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The Mail actually has a pretty good article on the GP appointment fees vote: http://www.dailymail.co.uk/news/article-2621886/GPs-vote-charging-patients-10-25-appointment.htmlquote:The idea is to deter patients from missing consultations – a problem that costs £160million a year. The fees – possibly between £10 and £25 – would be the first since the NHS was founded in 1948. There's also the obligatory NHS-bashing quote from a Taxpayers' Alliance spokesthing in the full article.
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May 7, 2014 12:50
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quote:The idea is to deter patients from missing consultations – a problem that costs £160million a year.
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May 7, 2014 12:54
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Is there any problem with a mandatory £50 (or whatever) fine for missing appointments without extenuating circumstances?
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May 7, 2014 12:59
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LemonDrizzle posted:The Mail actually has a pretty good article on the GP appointment fees vote: http://www.dailymail.co.uk/news/article-2621886/GPs-vote-charging-patients-10-25-appointment.html The thing about missed appointments is spot on. My mother had to wait almost two weeks for a non-emergency appointment, but she told me that when she went along this morning the receptionist said she was the only person to have shown up. The most likely cause for this is that people are having to wait so long for an appointment that they get better, so they don't go. This then has a knock on effect because them not cancelling their appointment means everyone else has to wait longer too. I don't favour charging people for appointments, but if someone came out with a plan to charge people for appointments they missed and failed to cancel I'd support that. (Of course it'd go to Atos or Serco and people would be fined for not showing up due to dying, but we can hope.)
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May 7, 2014 13:00
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tentish klown posted:Is there any problem with a mandatory £50 (or whatever) fine for missing appointments without extenuating circumstances? Recovering the fines? Deciding on whats an extenuating circumstance?
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May 7, 2014 13:02
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tentish klown posted:Is there any problem with a mandatory £50 (or whatever) fine for missing appointments without extenuating circumstances?
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May 7, 2014 13:08
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£160m is loving piss in the ocean to any UHC system, what an awful excuse for an awful idea. If it wasn't being garroted it wouldn't notice.
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May 7, 2014 13:10
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GP's were one of the groups that objected to the NHS orginally if I remember correctly, not surprisng some of them want to start tearing it down.
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May 7, 2014 13:14
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tentish klown posted:Is there any problem with a mandatory £50 (or whatever) fine for missing appointments without extenuating circumstances? a) a fixed fine disproportionately affects the poor b) a potential fine would discourage people from making appointments in the first place, which means underlying problems may go unchecked (though I admit this would probably be a small effect) c) recovering the fines and managing an appeal process would cost money, which the fines alone would be unlikely to pay for If there's a big problem with missed appointments, then the best solution is a guilt-tripping program (my dentist uses this). It goes like this: the day before, ring up the patient and ask them if they are still intending to make the appointment, and ask them to let the care centre know if they're unable to make it. If they miss an appointment, ring them up and ask them why they missed it and why they didn't inform the care centre, whether they'd like a new appointment (chances are it's a yes) followed up with a polite request to not miss it this time or at least inform them if they can't. Guilt: tripped. Not only is it effective but it's incredibly cheap to run: all it takes is a string of phone-calls that a secretary could do, there's no guilt recovery process, no financial admin, and no appeal process to manage and adjudicate.
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May 7, 2014 13:30
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One upside might be that somehow doctors receptionists stop being utterly unhelpful arseholes. But I doubt it.
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May 7, 2014 13:31
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The conference proposal won't pass. It being brought up at all is just a sad acceptance that raising the health budget just isn't going to happen. loving Zanu-LIEbour Party.
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May 7, 2014 13:42
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Maybe I'm missing something, but won't this just mean people go to A&E instead?
