This year

• 14 Aug 2026 The workload the formula can't see Appointments at record levels, GP numbers below 2015, sessions that run six hours, and a population aged 90+ up more than half in twenty years — set against a funding formula built in 2004 on 1990s data.
• 11 Aug 2026 The list is the business Almost everything a practice earns multiplies by one number: the registered list. Ghost patients, list cleansing, students, summer tourists, new-build estates and care homes — and why a patient is not a patient.
• 11 Aug 2026 Add up every GP list in England and you get more people than live in England LinkedIn LinkedIn share for part 5 of the How GPs are paid series: ghost patients, list cleansing, the patients nobody counts, and the care home arithmetic.
• 5 Aug 2026 In 2020 the government wrote off £13.4 billion of NHS hospital debt LinkedIn LinkedIn share for part 4 of the How GPs are paid series: hospital debt written off versus GP partners' personal liability, and the losing spiral that drives practices to close.
• 5 Aug 2026 Who carries the risk? Hospitals get their deficits written off; GP partners are personally liable for practice losses. A look at the asymmetry, the losing spiral it creates, and why the risk is also why general practice is cheap.
• 2 Aug 2026 The plumbing: profit, partnerships, VAT and limited companies Why two identical practices make different profits, how drawings and capital accounts really work, why leaving money in the practice hurts, and the VAT and limited-company traps waiting for PCNs.
• 31 Jul 2026 No 2 in my How GPs are paid series — the surgery building LinkedIn LinkedIn share for part 2 of the How GPs are paid series: why owning your surgery was once policy, last partner standing, and whether ownership decline affects length of service.
• 31 Jul 2026 The surgery building: asset, anchor or millstone? Why owning your surgery was once official policy, how rent reimbursement really works, the rise of last partner standing, and the questions to ask before buying into practice premises.
• 30 Jul 2026 How GPs are paid, the 2026 update! LinkedIn Announces the 2026 rebuild of the How GPs are paid article: 49p per patient per day, why practices hold no budget for tests or prescribing, and Howbeck's marketplace workshops.
• 30 Jul 2026 How GPs are paid: the 2026 update A full rebuild of this site's most-read piece: where every pound of GP practice funding comes from in 2026, where it goes, and why profit = income minus expenses still explains everything.
• 28 Jul 2026 Neil's AI Tip #9 — Stop reading about AI. Build something. Here's a starter project that could save you money! LinkedIn Invites readers to build their own electricity-usage analyser with AI on the Octopus API — a three-stage starter project, with the full prompt and guardrails on the blog.
• 28 Jul 2026 Neil's AI Tip #9 — Here's Your Starter Project: Your Own Energy Analyser A worked example: prompting an AI into building a private electricity-usage analyser on the Octopus API — API keys, guardrails, model choice, and the mistakes that taught the most.
• 26 Jul 2026 Fourteen versions later: what a silly holiday game taught me about listening to users The holiday card game's changelog as a user-research diary: nine complaints from family playtesters, and how each one — with an AI pair-programmer — became a shipped fix by bedtime.
• 23 Jul 2026 Get Me To The Hotel! What building a silly holiday game taught me about serious software The story behind a multiplayer phone game built on a family holiday in Bermuda with AI — the PDSA-style iterations, the game-design rabbit holes, and what it shares with GP triage.
• 22 Jul 2026 Who do your patients actually see? A free continuity tool for GP practices Introduces a free browser-based tool that checks a practice's Usual GP field against who patients really see, and reflects on building clinical software with AI.
• 22 Jul 2026 The first time I met AI was 1993 In 1993 I spent two months testing whether a neural network could predict insulin doses better than a pharmacokinetic model. It couldn't — the data was the problem, not the maths. Thirty-three years on, it's a product you can buy.
• 20 Jul 2026 This site was rebuilt by an AI (mostly) Why drneilpaul.blog moved off WordPress to a fast static archive built with Claude — recovering lost columns, folding in 1,300+ LinkedIn posts, and keeping a human in the loop.
• 11 Jul 2026 My eldest daughter Meredith Paul got her end of 2nd year results today in Applied… LinkedIn
• 5 Jul 2026 As well as writing AI tips, I've really been using AI to learn how useful it can be. LinkedIn Shares an appointment simulator he built showing how same-day slot holdback and workforce mix trade off patient access, continuity and GP workload.
