"we have no appointments so we'll make an appointment with another surgery"

[Proxima Centauri]

I'm registered with the Gardens Surgery and, today, they didn't have any appointments and so made one for me at the Lister Primary Care Centre. I haven't been to a GP in ages so not up to date with current procedure. Is it normal to be sent to a different surgery these days and has anyone else encountered this? Thanks.

[Jeremy]

I don't think it's normal practise, but then again I think the Lister Primary Care Centre is a special case. They used to operate a walk-in centre, but was recently changed (I believe) to a GP referral system instead.

[steveo]

I've wondered of late if there isn't a tacit agreement among surgeries to make getting appointments increasingly difficult so that people give up and go away.

If there is, I kind of approve

[Bic Basher]

The rules were changed recently that if a local GP had no bookings, you are now referred to the Lister.

[BrandNewGuy]

steveo Wrote:

-------------------------------------------------------

> I've wondered of late if there isn't a tacit

> agreement among surgeries to make getting

> appointments increasingly difficult so that people

> give up and go away.

>

> If there is, I kind of approve

But then they go to A&E, helping to contribute to the A&E crisis. I'd be up for a system similar to those used in other countries where you get a certain number of 'free' GP appointments a year and, unless you're pregnant, have a baby or a chronic or serious condition (in the manner of those for free prescriptions), you then pay a ?20 every visit over and above your 'free' allowance. That would put a stop to freeloaders going to their GP when they have a cold.

[steveo]

Yup

[Mustard]

Does that mean that the Lister has access to your medical records, even if you are with another surgery?

[miga]

.

[steveo]

It's a conclusion but it's not logical

[BrandNewGuy]

miga Wrote:

-------------------------------------------------------

> BrandNewGuy Wrote:

> --------------------------------------------------

> -----

> > steveo Wrote:

> >

> --------------------------------------------------

>

> > -----

> > > I've wondered of late if there isn't a tacit

> > > agreement among surgeries to make getting

> > > appointments increasingly difficult so that

> > people

> > > give up and go away.

> > >

> > > If there is, I kind of approve

> >

> > But then they go to A&E, helping to contribute

> to

> > the A&E crisis. I'd be up for a system similar

> to

> > those used in other countries where you get a

> > certain number of 'free' GP appointments a year

> > and, unless you're pregnant, have a baby or a

> > chronic or serious condition (in the manner of

> > those for free prescriptions), you then pay a

> ?20

> > every visit over and above your 'free'

> allowance.

> > That would put a stop to freeloaders going to

> > their GP when they have a cold.

>

> Or to take this to its logical conclusion, it

> would certainly suit me personally if I didn't

> have to pay for the NHS *at all* since I'm a very

> light user, and my family is privately insured.

> That'll get the "freeloaders" off my back.

No, that's not a logical conclusion, it's a 'reductio ad absurdum'. Something like the arrangement I outlined works in lots of countries I regard as civilised with excellent healthcare systems that are the equal of or better than ours and don't discriminate against the poor and needy. I despair sometimes at the inability of many in the the 'save the NHS' brigade to at least engage with the serious problems we have. And no, they're not all the fault of the Tories.

[miga]

.

[Proxima Centauri]

Thanks all.

Just so people know, there is now a system in place whereby should your GP have no appts. and you are deemed in need of an appt. by a GP who telephones and questions you, you will be given an appt. at the Lister. I was seen on time and received a very positive experience. The doctor I saw said she would send details of my visit to my GP so I don't know whether she had access to my records.

[BrandNewGuy]

miga Wrote:

-------------------------------------------------------

> It's also a poorly structured argument to make a

> prejudice or suspicion your conclusion, then work

> backwards; the problem are the freeloaders,

> therefore we should make it expensive to go and

> see a GP unless it's a real problem, as

> self-assessed on some subjective scale of wellness

> by the patient.

>

> But really, the reason getting a GP appointment is

> difficult could be down to any number of factors,

> not sure why you'd just go with the "freeloaders".

> Hence my little flourish. Happy to be shown

> numbers, though.

No, I didn't say the problem was freeloaders, if you'd bothered to read my post properly. I said the NHS has 'serious problems', of which the pressure on GPs is just one. And part of *that* problem is there's absolutely no disincentive to freeloading ? and, yes, I know people who go to the GP for the most ridiculously trivial 'complaints'. I suggested a solution to that part of that problem. You need to ask why other countries either charge for appointments (as in France, where you recoup the moneys later) or charge for appointments above a certain number per year unless you have one of the conditions I mentioned.

