year-end for Practices and PCNs, looking forward to 21-22

Changes to workload pressures QOF restart
We’re looking at some stories and tell you about content coming up in next few weeks…

03:30 GPs working average 11-hour day, major survey reveals

https://www.pulsetoday.co.uk/news/workload/gps-working-average-11-hour-day-major-survey-reveals/

11 Hour WW notes
Results from Pulse workload survey – 1,400 GP respondents
Look at the infographic and discuss
11 hours working day and 37 patient a day (28 thought to be safe)
Longer consultation times

Survey also asked about the impact of the pandemic
See infographic and discuss

Are telephone and online consultations saving time?
More stressful, less information (body language etc.), risk of f2f in a pandemic to manage

What can we do?
Erm….. Difficult
Recognise the impact of technology – pandemic safety and patient convenience yes, helping doctors – no?
Restart some old discussions about funding models, presentation of availability by gov/nhs, managing demand, token charges……?????

18:20 BMA says GPs can refrain from non-essential work despite April restart orders
https://www.pulsetoday.co.uk/news/workload/bma-says-gps-can-refrain-from-non-essential-work-despite-april-restart-orders/

Notes
Ready to restart QOF activity in April, CQC resuming some inspection activity
But joint BMA.RCGP guidance – January –
But ongoing Vaccination clinics, maintaining social distancing… which says ‘most’ GP practices should pause all or a ‘significant proportion of their non-essential work, depending on local Covid rates – ‘remains relevant as we continue in the pandemic situation
Ongoing discussions about pausing QOF again???? – BMA spokesman
? non-story ish?

Workload impact of vaccine passports?

21:30 GPs should have no role in administering any vaccine passport scheme, RCGP warns

https://www.pulsetoday.co.uk/news/clinical-areas/infectious-diseases/gps-should-have-no-role-in-administering-any-vaccine-passport-scheme-rcgp-warns/

Notes
Government is likely to make some activities dependant on vaccination status – pubs, holidays abroads….
RCGP getting ahead of this and stating scheme should have zero impact on GP workload

Episode coming up about Vaccine passports when we know more in the coming weeks

Just use the NHS App as the basis for “passports”? Tab on their confirming vaccine status with authenticating QRcode?….Just call it allowing people to demonstrate vaccination status… legislate for misuse/discrimination and let industries decide.

What is new?

26:28 New DES Guidance published: https://www.england.nhs.uk/gp/investment/gp-contract/

GP appointment data standardisation work
Investment and impact fund
Cancer early diagnosis
Structured Medication reviews
Enhanced health in care homes
New ARRS roles
– Mental health worker
– Paramedic
– Advanced practitioner

info and Content coming up about this from eGPLearning in the next few weeks to help you digest it

32:05 Work as normal?

Exhaustion
Vaccination phase 2
QoF restart
PCN work
ICS work

GPs could be asked to review hospital waiting lists ‘on an ongoing basis’

https://www.pulsetoday.co.uk/news/referrals/gps-could-be-asked-to-review-hospital-waiting-lists-on-an-ongoing-basis/

6.6b to NHS for first 6m

https://www.pulsetoday.co.uk/news/coronavirus/health-secretary-announces-6-6bn-further-covid-funding-for-the-nhs/

120m to General practice in first 6m
https://www.pulsetoday.co.uk/news/breaking-news/gp-practices-to-be-supported-with-new-120m-covid-fund-until-september/

THIS Simple Online Business From Home PAYS $1000 PER MONTH (EASY Make Money Online Tutorial 2020)

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