Personally, no. I don't know of anyone they've taken to court. I do however know of colleagues in other practices that have faced enforcement action, I don't doubt that had they not complied then the NHSBSA wouldn't have just forgotten about it... I'd advise taking some proper advice from perhaps citizens advice and to see if you can reach an agreement with them.

All of those cases are absolutely shocking! The 'register at multiple practices' trick to get certain medications is, although not related to the OP's case, a massive problem for us in general practice. The most common issue is with Co-Codamol (Zapain) in the 30/500 strength. It's astonishing the lengths that people will go to in order to obtain a supply of it. We have several 'zapain ladies' who will visit neighbouring surgeries explaining that their supply has been lost, left in a friend's house etc etc... Thankfully we very quickly get to know them and encourage our colleagues to call us to check the visitor's prescription status, our local chemists are now in on the act too and will call us to check they're not dispensing too much. Sorry, digression from the OP's question there... OP, try to appeal it if you still have time to do so. The NHSBSA are notoriously 'keen' on recovering sums due, even us practice staff are scared of them...

I'd also be tempted to ask to speak to the practice manager in the GP practice (what I do for a living), for a letter detailing when your appointments are and how the pressures placed on primary care mean that these are non-negotiable from a resourcing/timing background and from a health one too. Bear in mind that an employer ought to give time off for medical appointments so there's a reasonable expectation that a WP provider should also. It wouldn't be the first time I'd written a very shortly worded letter on behalf of a patient explaining a few home truths. There's nothing stopping you going in to Ingeus before/after your appointment with the GP/Nurse. We see people for B12 injections here in a five minute consultation - but if that appointment lands smack in the middle of your ingeus appointment well, it's reasonable to expect Ingeus to flex around that.

You can ask your GP anything, they may or may not agree with you but unless they're specifically aware of the situation with Ingeus and your general health's affect on your ability to meet your obligations then they wouldn't automatically offer a med3.

When you changed trusts, would I be right in thinking that you were given a new contract, new Ts&Cs, pay scale agreed at that point? Or, did you carry over any continuity of service from your previous trust? You also say that you've recently started a new role so if I read it right you were started on band 2 as any other new starter would have been? My thoughts would be that if you have continuity of service you could at least ask the question, if however you've really only just started and are on a new contract with a new trust and were taken on as a new starter that your opportunity to negotiate would have really been at the start of the contract. That said, there's no harm in asking and seeing what the response is.

Well seeing as the ICO loosely define protected characteristics as those which were likely to land you in a concentration camp it was never far away. Enjoy your drink...

I suppose it does... "So Anne Frank, did you mind being hunted down and persecuted by the Nazi party?" "No, they were just having a laugh." "How about you, Rosa Parks, was it okay that you were told where to sit based on your race?" "Yeah, they were just confused..." "and you, Emmeline Pankhurst, not voting? Acceptable to you?" "oh, totally - I was just a bit bored to be honest, thought I'd shake things up a bit, nothing to do with equality or a sense of what's right." "Alan Turing, you insisted that there was nothing wrong with your sexuality yet you were forcibly administered with oestrogen injections for a year. A bit of fun?" "Yeah, it was still seen as deviancy - so it was okay by me even though my contribution to the war effort was so dramatic." and to think we seek to normalise this as a bit of harmless fun. What do we do today that in future we'll be looked back upon with disdain? I'm sorry that you don't seem to share my level of concern, I've spent almost every working day since 2004 working to support equality with charities like CAB, Age UK and those that support people with learning disabilities. I'm not sorry that I find intolerance and ridicule unacceptable, especially on a forum that sets out to help people.

Fun? Would this thread be any less acceptable if it was about names used to refer to people of different ethnicities? How about sexuality? Or age, "what do you mean people want to be treated with respect, how dare they! An n-word is an n-word, and now they want to be called 'black'? It's too much for me to understand..." All, of course - including gender, protected under the Equality Act (2010). Would this be fun for someone who struggles with their own gender identity to read: To answer your question - yes; I’m forming an opinion on what I’m reading. I've no issue with interpretation.

I'm genuinely surprised to read some of what's written above... Something wrong with society? Yeah - look in a mirror. What does it matter to you, or anyone else for that matter, how somebody else choses to identify themselves? There clearly aren't just two types of 'tackle', pick up a urology / endocrinology textbook and you'll see that for yourselves. It's like being back in the 80's with attitudes towards homosexuality, race or mental health... Just wow...

Hi GS, just looking at this and your other post - do you have continuity of service or have you just been re-employed?