Let's hear your suggestions.

[miga]

.

[BrandNewGuy]

miga Wrote:

-------------------------------------------------------

> (other than that you think some people

> you know are hypochondriacs), it's just an

> assertion.

I certainly did not say that people I know are hypochonriacs. Why do you think surgeries employ medical secretaries to give advice, and why there are ad campaigns to get people to ask their local pharmacist about minor ailments? Why did Labour intriduce NHS Direct? Because they're all worried about increased demands on GPs when they're not necessary.

> If you're asking how to increase GP capacity, I

> think more surgeries should do it.

And how do you propose to do that?

[steveo]

miga Wrote:

-------------------------------------------------------

> If you're asking how to increase GP capacity, I

> think more surgeries should do it.

'If you build it they will come'

[miga]

.

[BrandNewGuy]

Well don't 'extrapolate' then. Bit like your 'logical conclusion' thing.

Here's an example of 'freeloading'. Despite countless campaigns, leaflets and advice about the uselessness of going to the doctor when you have a cold or flu, people still go in their droves:

"In addition, new research done by the website doctors.net.uk to support the launch of the campaign shows that GPs struggle to cope with their caseload as the months get colder.

On average, doctors in the South West say almost a quarter of their consultations in the winter are for patients with cold and flu symptoms which don't in fact warrant a GP appointment.

Eighty-five per cent said they had felt pressured by their patients to prescribe an unnecessary antibiotic.

The research also shows GPs are spending an average of three full hours a week seeing patients who could have been treated by a pharmacist."

http://www.westernmorningnews.co.uk/Cold-sufferers-urged-avoid-unnecessary-GP-visits/story-20093142-detail/story.html#ixzz3M8ynTTP6

And www.treatyourselfbetter.co.uk

These people aren't 'hypochondriacs'. They're behaving in a system for which there are no disincentives for changing their behaviour.

You could just build a lot more surgeries and train and employ thousands more GPs, but people would then find it easier to get appointments to go to the GP with trivial ailments and therefore more likely to.

As I said, this only a small part of a problem that's one among many facing the NHS. And I'd agree that many aspects of the NHS are underfunded, but simply spending more and more will not work in the long term.

[JohnL]

I know there are many people like me - who only turn up at the GP/Outpatients when things are really bad.

I've was told not to do this - damage to kidneys etc.through dehydration.

miga Wrote:

-------------------------------------------------------

> BrandNewGuy Wrote:

> --------------------------------------------------

> -----

> > miga Wrote:

> >

> --------------------------------------------------

>

> > -----

> > > (other than that you think some people

> > > you know are hypochondriacs), it's just an

> > > assertion.

> > I certainly did not say that people I know are

> > hypochonriacs. Why do you think surgeries

> employ

> > medical secretaries to give advice, and why

> there

> > are ad campaigns to get people to ask their

> local

> > pharmacist about minor ailments? Why did Labour

> > intriduce NHS Direct? Because they're all

> worried

> > about increased demands on GPs when they're not

> > necessary.

>

> No, you said they're freeloaders who go to their

> GPs when there's really not very much wrong with

> them. I extrapolated that to hypochondriacs

> because that's what it's called when people who

> aren't ill think they are. But really, this little

> discussion is going nowhere, because you're unable

> to offer any evidence about your

> freeloader/capacity theory (prejudice coming from

> personal experience doesn't count).

[kristen]

What about the elderly or people that need to see a GP but can't battle through the 1hr phone queue or stand outside waiting for an on the day appointment? My dad - in his 90s - doesn't see his GP when he really should for these reasons resulting in him needing more care and "costing" the NHS more.

Also ?20 is a massive amount if you're on a low income. I have a chronic condition but I suspect if this was a condition for seeing a GP for free then the GP (or whoever decided this) would argue the case on that one. I'm currently in a situation where the GP is saying they have not seen any of my consultants notes since 2012 and are refusing to prescribe medication (despite me having copies of letters sent from the hospital to the GPs). So because they can't my diagnosis on their system apparently I'm cured! Great! Added to this I got a phone message a few days ago telling me I was an "inactive" patient so they were taking me off their list.