• 4 Jul 2026 Not enough people are talking about Blinx Solutions Analytics dashboard in their PACO… LinkedIn Praises the Blinx Solutions PACO analytics dashboard for fast PCN-wide queries across millions of records.
• 23 Jun 2026 Just rang my private dentist (had a great NHS one but he retired and no one took over -… LinkedIn Contrasts a three-month wait for his private dentist with NHS GP access, questioning claims that private care is faster.
• 19 Jun 2026 When AI Gets It Wrong LinkedIn A partnership profit-split calculation where AI stayed confidently wrong for several rounds illustrates why outputs must be sense-checked — right and wrong answers sound identical.
• 17 Jun 2026 Vibe Coding Is Brilliant. Information Governance Still Matters. LinkedIn Applauds GPs vibe coding their own tools but warns nobody is asking information governance questions — staff data counts too, DPIAs exist for this, and free AI tiers offer no data protections.
• 13 Jun 2026 Wow Anthropic have just had to pull Fable 5 (their most powerful ai model yet) from… LinkedIn Reacts to Anthropic reportedly pulling its powerful Fable 5 model after a US government edict, lamenting a possible cap on AI capability.
• 10 Jun 2026 Choose your AI App Wisely LinkedIn A framework for picking an AI tool: separate the app from the model, match the engine to the job, weigh generalists against specialists like Medwise, and mind where your data goes.
• 8 Jun 2026 Anyone coming to see me talk at the Management in practice conference Birmingham tomorrow? LinkedIn
• 5 Jun 2026 Ask AI how you can use it better LinkedIn Suggests asking AI tools directly how to use them better, surfacing features like Projects, scheduled tasks and connectors, explained in your own working context.
• 3 Jun 2026 If you want to try Vibe Coding - Use GIT LinkedIn Why anyone letting AI write code should learn git first: snapshot-and-rollback protects vibe-coding experiments, and AI assistants can run the commands for you.
• 2 Jun 2026 Just about to start my talk at Management in Practice Manchester- on my adventures with… LinkedIn
• 29 May 2026 Come see me at MIP next week - Ive got a great talk about 7 amazing projects I've done… LinkedIn Promotes his MIP and Birmingham show talk on seven projects built with Claude AI and the lessons learned for others exploring AI.
• 29 May 2026 our model of delivering this at scale - delivers a high quality affordable sensible… LinkedIn
• 26 May 2026 Just been informed my poster for the Primary Care Cardiovascular Society Spring… LinkedIn Marks his Highly Commended poster on using AI to write code that mined 16,000 free-text echo reports to improve a PCN heart failure register.
• 12 May 2026 Lovely to hear this feedback LinkedIn
• 12 May 2026 It was a good day thanks for coming LinkedIn
• 1 May 2026 AI Does What You Ask — Not What You Mean LinkedIn Why vague AI prompts produce generic results: a headshot-editing demo showing how explicit constraints, especially what not to do, get the output you actually want.
• 21 Apr 2026 Our Digital Clinical Safety Officer Service website is now live! LinkedIn Announces the launch of Howbeck's retained Digital Clinical Safety Officer service for GP practices at an affordable price.
• 19 Apr 2026 Happy to take on new clients!! LinkedIn
• 15 Apr 2026 Should we invest in an AI Machine? LinkedIn Explores running local AI models with Ollama on Mac hardware and asks whether each neighbourhood should own an AI service for data analysis and risk stratification, keeping patient data on-site.
• 14 Apr 2026 Does everyone else know this and Ive just missed it? LinkedIn Explains how wifi-enabled appliances could shift usage to cheap, low-carbon grid power and cut household bills.
• 13 Apr 2026 ive also been playing with claude and national data sets but not done anything as clever… LinkedIn Notes experimenting with Claude on national datasets, crediting Anne Marie Cunningham's more sophisticated analyses.
• 13 Apr 2026 Stop Starting From Scratch: Use Projects LinkedIn Explains how AI Projects give ongoing work persistent context — an instructions file, reference documents and a living knowledge base — so serious collaboration stops restarting from scratch.
• 8 Apr 2026 Stop Asking AI for Word Docs LinkedIn Practical tip for non-techies: ask AI for Markdown rather than Word documents, using plain-text files as knowledge bases, handoff notes and task lists that survive copy-paste and versioning.