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May 7, 2014 13:44
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KKKlean Energy posted:If there's a big problem with missed appointments, then the best solution is a guilt-tripping program (my dentist uses this). It goes like this: the day before, ring up the patient and ask them if they are still intending to make the appointment, and ask them to let the care centre know if they're unable to make it. If they miss an appointment, ring them up and ask them why they missed it and why they didn't inform the care centre, whether they'd like a new appointment (chances are it's a yes) followed up with a polite request to not miss it this time or at least inform them if they can't. Guilt: tripped. This may work great for smaller departments or practices, but (for example) repeatedly calling the volume of people we book every day in the physio department I work at would be completely unrealistic. We get plenty of DNAs without contact, and it's almost certainly because their niggly lower back pain or whatever goes away a few weeks after they see the doctor, but we then just discharge them straight off. A lot of people get cross about that when they call up a month later and find they have to go back to the start of the waiting list, but it's the only way we can manage our vastly over-subscribed and under-staffed service (and even then it's still slowly falling apart under increasing referral numbers and staff cutbacks).
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May 7, 2014 13:46
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Trickjaw posted:Maybe I'm missing something, but won't this just mean people go to A&E instead? Those that can, yes, I can't exactly go to A&E for my 3 monthly HBA1c tests SybilVimes fucked around with this message at 13:53 on May 7, 2014 |
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May 7, 2014 13:50
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SybilVimes posted:Those that can, yes, I can't exactly go to A&E for my 3 monthly HB1Ac tests You know what your on about though. I had visions of hordes of people with a poorly tummy or a headache crowding around an A&E dept.
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May 7, 2014 13:54
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May 7, 2014 14:00
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^ Barry Foster posted:This may work great for smaller departments or practices, but (for example) repeatedly calling the volume of people we book every day in the physio department I work at would be completely unrealistic. Well even in a small department, the secretary is probably already over-worked. It's not a program that can be neatly slotted into existing work-schedules, it would almost certainly require additional staff or longer working hours. But I'm only suggesting it as an alternative to all the admin involved in issuing fines, chasing them up, processing the financials etc. If your place of work had to do one or the other, which is the most practical? Microplastics fucked around with this message at 14:05 on May 7, 2014 |
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May 7, 2014 14:00
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Tsk. More media mud-slinging. I want to write him a letter of support, but thats sadly no longer possible 
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May 7, 2014 14:03
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Trickjaw posted:You know what your on about though. I had visions of hordes of people with a poorly tummy or a headache crowding around an A&E dept. There aren't hordes of them, but the attempted use of A&E as a quick GP appointment is a problem even now. Made worse by the closure of walk-in clinics.
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May 7, 2014 14:03
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Trickjaw posted:Tsk. More media mud-slinging. I want to write him a letter of support, but thats sadly no longer possible I don't think letters are his favourite thing today - that letter from his schoolmaster that described him as a racist & fascist that was constantly singing hitler youth songs in school, is making the rounds again.
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May 7, 2014 14:04
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Trickjaw posted:You know what your on about though. I had visions of hordes of people with a poorly tummy or a headache crowding around an A&E dept. People visiting GPs with a poorly tummy or a headache are part of the reason why charges are being proposed in the first place.
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May 7, 2014 14:05
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Pissflaps posted:People visiting GPs with a poorly tummy or a headache are part of the reason why charges are being proposed in the first place. Which in turn is largely caused by employers that insist on a medical note for every little thing, even if you wake up with an upset stomach. Sure, you COULD go into work and poo poo all over the floor...
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May 7, 2014 14:12
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Trickjaw posted:Maybe I'm missing something, but won't this just mean people go to A&E instead? No they already started closing most of those. They closed those because a lot were underfunded and badly run. K&C killed a fair few people they shouldn't have and my experiences with them weren't exactly to their favour.
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May 7, 2014 14:13
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KKKlean Energy posted:Well even in a small department, the secretary is probably already over-worked. It's not a program that can be neatly slotted into existing work-schedules, it would almost certainly require additional staff or longer working hours. But I'm only suggesting it as an alternative to all the admin involved in issuing fines, chasing them up, processing the financials etc. If your place of work had to do one or the other, which is the most practical? Don't get me wrong, I absolutely wasn't arguing for charging which, you're right, would take up just as much or more time and also involve a lot more departments and hassle. If I had to choose between the two, I'd go with the calling the patient before, during and after the appointment thing, but it'd take (in my office, for instance) at least an extra ten office staff. Which we'll never, ever, ever get. Of course, I'd like to pick the third option, which is 'provide us with more staff and facilities, you bastards, and accept that there are always going to be DNAs and they're not our fault, also they give our overworked physios time to actually write notes', but I'd also like a solid gold telephone.
