Diabetes confirmation

[judes46]

I have read somewhere on Diabetes.co.uk that every new person who is confirmed with Diabetes, that their doctors practise get £2.000 a year, so hmmm !!!!

 

[chris lowe]

Hi Jude, yes I've read that as well, and I'm sure the two visits to the diabetic nurse don't cost that much so why are we made to feel as if they are doing us a favour? I guess I can say that I've just paid for the GP's holiday this year.

 

[ladybird64]

I mentioned this briefly to my GP a while ago, didn't get right into the debate but his answer was the practice DIDN'T get money for me.

Do we actually have anything by a professional body that says this is the case and if so, can I have a link please? Ta.

 

[judes46]

It was an article on diabetes uk id have to look for it, let you know when i find it, ok

 

[judes46]

Yes chris, aww dam so you have hahaha, id prefer a holiday myself lol

 

[catherinecherub]

I think the money allocated to G.P.'s for patients goes into one big pot. If all yours was not spent on you but some of it went to fund a person with multiple health needs would you object? If M r. X had terminal cancer and needed expensive drugs or Mrs Y needed a heart transplant or Miss Z needed specialist input for mental health problems would you feel that this was not fair? If these people were your nearest and dearest you would want the best care available for them I am sure. The NHS is underfunded and there is not much any of us can do about that.

How would you like a Personal Healthcare Budget and this makes it clear how much money is available for your care and you decide how it is spent?

Pilot schemes of this method have been ongoing and in October these will be evaluated to see if they are a viable alternative. Interesting that some people on the pilot scheme are using them in a fraudulent way.

http://www.onmedica.com/viewsarticle.as ... 235839c370
http://www.onmedica.com/newsarticle.asp ... e835adcd74

 

[lovinglife]

I think the money allocated to G.P.'s for patients goes into one big pot. If all yours was not spent on you but some of it went to fund a person with multiple health needs would you object? If M r. X had terminal cancer and needed expensive drugs or Mrs Y needed a heart transplant or Miss Z needed specialist input for mental health problems would you feel that this was not fair? If these people were your nearest and dearest you would want the best care available for them I am sure. The NHS is underfunded and there is not much any of us can do about that.

How would you like a Personal Healthcare Budget and this makes it clear how much money is available for your care and you decide how it is spent?

Pilot schemes of this method have been ongoing and in October these will be evaluated to see if they are a viable alternative. Interesting that some people on the pilot scheme are using them in a fraudulent way.

http://www.onmedica.com/viewsarticle.as ... 235839c370
http://www.onmedica.com/newsarticle.asp ... e835adcd74

:clap: :clap: - totally agree here Catherine

 

[ladybird64]

I think the money allocated to G.P.'s for patients goes into one big pot. If all yours was not spent on you but some of it went to fund a person with multiple health needs would you object? If M r. X had terminal cancer and needed expensive drugs or Mrs Y needed a heart transplant or Miss Z needed specialist input for mental health problems would you feel that this was not fair? If these people were your nearest and dearest you would want the best care available for them I am sure. The NHS is underfunded and there is not much any of us can do about that.

How would you like a Personal Healthcare Budget and this makes it clear how much money is available for your care and you decide how it is spent?

Pilot schemes of this method have been ongoing and in October these will be evaluated to see if they are a viable alternative. Interesting that some people on the pilot scheme are using them in a fraudulent way.

http://www.onmedica.com/viewsarticle.as ... 235839c370
http://www.onmedica.com/newsarticle.asp ... e835adcd74

Unfortunately Catherine, you know as well as I do that this isn't really a convincing argument. If people feel ill and are not getting the level of care that enables them to feel well and to carry out their daily life as normal then they are not going to be thinking about someone who has multiple health needs, they will think about themselves and the money that they personally have paid into the NHS to provide for that care. Just as there are many diabetics who don't don't do the best for their health, there are plenty of others too. Those with cancer/heart disease who continue to smoke, those with liver problems that continue to drink, do we not feel entitled to get the proper care of we are trying to keep ourselves well?

Let's be honest, those that don't give a **** about their diabetes and their overall health would not be attending the GP or complaining about a lack of services would they?

I know it is a difficult situation and to a point I agree with you but think we cannot go down the comparison route of those worse off than ourselves..too much of a grey area.
We could also talk of those who haven't paid anything into the NHS because they haven't lived here that long..should they and their heath take priority over somebody who has paid NI all their lives?

Like I said..complicated but too many are getting at best, a poor service, if any at all. Just look at the intro pages on this forum.

 

[Juliette40]

I have read somewhere on Diabetes.co.uk that every new person who is confirmed with Diabetes, that their doctors practise get £2.000 a year, so hmmm !!!!