• 6 Apr 2026 Lexacom New Features LinkedIn Lexacom AVT now pulls EMIS patient data into ambient consultation notes locally on the desktop, and a new mobile app takes dictation to home visits and meetings.
• 4 Apr 2026 Neighbourhood Working - Part 2 LinkedIn Argues that capitation gives general practice a structural incentive for prevention, so PCNs should set the population health agenda using individual-level data rather than postcode proxies.
• 3 Apr 2026 Neighbourhood Working - Part 1 LinkedIn Argues neighbourhood working is being shaped by acute trusts' short-term cost priorities, citing Geoffrey Rose on middle-risk prevention and the limits of area targeting.
• 2 Apr 2026 The large pachyderm in the room: Planning guidance out today - its all about A&E… LinkedIn Argues the new NHS planning guidance is really about A&E avoidance and cutting bed stays, the true purpose of integrated neighbourhood teams.
• 2 Apr 2026 Looking like a good day - if nothing else come hear me talking about my experiences with… LinkedIn
• 2 Apr 2026 Research Delivery in Primary Care LinkedIn Identifies unreliable courier logistics for time-critical trial samples as an overlooked bottleneck in primary care research delivery, drawing on Cheshire and Mersey CRDC site experience.
• 1 Apr 2026 Interested in our dpo service get in touch LinkedIn
• 26 Mar 2026 Any companies or organisations with a product or service looking for a primary care or… LinkedIn Offers his Cheshire team as a primary care or community partner for organisations applying to the NIHR i4i FAST funding call.
• 20 Mar 2026 Why is study set-up still so manual in 2026? LinkedIn Questions why trial site set-up still means repeatedly emailing CVs, GCP certificates and delegation logs to each sponsor, and calls for a single live source of truth for research sites.
• 18 Mar 2026 Building Primary Care Tools Without Coding: An AI Experiment LinkedIn A conference poster on using AI as a programming collaborator so clinicians can build in-practice data analysis tools, applied to heart failure register validation in SMASH PCN.
• 16 Mar 2026 As many of you may know I'm always looking for ways to speed up clinical trial delivery. LinkedIn Seeks innovative tools to automate post-visit data upload to electronic case documents, a persistent bottleneck in clinical trial delivery.
• 16 Mar 2026 fascinating - why follow the bad advice? LinkedIn
• 13 Mar 2026 Today my surgery is posting 2 job adverts on NHS jobs to expand our clinical trials team. LinkedIn Neil's surgery recruits a junior research practitioner and an experienced research nurse to grow its commercial clinical trials portfolio.
• 16 Feb 2026 An article I wrote for DTLs in Pulse. LinkedIn
• 12 Feb 2026 Interesting post and I agree we don't have enough good managers in the NHS. LinkedIn Argues practice managers grown from within miss external talent, and calls for rotational manager training in general practice.
• 2 Feb 2026 Can artificial intelligence (AI) save UK primary care? BJC TV Video interview for the British Journal of Cardiology: Dr Neil Paul and Dr Martin Godfrey on how AI and digital healthcare may revolutionise general practice.
• 26 Jan 2026 At last weeks all docs meeting at my surgery - I demo'd the free to use Medwise AI and… LinkedIn Reports demoing Medwise AI's UK-guidance-locked search at a practice meeting, where colleagues found it game-changing and now use it constantly.
• 19 Jan 2026 Used Lexacom's Ambient Voice AI today to listen in to a two and a half hour meeting with… LinkedIn Reports using Lexacom's ambient voice AI to minute a long meeting, suggesting uses beyond consultations.
• 15 Jan 2026 I don’t know these image editing AIs can be quite useful when trying out new uniforms -… LinkedIn Observes that image-editing AIs are handy for previewing new uniforms, with a warning against others reusing his image.
• 12 Jan 2026 Ive been a bit quiet recently on here as so many exciting projects on the go that I hope… LinkedIn Shares a document for local GPs on text-messaging costs, noting SMS fragment use varies from 3 to 89 per patient per year.
• 12 Jan 2026 as ive commented in the piece I was doing some back of the envelope calculations and an… LinkedIn Estimates that an extra £50 per head, redirected from Pharmacy First, could raise GP appointments by 30 percent.

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