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May 7, 2014 14:37
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Pissflaps posted:People visiting GPs with a poorly tummy or a headache are part of the reason why charges are being proposed in the first place. Don't they filter these people out on the phone already though? That's what happens at my GP, the doctors can even write you a prescription over the phone (if you can get the unbelievably lovely receptionists to put you through to a doctor) so you don't have to come in at all. If that's widespread practice then these hoardes of people wasting time by coming in for minor illnesses don't even exist, and the only people being charged will be people who have already been confirmed to have a condition serious enough to consult a doctor about. Or people who don't have serious illness but they want to get money off 
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May 7, 2014 14:38
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Yeah so gently caress the Spectator and James Delingpole
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May 7, 2014 14:39
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KKKlean Energy posted:If there's a big problem with missed appointments, then the best solution is a guilt-tripping program (my dentist uses this). It goes like this: the day before, ring up the patient and ask them if they are still intending to make the appointment, and ask them to let the care centre know if they're unable to make it. If they miss an appointment, ring them up and ask them why they missed it and why they didn't inform the care centre, whether they'd like a new appointment (chances are it's a yes) followed up with a polite request to not miss it this time or at least inform them if they can't. Guilt: tripped. They could do what UCLH Radiology does, computer generated text messages to remind you of your appointment time and date. UCLH sends texts a week in advance and includes a phone number to call if you need to cancel or rebook. UCLH also has a unified outpatients' appointment call centre with a single number where you can call to rebook/cancel outpatients appointments for any department. You can still call your consultant's secretary if you need to, but the call centre relaxed the work load on the secretaries. I appreciate the texts, and being able to easily reschedule my outpatient appointments, it's a much better system than they used to have. No reason a GP surgery couldn't do something similar with the computer generated texts to remind people about their appointments, and they could set up online or automated booking/cancelling for appointments. Chasing up the serial DNAs would help too, I agree. The way my GP surgery has reduced missed appointments is to almost entirely eliminate anything other than same day appointments. You want to see the doctor, you ring up at 8:30am and book an appointment for later that day. If you want to see the doctor at another time, you're going to wait a fortnight unless you're booking a follow up appointment in person. You need tests/injections etc, you see the nurse. It seems to work, I've never found myself in a situation where I've had to wait for an urgent appointment. The thing that they do need to sort out is getting repeat prescriptions, it's a mess and incredibly inefficient (takes two days for the prescription to be written, and if you're like me and have items that pharmacists don't stock it can be another day or two for them to get them). They need to computerise and automate that pronto.
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May 7, 2014 14:42
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Barry Foster posted:I'd go with the calling the patient before, during and after the appointment thing, but it'd take (in my office, for instance) at least an extra ten office staff. Which we'll never, ever, ever get. Pretty sure that texting reminders for your appointments is a feature of System One, and while it's probably not as effective as a personal call, I bet it increases the number of people that attend - the only DNA I've done (assuming we discount ones where I call as soon as possible to say that I can't attend the appointment) was where I got the date wrong on a dietician appointment, so got the 'why aren't you here?' call from her at the time of the appointment. Of course, System One is specific to this area, and I don't think there's any plan to roll it out nationwide. I've had a GP that did the call before/after thing before, and I always felt like I was being accused of being a bad patient (I almost died of shame the one DNA I mentioned above, which was with a different GP anyway, so I go out of my way to not be even 1 minute late, etc). That GP was far ahead of the norm though, had electronic automatic patient call in the waiting room, online booking, etc etc 10 years ago.
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May 7, 2014 14:46
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tentish klown posted:Yeah so gently caress the Spectator and James Delingpole Sometimes I wish we still burned people at the stake in this country, mainly when I remember James "I'm too busy to learn anything about what I'm writing about" Delingpole exists.