Hi Jude

I'm not surprised. A reply from Chris Lowe was a little scathing I thought. If my GP surgery gets money for me then I'm fully backing that. I'm type 2 and lucky enough to get test strips on demand. That's 100 a month at a cost of £50. Additionally, since my diagnosis 13 months ago I have had 3 HbA1c tests with all the usual function tests taboot. In the initial months I saw my diabetes nurse at the surgery on a weekly then fortnightly and then monthly basis. Now I see her every 5 months. I have received all the stipulated health checks, been given excellent advice and support and have been sent on an X-PERT diabetes training course which was invaluable. And not forgetting the free flu jab which would cost me dearly at the chemist.

As I age, I may require more visits to the surgery as complications may arise. £2000 a year seems nothing given what I am getting out of my surgery. I praise my local NHS trust and thank my lucky stars that I live in Britain.

Cheers to the NHS
Juliette :thumbup:

 

[catherinecherub]

I think the money allocated to G.P.'s for patients goes into one big pot. If all yours was not spent on you but some of it went to fund a person with multiple health needs would you object? If M r. X had terminal cancer and needed expensive drugs or Mrs Y needed a heart transplant or Miss Z needed specialist input for mental health problems would you feel that this was not fair? If these people were your nearest and dearest you would want the best care available for them I am sure. The NHS is underfunded and there is not much any of us can do about that.

How would you like a Personal Healthcare Budget and this makes it clear how much money is available for your care and you decide how it is spent?

Pilot schemes of this method have been ongoing and in October these will be evaluated to see if they are a viable alternative. Interesting that some people on the pilot scheme are using them in a fraudulent way.

http://www.onmedica.com/viewsarticle.as ... 235839c370
http://www.onmedica.com/newsarticle.asp ... e835adcd74

Unfortunately Catherine, you know as well as I do that this isn't really a convincing argument. If people feel ill and are not getting the level of care that enables them to feel well and to carry out their daily life as normal then they are not going to be thinking about someone who has multiple health needs, they will think about themselves and the money that they personally have paid into the NHS to provide for that care. Just as there are many diabetics who don't don't do the best for their health, there are plenty of others too. Those with cancer/heart disease who continue to smoke, those with liver problems that continue to drink, do we not feel entitled to get the proper care of we are trying to keep ourselves well?

Let's be honest, those that don't give a **** about their diabetes and their overall health would not be attending the GP or complaining about a lack of services would they?

I know it is a difficult situation and to a point I agree with you but think we cannot go down the comparison route of those worse off than ourselves..too much of a grey area.
We could also talk of those who haven't paid anything into the NHS because they haven't lived here that long..should they and their heath take priority over somebody who has paid NI all their lives?

Like I said..complicated but too many are getting at best, a poor service, if any at all. Just look at the intro pages on this forum.

I really did not think I was creating an argument. :crazy:

I am sure on other forums for cancer/heart disease/mental health/obscure genetic conditions, to name a few, people there feel equally incensed about what they perceive as lack of care. The NHS is struggling to survive, nobody wants to pay higher taxes, we are living longer, not always in the best of health.

Even if the money that G.P.'s receive for Diabetes Care is kept for diabetes use only, there are always going to be some poor souls who need more care than others. Kidney disease, heart disease peripheral neuropathy, autonomic neuropathy, retinal complications are all things that are happening all the time to established diabetics. It is sad that newly diagnosed are not getting a good level of care in some places, this postcode lottery that we all talk about, and there is nothing that I personally can do about it. It will have repercussions because it will create more complications. Type2 diabetes is on the increase daily and I really believe that nobody in the NHS was prepared for it. Unless the NHS gets a massive cash injection IMHO it will slowly go under. We all want the best care but how do you propose we can ration it? Shall we plough more into diabetes care at the expense of another illness/chronic condition?

As for whether somebody has paid enough N.I. contributions, that is not something I would like to see. The NHS is there for all and we cannot do a selection process of who should and should not receive care. How about the people who have paid in all their adult life? Should they be entitled to a refund if they have not had to use the NHS to the extent that others have to?

You did not mention how you feel about a Personal Healthcare Budget I mentioned in my post? Perhaps that will be the way forward.

 

[lucylocket61]

If there is a situation where others with other needs, or extra needs do not have their needs met due to budget constraints, then that is both the fault and responsibility of those who allocate and set the NHS budgets.

it is not good enough to bring on the "what about those worse off than you" card. I refuse to feel guilty about using resources at the expense of someone else, and deny myself needed care, due to the accounting errors or mean-minded calculations of those in charge of NHS budgets.

