Should people be fined for wasting GPs / Hospital's time?

[virtual22]

I'd be happy for there to be £20 fines for missed appointments. It really doesn't take much effort to phone up and cancel. Might also make people think about whether they really need to see the Doctor. Maybe introduce a three strikes rule, you get away with two missed and after that all others are charges?

Would also like to see some form of cost being put in place for people turning up in A&E having had way too much alcohol.

My GP's is great for booking online if it's non urgent, can book an appointment a couple of weeks away, ok if you need to see someone urgently but then with all the housing being planned in the area with no new planned doctors at all I can see this falling apart in the not too distant future.

Can't fault the staff though, both at the local GP's and the Physio's at the Princess Royal are just amazing!!!! Christ knows how much my treatment for ruptured ACL and cartilage damage would have cost in the US by now, even with Insurance. Plus you read up online about after care and they're scared to go back because it costs so much then get all sorts of other problems. I bitch and moan about the waiting times soon but when you do get seen, my experience is that the service it outstanding.

 

[KZNSeagull]

It's disgraceful. The problem I had was being told that you couldn't under any circumstances book an appointment in advance, then calling up at 8am to be told that there were no appointments available! The receptionists also insist that you tell them what is wrong with you ... like it's their ****ing business. Very very glad I moved - can book an appointment very easily now and the staff aren't complete c***s - i just hope it doesn't go the same way.

Is that not an attempt to filter out those people who are potentially going to waste the doctor's time?

 

[brightn'ove]

Is that not an attempt to filter out those people who are potentially going to waste the doctor's time?

I guess so, but i'm not really prepared to tell somebody completely unqualified what is wrong with me so that they can decide whether I should have an appointment or not.

 

[Ned]

Inapproriate attendances (eg for colds, cuts and bruises etcetc) at A&E and GP surgeries and not attending GP or outpatient appointments are one of the biggest causes of NHS inefficiency and additional cost. It is difficult to maintain the principle of "free at the point of delivery" if fes or fines are introduced but this may well be the only way of overcoming these problems which the NHS has failed to resolve for years.

There are facilities for minor injuries (Lewes Hospital have clinics) and the practise nurse will see minor complaints.

 

[Lord Bracknell]

I recently missed an appointment for a CT scan, because the letter telling me about the appointment didn't arrive until two hours after the time of the appointment. Imagine the bureaucratic nightmare that would arise if a system of fines was introduced and appeals were allowed.

 

[yxee]

The problem with this (and I dont disagree with your sentiment) is twofold: some people don't have a spare £3 and if they were blocked from their GP they'd just pitch up at A&E or call an ambulance.

I would say that they should then be charged a £100 fee for wasting the ambulance time. Until they pay the £100 they cannot call another ambulance.

 

[symyjym]

The problem with this (and I dont disagree with your sentiment) is twofold: some people don't have a spare £3 and if they were blocked from their GP they'd just pitch up at A&E or call an ambulance.

If someone can't be bothered to phone up and cancel, I doubt they will be motivated to find 4 hours waiting time in A&E a better alternative . If anyone thinks that they are being clever phoning for an ambulance for a non emergency, and they are on record for not paying the £3, charge them another £3. Until the the money is paid they will not have access to the GP or ambulance service.

If someone is really worried about their health £3 is a bargain. I would pay that amount just to see a GP, and I am sure it's not beyond affordability even for the worst off.

 

[symyjym]

I recently missed an appointment for a CT scan, because the letter telling me about the appointment didn't arrive until two hours after the time of the appointment. Imagine the bureaucratic nightmare that would arise if a system of fines was introduced and appeals were allowed.

Easily solved, it should be sent electronically via email and or text with a system for you to confirm or request a new date if you are not available.

Sending these appointments by post just lends to the excuse of not recieving it in time, even if it is not true.

 

[Albion_Dave]

With appointment DNA's running at nearly 10% it is a huge problem for surgeries.

It's not the patients that miss the odd appointment it's the seriel offenders that do most damage by not turning up time after time.

The problem is that these patients also tend to be the most vulnerable ie elderly or adults with mental issues.

 

[Notters]

There was a general consensus that the NHS was underfunded,

Well I'm pretty sure it isn't. It's just terribly organised. At least that's the impression I get from every member of my immediate family who have all worked for the NHS (I never have, fortunately!)

