GP's

[craigwalsh]

Good grief --- it's not a pretty picture from the other side of the fence. My heart really bleeds for you.

One of the websites you pointed me to (a BBC website) has this snippet:

In Essex, a 38-year-old woman was banned from abusing the emergency services, after she called 999 38 times in nine months. A court heard she pretended to be unconscious and swore at ambulance crews who went to treat her, forcing them to take a police escort. A similar case in Hove, Sussex saw a woman banned from dialing 999 after she made hundreds of hoax calls and also rang the NHS Direct advice line more than 240 times.

Now I'm not a bleeding heart liberal --- more a George Bush-esque Republican Conservative. But in these brief stories it sounds like the people need help --- as in treatment or counseling. Instead, in caring Britain, they're slapped with an ASBO. That'll teach 'em.

Of course, just reading these few sentences I have no way of knowing if the two cases, both in Sussex (hmmm . . . . ), are just nasty people out to be nasty. I believe that there are, in fact, people out there who are just plain bad. Or whether these people have more serious mental illnesses, for which the solution is treatment, not an ASBO.

If these folks do have a mental problem, will an ASBO really stop them from doing something that is compulsive?

You're right about the nice BUPA lady. She is dealing with a more rarefied group of callers: a smaller number, quite possibly better educated, older, and I would guess more "polite." She's more Waitrose, whereas you're stuck in Asda.

Why don't you find the nearest BUPA call center and drop off your C.V.? Maybe you can become happy again.

Life is far too short to have the bosses at the NHS make you miserable.

[sicksadminion]

I think I'm too much of a socialist (but only with a small 's' ) to work at our local BUPA hospital!) I felt really upset last year when I had to use a private hospital, I've been brainwashed

With regards to the ASBO thing- a *lot* of consultation happens first. There are meetings between all parties involved, interim measures are taken, and it is an extreme last resort. These callers need serious help, but to use your supermarket analogy - mental health services in the UK are currently like Netto or Lidl. Makes me horribly sad sometimes. Even a hardened cynic (!) can't help but be affected. I have a long car ride home at night, I've often spent it in tears.

This is partly why situations like yours happen (awful btw). The services that should be looking after regular patients have to mop up the overspill from a failing mental health system. It's particularly bad OOH. You just can't contact anyone. Services are stretched, tempers fray, and everyone loses.

Here's to the New Year, hopefully a change in administration, and improved access for all! (Ever the optimist!)

[Elen]

Originally Posted by sicksadminion

Oh and what you also should remember is, PATIENTS LIE.

Please don't patronise me. I've been working in the NHS a long time and am well aware of this fact. I'm only sorry you take criticism of your service so badly. We should all try to improve the service we provide.

I had no idea working for NHS Direct was so dangerous. Try locking up in the evening by yourself in an area where your patients live and working where they 100% know where you work. I really fail to see how working for NHS Direct is any more dangerous than any other part of the health service, but if it's a threat to your safety/life, I'd be inclined to take it up with your manager.

The GP receptionist cases you cite don't surprise me - a lot of them act like mini doctors, thinking they know best. But a lot of them aren't like that. The majority of our patients were very happy with our service (80% rating reception very good or excellent in the patient questionnaire). There are always ways of trying to improve the advice we offer. Sometimes the tough call comes right at the end of a hectic week and it's difficult to think very clearly. But whenever I was in doubt over anything I would always put the patient in for an emergency appointment. If it was someone who was complaining of something more serious I would always suggest calling 999 if their condition were to deteriorate before the doctor could visit. Having said all that, patients lie to other healthcare workers about the way they've been treated by their surgery. They make so much crap up, it's unbelievable.

Originally Posted by sicksadminion

But the point is, if sick people could access their GP when they needed them, they wouldn't have to lie, scheme and abuse the system.

