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think about it

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  1. Being ‘in the trade’ you’d think that I might have explained some of the issues earlier in the thread. Oh wait, I have; at length. ‘Stepping over the bodies’ or acting like rock stars as you put it is not what we do; instead we arrive at our nationally agreed opening time, unable to control the actions of those who arrive any earlier than we do. So, as I’ve said at least twice already: 1. if we were to open the doors any earlier then people would arrive earlier to be at the front of the queue. 2. Fair access is what we do, everyone has the same opportunity as anyon
  2. Mariner, it's an interesting point - however it's not borne out by the data available. For example, in 2016 the NHS accounted for 6.6% of GDP, in comparison with 7.4% in the previous year, 2014 accounted for 9.8%. So, we've seen a 3.2% fall in terms of the percentage of GDP over those few years. I'm the most ardent supporter of the NHS however even I could not reconcile spending 100% of our GDP on healthcare, especially when that would account for a 15 fold increase in current figures. So, is Boris' suggestion so far out of whack? Well, it would seem that a figure 3.
  3. Hi Sali, quick answer first - Yes, mainly because the over the counter treatment for them is expensive and seeing as children share head lice in a heartbeat in the school environment it’s a very common request. Secondly, first hour open surgery is unmanageable in the most part, say for example 20 people are waiting at the door but if we’re using at least 10 minute appointment then with two GP’s you only have capacity for 12 patients in that first hour then the remaining 8 are either turned away or you have a 40 minute delay starting your scheduled appointments at 10:00 am. The whol
  4. I may have worked for one such company in the dim and distant past. Full price goods were displayed in our store as one of the larger ones in the company. Generally towards the back of the showroom or in the aisles with the full price tickets on for a couple of months before being swapped into a proper display fitting as they went ‘on offer’. Predictably, very few were sold although some people did buy them.
  5. It’s a good question CitB, I’m in Wales so I can only assume that it’s a policy decision as both devolved nations offer patients free prescriptions. Interestingly enough we’ve recently (as in about 10 days ago) been told not to prescribe OTC medication because it represents such as massive cost to the Welsh NHS but is remarkably cheap to buy. So your 19p generic paracetamol would cost the NHS perhaps £10 by the time you factor in dispensing fees. We also offer a pharmacy led minor ailments service here in Wales which provides all of the medicines we’ve been asked not to prescribe for fre
  6. And of course, it wouldn’t be much good if I didn’t give some independent sources of my information: http://www.bbc.co.uk/news/health-42652675 http://www.pulsetoday.co.uk/clinical/prescribing/gps-asked-to-prescribe-antivirals-to-well-patients-in-care-homes-to-prevent-flu/20035955.article http://www.pulsetoday.co.uk/clinical/more-clinical-areas/infectious-diseases/phe-warning-as-high-number-of-patients-visit-gp-with-flu/20035902.article
  7. In fairness what we’re seeing, and this is backed up by the weekly public health updates which we receive, is that an increasing number of patients are presenting with genuine influenza which is especially worrying. I too, along with my colleagues and family are vaccinated against the nasty communicable diseases but lots of people are not. And, the suggestion that the medical profession are being snowflakes by warning people who are most vulnerable to the effects of this disease to exercise caution is just comical. I agree that you ‘know’ when you have flu, but unfortunately we’re seeing
  8. Would my brother’s death from flu at the age of 20 be snowflakey enough for you? Our waiting room is packed with people suffering from something horrible and I personally wouldn’t wish it on my worst enemy. Interestingly that same sort of rhetoric fuels the anti-vaccination lobby too, oh and kills children who die prematurely from preventable diseases.