 

[Meade's Ball]

Good god no for the fining system. As I mentioned yesterday, I had a completely time-wasting appointment last week, so really it's a two-way street of potential disappointment. They hope that I will turn up with something worthy of their time, whilst I hope they will be skilled and knowledgeable enough to ease the pain or discomfort or refer me to the correct people to do so. There's no guarantee either way.

 

[Tom Hark Preston Park]

One area that could free up GP's time and associated paperwork is the nanny state attitude towards some prescription drugs. Ran out of asthma inhaler on a fairly recent trip to Oz so went into a chemist and showed my UK prescription renewal slip by way of proof that I used an inhaler. 'Sorry mate, that forms not valid here' said the chemist. Fair enough, says I, what IS valid here? 'Ten dollar bill mate'. And so it proved. Cheaper than a UK prescription also, so I stocked up on inhalers for the trip home. Wonder how many other drugs could be taken off prescription over here and what the savings to the NHS would be?

 

[Guinness Boy]

One area that could free up GP's time and associated paperwork is the nanny state attitude towards some prescription drugs. Ran out of asthma inhaler on a fairly recent trip to Oz so went into a chemist and showed my UK prescription renewal slip by way of proof that I used an inhaler. 'Sorry mate, that forms not valid here' said the chemist. Fair enough, says I, what IS valid here? 'Ten dollar bill mate'. And so it proved. Cheaper than a UK prescription also, so I stocked up on inhalers for the trip home. Wonder how many other drugs could be taken off prescription over here and what the savings to the NHS would be?

Australia is brilliant for health care IMO. Had to visit the docs twice while over there (and was only there a year), once getting a prescription despite being a Pom, while another time being given the same advice as you. When in India I was with a colleague who had travelled there from Oz. I just had a couple of injections, he had a box full of useful drugs and a flow chart. It was thanks to this that we were both able to diagnose and cure the bacterial dysentery we got separately.

Totally agree with you on the prescriptions thing here too. My Facebook was awash the other week with mums from my son's school sharing a post from some bint to all her "mammy friends" who had "discovered" that Calpol was free on the NHS. It always had been but thanks to this really helpful FB post resources are now allocated to a cheap child's cough medicine instead of, say, cancer drugs.

 

[Bozza]

One area that could free up GP's time and associated paperwork is the nanny state attitude towards some prescription drugs. Ran out of asthma inhaler on a fairly recent trip to Oz so went into a chemist and showed my UK prescription renewal slip by way of proof that I used an inhaler. 'Sorry mate, that forms not valid here' said the chemist. Fair enough, says I, what IS valid here? 'Ten dollar bill mate'. And so it proved. Cheaper than a UK prescription also, so I stocked up on inhalers for the trip home. Wonder how many other drugs could be taken off prescription over here and what the savings to the NHS would be?

I've picked mine up from Asda before as it was more convenient than my Doctor. No prescription needed: http://www.pharmaceutical-journal.c...mol-inhalers-via-private-pgd/11104436.article

 

[Guinness Boy]

Well I'm pretty sure it isn't. It's just terribly organised. At least that's the impression I get from every member of my immediate family who have all worked for the NHS (I never have, fortunately!)

I don't doubt there is wastage and red tape. TBH no large organisation, private or public, is going to be very efficient. But is it the correct size for our growing population? Do we have adequate hospitals with good doctors in the correct places? I would say absolutely not (ask people in Eastbourne and Hastings who have two good hospitals which keep trasferring or losing departments between them). New hospitals and good quality doctors and nurses cost.

 

[Tom Hark Preston Park]

I've picked mine up from Asda before as it was more convenient than my Doctor. No prescription needed: http://www.pharmaceutical-journal.c...mol-inhalers-via-private-pgd/11104436.article

Good to know. Thanks

 

[skipper734]