Yeah, right. Some patients can't be bothered to even ring or turn up at their GP to see if there's an appointment, just go straight to A&E and lie about not being able to get an appointment. It's truly unbelievable. We always had on the day appointments available and yet every week without fail we would receive a phone call from MIU from a nurse shouting at us for not offering a patient a reasonable appointment. Time and again I had to politely inform them that the patient hadn't even attempted to ring and if they had would have been offered one of eight routine appointments that day.


I love working in the NHS. You have to be able to deal with all the problems the patients throw at you during the day and be able to leave it behind when you leave the surgery/hospital. You have to be able to laugh about some truly awful stuff in order to keep your sanity. The NHS has made me a little cynical, but I still believe in the service and its continual improvement.

[Elen]

Originally Posted by sicksadminion

There's no way I'd say to a patient "Don't bother with your doctor, he's rubbish" or "Hospitals don't know what they're doing", so why do you, and people like you think you have the right to do that to us?

I have never told a patient to not phone NHS Direct because I believe it's crap (which I don't, even in the slightest, I've just had a few problems with the effects it has caused on some of the patients). In fact I've never had to tell a patient to ring you at all because our surgery actually provides a good enough service. I would never make allegations about the competency of another NHS organisation because that is extremely unprofessional. How dare you suggest that I would.

[gp2]

Post Shipman and Dame Janet's inquiry I would imagine that prescribing strong opioids for chronic non-malignant pain has reduced.
the withdrawal symptoms that you experienced were physiological, and did not mean that you were becoming a junkie.

[craigwalsh]

I would imagine that prescribing strong opioids for chronic non-malignant pain has reduced.

I keep meaning to go to Boots to return (for destruction) alll of the strong opioids that were prescribed for my chronic, non-malignant pain.

Here's Exhibit A, the little scrap of paper given to me by Dr. J. J. Lee at BUPA South Bank in Worcester:

Dr. Lee didn't want to write the prescriptions --- he wanted me to go back to my GP. His explanation (excuse?) was that a private prescription would cost more than an NHS prescription. When you're experiencing the level of pain I've experienced, saving a few pounds is the least of my worries.

My GP prescribed the Durogesic DTrans patches (fentanyl) -- 50 mcg/hr. This caused all sorts of problems, so I was then put on BuTrans 10 mcg/hr (buprenorphine) patches plus eight 50mg Tramadol a day --- plus eight Paracetamol (prescribed) for good measure.

If this is a reduction in the prescribing of strong opioids for chronic non-malignant pain, what were they doing before?

[gp2]

the GP is on a loser here. where there are difficulties with pain control and a private doctor suggesting unspecified doses of opiates, if things go badly the GP takes the heat. if things go well the private doctor takes the credit.
I should have said that the proportion of GPs prescribing strong opiates will have reduced, not the amounts which are titrated according to response.

[craigwalsh]

The GP is on a loser here.

Yes, you're right. But only because the GP didn't take the time to talk to me. He just wrote the prescription, didn't even discuss side effects or the possibility of addiction, and sent me on my way. Within a week I was in A&E.

It's curious. I requested, and received, all of my notes (under the Data Protection Act) from my GP's surgery. The notes of this fateful September 15 consultation are missing. There's a stamp on the notes for the date and the word "Comp," which I'm guessing might mean "computer." But as I filed a Data Protection Act disclosure requst, did the practice manager not think that included computer records?

All the GP has to do is talk to his or her patient. Sadly, doesn't happen. And that's why the GP is on a loser.

[Elen]

But as I filed a Data Protection Act disclosure requst, did the practice manager not think that included computer records?

If you asked for copies of your notes under the DPA, this should now include both paper and electronic records, especially as many doctors now only write the date and one word in the paper records.

sicksadminion - I recently found out NHS Direct employees are paid at a rate of £8/hour and up to £12/hour at weekends. This is significantly better than a lot of NHS jobs, including mine... not that I'm bitter and twisted of course.

[gp2]

Did the private GP discuss the side-effects of the medications he was recommending?
Since OOH services now record telephone conversations it has become obvious that some patients are obviously untruthful when they later complain.