  9. I’d be ecstatic if someone knocked on my office door and said “here’s the solution to your capacity issues” but we know it doesn’t work like that. Imagine that, “there you go TAI, there’s the keys to a new building that’s big enough to house everything you need to do and there’s no big maintenance costs creeping up on you, we’ve found 2 extra experienced GP’s for you too, and a telephone system that can cope with the influx of calls that doesn’t cost £30,000 then there’s a total re-jig of the GMS contract too so you can afford to recruit enough people to help out and what’s best is that we’ve
  10. As Bazza says, I too get the impression that unless the PM magically finds a new GP and increases capacity to the point where there are an excess of appointments then you’ll feel unsatisfied with their response. I base that on your reaction to my explanations of how primary care works, how different appointment systems simply slice the same cake differently and your take on the recruitment crisis. It’s not like they are going to sit around the PM’s desk next week following receipt of your letter and think: “oh no, we’ve been rumbled, all of those empty appointments that we sat doing nothi
  11. Dear PM, I’m writing to raise a concern with regards to your appointments system. I have had significant difficulty in obtaining an appointment of late, either by calling the reception which seems to be almost permanently engaged or via online booking where appointments are seldom made available. I also have a concern that it seems to be common practice to advise patients to queue outside prior to the opening time of the practice in order to secure an appointment, especially when those patients may be unwell / elderly. I would appreciate it if you could consider reviewing your appointment
  12. Indeed, how much of what is seen by GP’s is unspoken or perhaps presents as X only to be found to be Y. Prof. Stokes Lampard has a point however and self limiting illnesses are indeed just that, the thing that frequently surprises me is the speed at which some patients will make an appointment following the onset of symptoms, so often I see “Cough, started last night - asking for abx” in the records. Education is most definitely key in ensuring appropriate and safe use of clinical resources. As I’m sure is the case everywhere at the minute our entire practice team is
  13. Dear OP, I’m going to be blunt because it seems you’re stuck. It’s not ‘impossible’ to get an appointment, otherwise the clinics would be empty. The reason you can’t get through on the telephone is that other people have. Like I said, repeatedly, there are only a finite amount of available appointments; once they have been filled there are no more – there’s no mystery or mismanagement to this. As I said with regards to online booking services, they can only release AVAILABLE appointments, if there are none then it cannot release them. As I explained in my first reply, there
  14. Getting back to the OP’s complaint. To be fair, it doesn’t seem that you need help drafting a letter, just copy-paste what you’ve written here. As I say on most of these types of post neither I nor anyone else I know who works as a practice manager is all that bothered if the letter isn’t perfectly worded, provided we can get the gist of the issue we’ll be okay and it’s normal practice to confirm the issues with you in our initial holding response. It’s perhaps easier for me to break down each of your points. So: 1. People waiting outside – this is something t
  15. and of course if the receptionist dare ask why someone would like cake so that they can be offered the most appropriate type of cake they get shouted at and told “I don’t want to tell you, you’re not a baker”
  16. Thanks for your suggestions, I’m only on my phone at the moment so it’s difficult to properly explain the rationale behind why we/don’t do certain things but I’ll reply more fully when I break out my laptop later today.
  17. An appointment system that suits everyone is sadly the impossible dream in primary care. If the practice were to do as you suggest and open their doors at say 7am and operate a ticket system then people would just get there at 6am to be first in the queue. It’s also worth noting that once the doors are open we need to have a clinician on site also, adding at least 5 hours a week to their and the reception team’s working week / salary bill. A colleague of mine in a neighbouring practice has just announced that they’ll no longer accept bookings over the desk of a morning and th
  18. It’d be interesting to see what the recommended supplement was and also in seeing the numerical results how that might change the OP’s position at all? I was under the impression that if requesting a test, a clinician has a responsibility to not only check the results but also to act on them and treat appropriately. That said, I wonder if this is a case of in the process of reviewing the results following a test for another purpose altogether the GP has noticed that the OP’s iron level is a bit low and has asked the receptionist to recommend that the OP take some sort of dietary suppleme
  19. and with almost a month as the last post snowdragon had thought they’d won.
  20. Aaron, sorry for the delay in replying. I can’t really speculate on what was / wasn’t said at the time. Nevertheless, many practices have a pricelist up in reception and on their website for these things. Unfortunately the NHS doesn’t cover banking and insurance and someone has taken the time to complete work that you requested quite often we end up doing these things at a time where we’ve supposedly finished for the day or are supposed to be getting something to eat as we don’t let private work impact on our commitment to the NHS and seeing patients. So I can’t really advise you to pay or not
  21. Hi Aaron, I’m a GP practice manager - quick answer is yes they can and should charge, private work isn’t covered by the NHS and it’s not for the practice to decide whether or not you still need/want that which you’ve requested without your say so. In effect it’s a bit like ordering food in a restaurant, having someone cook it and deciding you no longer want it as the server brings it to the table. There’s some guidance here on why we charge for some things: https://www.bma.org.uk/advice/employment/fees/why-gps-charge-fees In terms of how far they’ll take things? Well, it won’t impac
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