I dont even see this as a valid proposal. It is nothing to do with the needs of others, It is to do solely with our Diabetes care being properly funded at source.

and if the funds allocated, whatever the figure, are being used wisely to enable us to manage our Diabetes with knowledge, then we are SAVING money from the NHS budget by avoiding costly complications for as long as possible. Spending now to save later is a good thing.

 

[xyzzy]

Looked but I can't trace anything on a per individual basis although someone told me many months ago about the £2000 per patient figure. I would guess the surgery just receives it as one bulk payment for all patients but as Lucy says I also refuse to feel guilty about asking for what the NICE guidelines say I am entitled to.

However under the "Payments by Results Scheme" the following looks to be in effect but it relates to all the surgeries T2 patients not individuals. Do I worry about the fact my doctor being inventivised to perform? Probably not as it might make them look around for what actually helps rather than blindly sprouting the DUK starchy carbs with every meal nonsense.

http://www.drbriffa.com/2009/03/13/...regarding-diabetes-doing-more-harm-than-good/

So, it makes sense then keeping blood sugar levels in check should help to prevent the complications of diabetes. So important is this deemed to be, that the UK government gives general practitioners (GPs) money to ‘incentivise’ them to assist their patients in achieving relatively tight control over their blood sugar levels. From April [2009] of this year, if GPs can get half of their type 2 diabetic patients to have a HbA1c level (this is a measure of blood sugar control over the preceding 3 months or so) of less than 7 per cent, then the practice gets an additional payment of £3000. Prior to this, the target set by the government was 7.5 per cent. Clearly, the government feels that when it comes to HbA1c levels, lower is better.

 

[ladybird64]

quote]

I really did not think I was creating an argument. :crazy:

I am sure on other forums for cancer/heart disease/mental health/obscure genetic conditions, to name a few, people there feel equally incensed about what they perceive as lack of care. The NHS is struggling to survive, nobody wants to pay higher taxes, we are living longer, not always in the best of health.

Even if the money that G.P.'s receive for Diabetes Care is kept for diabetes use only, there are always going to be some poor souls who need more care than others. Kidney disease, heart disease peripheral neuropathy, autonomic neuropathy, retinal complications are all things that are happening all the time to established diabetics. It is sad that newly diagnosed are not getting a good level of care in some places, this postcode lottery that we all talk about, and there is nothing that I personally can do about it. It will have repercussions because it will create more complications. Type2 diabetes is on the increase daily and I really believe that nobody in the NHS was prepared for it. Unless the NHS gets a massive cash injection IMHO it will slowly go under. We all want the best care but how do you propose we can ration it? Shall we plough more into diabetes care at the expense of another illness/chronic condition?

As for whether somebody has paid enough N.I. contributions, that is not something I would like to see. The NHS is there for all and we cannot do a selection process of who should and should not receive care. How about the people who have paid in all their adult life? Should they be entitled to a refund if they have not had to use the NHS to the extent that others have to?

You did not mention how you feel about a Personal Healthcare Budget I mentioned in my post? Perhaps that will be the way forward.

Catherine, my apologies for using the word "argument" in my post, I was writing in a hurry and should have picked my wording more carefully. I still am in a hurry so will say that i will look at the links you have provided when I have time to take it all in.
On the point of the NHS and who it is there for, I am playing Devils advocate. It is like an insurance policy albeit with non moving premiums, you may not use it but it is there in case you need it, especially if you have paid for it all your working life as you rightly pointed out. Without wishing to stray from the purpose of the thread then in the same token should the people who have not paid into it be given priority over someone who has? Maybe morally right but otherwise? Open to debate I think.

There's a whole heap of possible scenarios but the bottom line is that for too many, the service provided for diabetics is shambolic. Numbers of those with diabetic complications is rising, hence what is being provided is falling short. Like anything else we expect what we pay for so if the service we get for the money we have paid in is poor, I think people are justified in asking why.

Will read the links later tonight, sounds interesting.

EDITED - I have just read the links Catherine. The things that stand out for me the most is that this Personal Healthcare Budget cannot be used for primary care..I believe it is the primary care (or lack of it) that so many people complain about.
It reminds me very much of a similar idea that has been put into practice within Social Services, personal budgets are being pushed onto people left, right and centre. The reasons given are that it puts the service user "In Control" and it some areas it is successful. However, It is of no good where there are a lack of suitable services in the first place..money can't buy what isn't available!
If you were asking me personally if I would like a personal budget for my diabetes then it is something I would look into carefully. I have received practically no offers of services from my practice and have learnt everything about my condition and how to live with it from this website so in reality they have spent very little on my care.