There is an issue with people thinking that GPs can solve/prescribe something for all their problems but I think there is a much bigger issue with GPs being under resourced. So it's impossible to get an appointment and when you do get an appointment most of the time it's a battle to get any quality of care. I have now seen my GP three times trying to get a referral - which they say I need - but each time they have given some kind of reason to delay this. This is just a waste of time and resource in the long run but in the short term it saves them money and I think they probably just hope I'll give up and go away.

What is a freeloader anyway - we all pay for the NHS. Most people aren't hypochondriacs - they're worried or concerned and don't really have anywhere else to go. If there was a better system of walk in clinics and pharmacists who were able to prescribe for simple conditions and give good advice this would help relieve the GP surgery.

steveo Wrote:

-------------------------------------------------------

> I've wondered of late if there isn't a tacit

> agreement among surgeries to make getting

> appointments increasingly difficult so that people

> give up and go away.

>

> If there is, I kind of approve

[Sue]

kristen Wrote:

-------------------------------------------------------

If there was a better system

> of walk in clinics and pharmacists who were able

> to prescribe for simple conditions and give good

> advice this would help relieve the GP surgery.

DMC in Crystal Palace Road, who are constantly getting slagged off on here, have an excellent pharmacist who can give advice and prescribe for simple conditions, as you suggest.

ETA: I was recently referred to the Lister by my GP, and the doctor I saw there did not have access to my medical records. It was shortly before the new system came in, so that may have changed.

[alice]

lister will have access to your records

[BrandNewGuy]

kristen Wrote:

-------------------------------------------------------

> What about the elderly or people that need to see

> a GP but can't battle through the 1hr phone queue

> or stand outside waiting for an on the day

> appointment? My dad - in his 90s - doesn't see his

> GP when he really should for these reasons

> resulting in him needing more care and "costing"

> the NHS more.

They don't pay prescription charges, so under my suggestion would be unaffected.

> Also ?20 is a massive amount if you're on a low

> income. I have a chronic condition

... so likewise, not affected by my suggestion.

> What is a freeloader anyway - we all pay for the

> NHS. Most people aren't hypochondriacs

Never said they were, but anything that is always free at the point of use will be used frequently by people who don't need to bother thinking about whether there's an alternative.

> - they're

> worried or concerned and don't really have

> anywhere else to go. If there was a better system

> of walk in clinics and pharmacists who were able

> to prescribe for simple conditions and give good

> advice this would help relieve the GP surgery.

Well, go to a pharmacist then. That's exactly what they do and what the government has spent tens of millions of pounds trying to tell people to do. Sometimes I despair...

[kristen]

@BrandNewGuy I despair too you seem to have just selectively quoted my post and & misunderstood what I was saying

- I wasn't talking about older people paying any charge - I was referring to Steveo's suggestion that he was glad that it was harder to access GP support - "I've wondered of late if there isn't a tacit agreement among surgeries to make getting appointments increasingly difficult so that people give up and go away. If there is, I kind of approve"

- I agree with you & think using pharmacists instead of doctors is a great idea my point was my experience of doing this has been mixed at best. I've been to pharmacists with my dad and children - in nearly all but a couple of cases they weren't able to help and should have been as it wasn't a major issue that we were seeking help with. Maybe it's training or maybe each time it was just bad luck but it hasn't worked for me.

- People on low income would be affected by the ?20 charge if it works as you suggest under the current criteria for free prescriptions - in order qualify for free prescriptions you have to get most of your income from benefits - there is some help for people on low income with prescriptions - I'm not entirely sure how this works but I think it has a low threshold.

- & the reason I raised having a chronic condition was not because I thought this wouldn't qualify me for a exemption under your suggestions but because I was trying to illustrate how difficult this might be to define.

- my main point was that I differ from you in the analysis of the problem - I don't think it's because people aren't thinking alternatives or because they want to see a GP and need to be taught a lesson by charging or some other punitive measure - but I think they do this because the services outside of this aren't that great and could be improved

[steveo]

AS a side issue, I once blundered on to an NHS cost of drugs web page and was astonished to find that some skin cream I occasionally use costs the NHS ?86 a pop. I imagine interferon is a good deal more.

If we were made aware of these costs at some point in the process there might be a lot less wastage