The GP system is broken. It started to break about 10 years ago when a government official in a suit decided on the amount of new Gp's that would be required to be trained for positions as GP's in 10 years time. They underestimated by a margin.
The time has come for a radical rethink of the GP system. GP's once upon a time were Family Doctors. There is no such thing any more as a Family Doctor, you are just grateful to get an appointment with any GP. GP's are basically a gateway into the system, they can give you pills to treat you or they can direct you hire up the ladder to a Doctor that is a specialist in whatever ails you. So dismantle the whole system, open walk in centers attached to Hospitals and in strategic areas in the particular Hospital Trusts catchment area. They are then in close contact to any referral you may need. If you need a pill, there you are off you go. Leg hanging off, up the corridor to A&E, a problem that needs diagnosis, referral to a suitable Specialist, as now.
If your old Mum needs a Home visit, these are taken care of by the pool of GP's attached to the walk in Centre. Under this system there is 24/7 care for the community.
GP's are not going to like this as it takes their autonomy away, but as I understand it, very few Medical Students want to become GP's at the moment anyway for various reasons. They would probably have to be paid as a level of Consultant, but the important thing is that it would be a Salary, and not how much for us and how much for everything else, as is at the moment.
I've tried this plan out on a friend who had been the Chairman of a couple of Hospital Trusts who had been thinking along similar lines. I have also closely observed Doctors training, from Medical Student to Senior Consultant. I have also been a sumtime Customer of the system.
Hasn't a hope of succeeding, but I guess that's what Aneurin Bevan felt back in the day.

 

[beorhthelm]

The GP system is broken.

agree with that and much the rest, though don't think the problem started 10 years ago. its ridiculous that you are tied to a single GP at a practice, and cant go elsewhere to enter the NHS system to seek treatment. except there is, A&E, which i believe is why that has increasing pressure as people seek out or hours/immediate attention that isn't necessarily emergency. Its was binned (for good reason) but they really need to revisit the national database so that medical records can be shared between healthcare outlets, so any where in the NHS, and dare i say private healthcare, can provide that initial assessment and referral service.

 

[Tricky Dicky]

J

said charge for appointment - agree with Badger this should be for no shows or obvious cases of time wasting (e.g. broken nail)

http://www.bbc.co.uk/news/uk-england-kent-13528444

No-shows without a good reason possibly, nothing else though. Thing is, GPs do so much more than medical stuff, they do some social work as part of the job, so if somebody turns up with a broken nail to use your example, there could be a much more serious reason under the surface, that they need to get to. Who's to judge what's a waste of time anyway.

In short, I kinda agree with the principle, but it won't work in practise. Just like charging people for being drunk in A&E - great in theory, impossible to implement.

If they don't want people showing up to A&E as a first resort they need to make GP surgeries accessible when people want them, then they become more like local A&E satellite centres. Successive governments have been all about centralising.

 

[happypig]

The GP system is broken. It started to break about 10 years ago when a government official in a suit decided on the amount of new Gp's that would be required to be trained for positions as GP's in 10 years time. They underestimated by a margin.
The time has come for a radical rethink of the GP system. GP's once upon a time were Family Doctors. There is no such thing any more as a Family Doctor, you are just grateful to get an appointment with any GP. GP's are basically a gateway into the system, they can give you pills to treat you or they can direct you hire up the ladder to a Doctor that is a specialist in whatever ails you. So dismantle the whole system, open walk in centers attached to Hospitals and in strategic areas in the particular Hospital Trusts catchment area. They are then in close contact to any referral you may need. If you need a pill, there you are off you go. Leg hanging off, up the corridor to A&E, a problem that needs diagnosis, referral to a suitable Specialist, as now.
If your old Mum needs a Home visit, these are taken care of by the pool of GP's attached to the walk in Centre. Under this system there is 24/7 care for the community.
GP's are not going to like this as it takes their autonomy away, but as I understand it, very few Medical Students want to become GP's at the moment anyway for various reasons. They would probably have to be paid as a level of Consultant, but the important thing is that it would be a Salary, and not how much for us and how much for everything else, as is at the moment.
I've tried this plan out on a friend who had been the Chairman of a couple of Hospital Trusts who had been thinking along similar lines. I have also closely observed Doctors training, from Medical Student to Senior Consultant. I have also been a sumtime Customer of the system.
Hasn't a hope of succeeding, but I guess that's what Aneurin Bevan felt back in the day.

Interesting and it has some merit but politicians would see any root & branch change like this to be a way of saving money rather than improving treatment. Any re-organisation needs to be cross-party and clinician led; any accountant coming within a mile of it should be summarily shot.