My first thing would be to check if the dentist discussed the chances of the treatment being a success, no treatment has a 100% success rate and part of the informed consent that needs to be sought before carrying out the procedure is an understanding of the chances of failure and what might go wrong/not work. For example, I recently had some surgery and on the form it says that there is a chance of: Paralysis, Death, making the problem worse, nerve damage, bleeding etc etc... An unsuccessful treatment(s) doesn't necessarily mean that the clinician has been negligent. Have a read of this: http://www.britishendodonticsociety.org.uk/patients/further-information.html However, as with anything it's a case of asking what does your wife want from all of this? You ask what are your options but in what respect? I'd say it's always worth writing a complaint to the dentist in question, asking for more details and for the problems to be put right (if possible). Good luck getting it sorted!

I've always staked my claim, even as a Earth Science graduate, as a bit of a sceptic. However, show me enough peer reviewed evidence that isn't funded by a pressure lobby on either side of the oil/green debate and I'll believe anything you tell me. But, that's not the point I've posted now to make. We talk about dredging/not dredging and the impact it has downstream, perhaps more interesting is our dead-set predilection for building on flood plains. Simple facts: trickles, brooks, streams, rivers... They all flood when faced with carrying more water than they normally do and there is precious little, besides a Los Angeles style set of flood drains that flow uninterrupted out to sea, that we can do to prevent that impact if we insist on building on the flood plains that the rivers themselves deposited. Somewhere in the grand scheme of all of this we need to make a decision, we either sculpt the land to meet our needs or we accept that sometimes nature will beat our half-hearted efforts. There's a stretch of major road about 10 miles from here which occasionally floods, effectively cutting off the region for a day or two. Now, the highways agency have chucked a million or so at it and they've put some grids and extra drainage in. Of course, over Christmas it flooded again. Interestingly, despite being the lowest point of this stretch of road, less than 100 meters away is a bridge over a river. A simple slipway could ensure that it NEVER floods again under anything less than absolutely catastrophic flooding of the sort that will see coastal areas under 30 meters of water. But, it will channel that excess water into that river very quickly and so there needs to be changes made downstream to cope with the excess flow occasionally One thing is undeniable, slipways - open drains - flood walls, none of it is pretty. So, make a decision - aesthetically pleasing with slight risk or less scenic but far less likely to flood. I'm sure the residents of those picturesque cities, towns and villages ould be devastated equally by an enormous civil engineering project as they would by occasional flooding. Rivers are pretty to look at, walk by, sit near and spend some time even, but for the love of god - don't buy a house next to one...

I suppose the big question is about what you're hoping to achieve by complaining? Given that nothing did get lost I can't see what that might be, sorry.

I'd be increasingly inclined to play her at her own game. "Hello Mrs. Adviser, you know what, I've been reflecting a bit on our conversations and I think you're right. I could do with a more recent reference and I guess there's no such thing as enough experience (pause for effect) so I've been a signed up with (insert a volunteering organisation here that interests you personally - citizens advice is a good one). They're going to train me, will give me real, valuable experience and will write a reference for potential employers. You have to agree that this is so much better than doing another 'placement' in an organisation that's of no real interest to me or even suitable for my job goals. Better still is that it saves you the admin of having to refer me, speaking of admin... I've reviewed my JSAG/CC and as you've requested I've detailed my 35 hours job-seeking activity. Well, actually, I've detailed all of my activity but it's all there, X number of jobs applied for, Y phonecalls made and Z CV's handed out. See you in a fortnight!" When I was an adviser with Ingeus I'd have roared with delight if someone had done that to me, I'd have been well and truly played and there'd be nothing much to say other than 'well done, see you in 2 weeks'. The alternative of course is to sit and pick fights, which people did and we'd end up knocking heads on something totally unhelpful for us both. It's like you, chester, are having to deal with a child. If you make them think they're winning they'll never notice that they've already lost. But, if you don't choose your fights you'll battle on every point.

I stand, quite happily, corrected then. The explanation I posted came from a Discovery style documentary on gang culture a good while ago.

Consumer Dude, open the link. This is about 2/3 of the way down the page. The distinction is whether or not your organisation is a registered charity I should think... When you don’t need permission You don’t need permission if the printed material is being distributed: in letterboxes inside a building, bus or taxi on behalf of a charity for political or religious purposes or other beliefs

I'm a bit of a sceptic, I accept that there is an impact but I'm unconvinced as to the magnitude. I need to stake my claim in this as an earth sciences graduate so I'm cynical but willing to be convinced otherwise. Over time the earth's climate has changed dramatically back and forth between hot and cold, tropical and polar so are these changes that we're sensing outside expected variation? Are they, in the terms of paleoclimate, statistically significant? I've promised myself some time to do some more reading on it whilst I'm recovering from my surgery, but there's some interesting data here: http://ossfoundation.us/projects/environment/global-warming/natural-cycle Although I accept and understand that it's difficult to find peer reviewed info for free online... -------------------------------------- On a far less significant front, perhaps it's time for another 'scrappage scheme' this time for the most polluting vehicles with additional assistance for people trading in gas guzzlers for more eco-friendly vehicles. My car is a 2.5 litre monster that struggles to average 28mpg on extended runs, but I'm not in a financial position to change it just because of the fuel consumption...