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May 7, 2014 14:46
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HortonNash posted:The way my GP surgery has reduced missed appointments is to almost entirely eliminate anything other than same day appointments. You want to see the doctor, you ring up at 8:30am and book an appointment for later that day. If you want to see the doctor at another time, you're going to wait a fortnight unless you're booking a follow up appointment in person. You need tests/injections etc, you see the nurse. It seems to work, I've never found myself in a situation where I've had to wait for an urgent appointment. You don't go to my GP do you, that's exactly how ours does it too. The 'have to hit redial repeatedly at 8:30 and hope to get in the first 3-4 calls answered' is annoying, but it seems to work. Thankfully the "diabetic clinic" appointments are done the old fashioned way, it would be annoying to have to play the phone roulette for the pair of appointments needed so regularly.
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May 7, 2014 14:49
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tentish klown posted:Yeah so gently caress the Spectator and James Delingpole This makes me furious beyond words. I literally can't think of anything to say.
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May 7, 2014 14:53
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SybilVimes posted:You don't go to my GP do you, that's exactly how ours does it too. Same system up here too. That said, I've missed the deadline before and used words like "depression" and "anxiety" and was booked in the next day's appointments, so it's not overly rigid that serious things get passed over.
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May 7, 2014 14:55
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I hate that same-day-appointment-only thing. I work full time and obviously if it's something low-priority like "check out this mole" or "do an anaemia test" I just want to book it on the god drat weekend and not take time off on the hope that I can snipe an appointment at 8:30 on a weekday. They tend to answer the phone, say "There aren't any appointments left, ring back at 8:30 tomorrow" and cut me off before I can get a word in. No poo poo guys, I'm ringing at 1pm, so maybe, JUST MAYBE, I don't want to book today!! It's a really stupid inconvenient policy if you work. Also "did women actually want the vote" 
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May 7, 2014 15:04
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tentish klown posted:Yeah so gently caress the Spectator and James Delingpole My favourite bit is the bit at the bottom 
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May 7, 2014 15:06
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KKKlean Energy posted:My favourite bit is the bit at the bottom Yeah, I read that and my jaw hit the floor. No, women clearly had the vote thrust upon them against their will, they just didn't know enough to make an informed choice and clearly wanted to leave important things like politics to the men while they get on with the task of being a home maker, which they are so perfectly suited to.  Part of me wants to read the article to try and understand why that question even needs to be asked, but the other part of me would rather just pretend The Spectator does not exist.
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May 7, 2014 15:12
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SybilVimes posted:The 'have to hit redial repeatedly at 8:30 and hope to get in the first 3-4 calls answered' is annoying e: my currunt one texts you to remind you a few times, its very helpfull, same system as the other guys have mentioned i guess. Seaside Loafer fucked around with this message at 15:19 on May 7, 2014 |
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May 7, 2014 15:12
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I am neither the biggest or toughest bloke around, but I would absolutely love to offer James Dellingpole out for a fight and kick seven shades of poo poo out of him.
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May 7, 2014 15:13
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My back up retirement dream (after being appointed to either the Canadian Senate or the house lords) is to be paid to write whatever I feel like.
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May 7, 2014 15:15
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KKKlean Energy posted:My favourite bit is the bit at the bottom The astonishing thing is that it manages to be arguably only the second most offensive thing on the page
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May 7, 2014 15:17
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SybilVimes posted:Pretty sure that texting reminders for your appointments is a feature of System One, and while it's probably not as effective as a personal call, I bet it increases the number of people that attend - the only DNA I've done (assuming we discount ones where I call as soon as possible to say that I can't attend the appointment) was where I got the date wrong on a dietician appointment, so got the 'why aren't you here?' call from her at the time of the appointment. We don't have System One (we will soon, thank god) but we do have a text reminder service. It doesn't seem to have helped much. To be fair, in the area I work language barriers are often a problem, which probably contributes to the issue. If the only info you get is written instructions, by letter or text, in English, then there's more of a chance you'll forget or not understand. Also, looks like the Skull Cracker's robbed a Chelsea Building Society down my road. Exciting stuff. Lotta cop choppers about.
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May 7, 2014 15:31
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