 

[Scardoc]

GP's do receive financial incentives for meeting certain levels of care and I personally have nothing against this. Why not? Attacking the "in" diseases needs to be done to try and reduce them and save money in the long term through less complications and treatment. Incentives are found in every industry and every human from birth learns and progresses through incentives.

For all it's detractors, the NHS is a wonderful service and I for one would hate to live in a country where private health insurance is the norm. We are an evolved, civilised society and by paying our taxes we ensure that the entire country is able to benefit from the NHS. Emphasis on the word we. I for one will gladly pay NI every month until the day I die, not because I have T1 diabetes and am receiving free medical care, but because I know that when some poor ****** gets run down, or is diagnosed with a horrible cancer, they will get the treatment they need and not asked if they can afford it. If GP's, surgeons etc make money in the process then great - they deserve too.

Disclaimer: although the NHS is (in my eyes) a great institution it is run by human beings and human beings do tend to make mistakes from time to time or not be as nice as they should be. Hence, not everyone receives the same level of care. To err is human, forgiveness is divine.

 

[chris lowe]

catherinecherub wrote:
I think the money allocated to G.P.'s for patients goes into one big pot. If all yours was not spent on you but some of it went to fund a person with multiple health needs would you object? If M r. X had terminal cancer and needed expensive drugs or Mrs Y needed a heart transplant or Miss Z needed specialist input for mental health problems would you feel that this was not fair? If these people were your nearest and dearest you would want the best care available for them I am sure. The NHS is underfunded and there is not much any of us can do about that.

The GP's get paid for thing like diabetic patients, the number of babies/children they inoculate, the number of blood pressure checks they do and so on. So their budget (and pay) is dependant on the services they provide. I think that if Mr X had terminal cancer and needed expensive drugs then that would come out of the Primary Care Trust budget which is why we get so many stories in the news about patients who are denied life saving drugs and why NICE (bit of a contradiction in terms I think) often decide that when a new drug can give someone an extra few months they decide that it's not worth the money (maybe not to them but for the person involved a few extra months is priceless). There seems to be a wide discrepancy between GP's - who I think are probably dictated to by the PCT - over who gets free test strips/meters and who doesn't. My particular GP won"t give out test strips and in two years I've had 50 strips and only then reluctantly given by the DCN who I think was new and not sure if she was allowed to prescribe them. So, if my GP is getting £2000 for my care it would be nice to get more than two visits to the DCN a year.I do get a flu jab each year, but last year Boot's were offering them at £12 a pop and as hubby isn't entitled to a free one I made him go and get one there.

 

[catherinecherub]

You might like to read this document that explains what your G.P. is paid for
better than me. We don't all have £2000 in a little box at the surgery that he takes money from when you get your HBA1c test but he is paid on overall performance.

You can find your surgery, see what he is awarded for diabetes care last year and even make comments if you are not happy with what you see
http://www.qof.ic.nhs.uk/

 

[jopar]

How our GP’s funding is worked out, is quite a complex formula, involving Global payments, QOF points payments and up lifters! So a lot what happens in any one practice will have a lot to do with management side of things…
The way funding is worked out; it basically means that management is based on robbing Peter to pay Paul.
Will things like ‘Individual Health Care Budget’ improve things for the patient, giving them access to test strips and education etc...? I very much doubt it
Problem is that, that there is always a set ‘fund pot’ and this will always be controlled by the health care professional, so if a GP decides that under the present system of funding that it’s not cost effective to provide a T2 with Test Strips, do you think under the new funding that he’s going to put into your personal ‘fund pot’ enough funds to cover Test Strips, as well has education to use said Test Strips I think not!
A similar idea was implemented by the social services for its Care Provision, which gave individual client a personal ‘fund pot’ for their care provision. It was meant to give the client more choice to how their care needs were met and by who etc., and claims that it would in turn make a better and cheaper more cost effective service!

Reality of it, is that the individual client still faces problems accessing actual funding, and it’s opened the door to all sorts of problems both for the client and the care providers, which has effectively not only restricted choice to the client, but probably shoved up the actual costs of care provision!

Whichever way the system is implemented and funds jiggled about, the outcome will roughly remain the same for the patient!

 

[Scardoc]

You might like to read this document that explains what your G.P. is paid for
better than me. We don't all have £2000 in a little box at the surgery that he takes money from when you get your HBA1c test but he is paid on overall performance.

You can find your surgery, see what he is awarded for diabetes care last year and even make comments if you are not happy with what you see
http://www.qof.ic.nhs.uk/

These QOF indicators are a financial incentive (ie a bonus) to GP's. They are paid a salary regardless of their overall performance and this is an additional bonus based on overall performance. It's not dependent on the GP's alone either, the staff working away in the background are equally important.