This is an American import, it originated in ghetto / poor areas where the use of 'hand-me-down' clothing is prolific. The thinking behind it is, I understand, to demonstrate that your older brother is much larger in stature than the wearer and therefore they're not to be messed with. An unspoken promise of a good hiding from the wearer's bigger, stronger, tougher brother.

I'd like to ban: Offend(ed) The hiding place of anyone who feels too high-brow to appreciate someone else's humour / language / speech etc. The usual extraction is "I'm offended by... and I want it banned!" Oh, wait...

Obvious question in this, have you approached the GP in relation to the same - we often recieve copies of consultant letters and outcomes of investigations.

I'm similar, I've only ever really needed ABx once or twice for pretty unpleasant sinus infections that have left me with rigors and raging temperatures. I won't take them for many other things, they're often hugely unpleasant in terms of their side effects and I'd sooner save them for if I ever 'really' need them. The phrase I hear a lot about the Dr. No's that I've worked with and known is that people come out saying "I'm not seeing them again, I didn't get anything..." and I tend to bite my tongue when perhaps I shouldn't. The patient may well have come out of the consulting room empty handed but they have benefitted from that GP's experience, training and knowledge and by choosing to not issue ABx the GP is helping that person. Unfortunately, me included here, we all like a quick resolution when we're unwell and for many people it's easy to believe that the answer is in a box of ABx rather than letting nature take its course.

An interesting story for general practice this morning. The post on the BBC website today links patient satisfaction with GP antibiotic prescribing levels. http://www.bbc.co.uk/news/health-35008128 As a practice manager I've seen this myself, people wanting to complain that their request for antibiotics (ABx) has been refused, normally accompanied by "well, Dr. X always gave them to me..." We have a nickname for GP's who prescribe appropriately, Dr. No! Because it seems they spend much of their day saying just that. You find that most younger GP's are quickly labelled as a Dr. No and they quiclky develop a whole tranche of patients who don't want to see them and would sooner see the older, 'easier' GP. Is it down to GP's who are less strong willed in the past changing public perception and expectations? I think it might be, it's far 'easier' to give someone what they want, but is it clinically appropriate? No, of course not. It was only in August this year that GP's were threatened by NICE with being disciplined for prescribing too many ABx(http://www.bbc.co.uk/news/health-33961241) So, what's your take on it? Are you left feeling short changed when you leave the surgery empty handed? Are you happy that your GP is one of the stronger, more clinically adept ones who prescribe appropriately or would you prefer one that NICE want disciplined/struck off?

Hi Paul, just to confirm what the others have said from an NHS complaints perspective is that, yes, you do need your father's express consent to be able to act on his behalf in relation to the complaint. It's a single page consent form that you'd both sign. Now, the other option is to ask that the problems are recorded on their incident reporting system. If it's in Wales (I'm sure I read in one of your posts that you were) then the system is called Datix. It logs all events and incidents and in fairness, I'd have hoped that the person you'd raised the issues with will have done this already. If not, challenge them to do so, these internal forms generate the same level of scrutiny as a complaint. As Conniff says, there's a big part here in supporting your father's wishes and perhaps giving him the confidence to question those around him, right or wrong the people involved in his discharge will assume everything is fine if the patient has capacity to make decisions and speak for themselves. Asking a question like "Now, you'll be alright won't you?" often generates a "yes, fine" response when the opposite is true, nevertheless it's not the nurse's place to doubt this. Perhaps give your father some time to recover first and bring it into discussion in a couple of weeks, he might be more ready to get involved then.

But, no one is pushing. They're following the very clear instructions on the road, they've been put there for a reason and consideration is that for all involved. If people followed these simple instructions then they'd have no need to get frustrated. Those signs have been placed to STOP people merging as early as possible to keep them out of the hazardous areas of the road. Interestingly it matters not where you merge, there's still a fixed level of possible throughput on a road, the only thing that changes is the physical length of the queue, spread it across two lanes and it's half as long. Mindful of the hazards further up the road the planners have specified that the queues ought to occupy both lanes and the drivers merge in turn; theoretically if people did so, no one would wait any longer than anyone else. So instead of being a force for good, the guy in the HGV is actually failing to, as you put it "Be polite and wait concentrate on the driving and not get frustrated" although perhaps that wasn't aimed at the HGV driver. If he got his head up and out of his dashboard he could see the impact of his actions and perhaps by looking in the mirrors as is part of 'concentrating on the driving' helped lessen the chance of an accident as the hundreds of cars behind him are needlessly held in a tunnel with no other route of escape besides either end. But, as you rightly say "It is called considerate driving"

That's quite different really, no one is using emergency lanes or threatening violence. The instructions are quite clear. https://en.wikipedia.org/wiki/Late_merge