GP or specialist care?

[goji]

Hi

I'm interested to know whether Type 1s on here get monitored by a specialist at a hospital clinic or by a GP?

When I first got diagnosed with diabetes, I always went to the local hospital clinic. In recent times, it seems that GPs want to take over care of diabetics with Type 1 (they already handle most of Type 2s). As my Hba1c is good, my hospital consultant is keen to dump me back to the GP surgery for monitoring.

I read that GPs are getting paid lots of bonus money for taking over diabetic care and meeting certain targets (eg. lowering cholesterol, BP or Hba1c). I'm not sure that many GPs are actually interested in diabetes in the same way that a diabetes consultant is and I wonder what kind of conferences they attend or what up-to-date information they have.

I'm just wondering how many of you got moved from hospital clinics to GP surgeries for care and whether you're happy about that?

Thanks
Goji

 

[jameshallam]

I am taken care of by the hospital.

I asked whether i should see the GP instead (it is a little closer to my house), but the DN said that the nurses at the GPs don't understand carb counting and that i should stay with the hospital as all the nurses there are DAFNE trained...

 

[jopar]

I'm underder the hosptial now, but this is because I use a insulin pump though..

MY OH who is also T1 is under our surgery..

It would depend on how they've set there system up with patient care is the hosptial providing as they should the support to the surgery diabetic team..

I know that our DSN in our surgery is in constant contact with the hospital team, she attends regualr training with them, also with the diabetic consultants who hold regular Q&A meetings with the different surgeries DSN's so that every-one is kept up to date with diabetic care..

And all the nurses are in direct contact with everyone, they are all just a phone call/e-mail away, so any querries and/or concerns they have concerning patients can be dealt with... And if necessary they will refer to consultant...

Works very well indeed, and I know that my surgery DSN is very good indeed, as I still see her for an intrim check between my hosptial lot... I've got the option of seeing any one of the team either clinic based or hosptial based not a bad deal at all..

 

[hanadr]

In my area, the GPs are being given the primary care of diabetes. T1 and all T2s. I think it's because the Hospital is so over subscribed. I don't think it's the Gps' choice
Hana

 

[kegstore]

I've been going to hospital clinics since day 1, even before I was on a pump. My GP commented once that he has (and wants) very little to do with diabetes care (other than to sign my repeat Rxs) and prefers to leave it up to the specialists at the hospital clinic. He is not comfortable even adjusting any of my BP meds, such a sensible man! Even if I didn't have a pump I would kick up such a fuss at the prospect of being transferred to GP, who I see for "routine" matters only.

 

[shedges]

I've experienced 'care' from two different hospitals and two GPs. Overall, I'd say the hospital unit is more dedicated, has more resources and more specialists, so is better equipped to deal with any problems, etc. The surgery was handy, as it was close to home, but I do feel now that the bigger team at Basingstoke & North Hants hospital provides more comprehensive care. Having said that, I've just been moved from 6-monthly checkups to annual checkups. Is that normal for Type 1?

What's anyone else's checkup frequency?

Only downside of hospital is paying for the parking ! :evil:

 

[sugar2]

Well, I am under hospital care..and always have been from teh age of 4. Alas, thsi is becuase I have not, until the last 10 years had very good control.
For me, in many ways, it wouldn't matter which was in charge..becasue I learn far more from you guys than I ever had from any Dr!
My GP is great. To get my prescriptions signed, I do have to go for an annual check with them, and yes, they get a bonus if my HbA1C is within target. The DSN at the surgery openly admits that she doesn't know very much about T1...and refered me to a Dafne course, so I coud report back on it to her! I think this comment was only half in jest.

I am in the same region as Hana (and Mr Hana) so can confirm that the hospital is completely oversubscribed. Last year, they cancelled my appointment 6 times, before I finally lost the plot and complained. Thsi year...they have cancelled it 3 times already. I did mange to get on teh pump training, so have to bear with them though.

I guess teh flppant response to who cares for your Diabetes...is "I do..with the help of this site"

 

[SophiaW]

Jess is under the care of a diabetes consultant at our local small hospital. We attend clinic every 3 months for weight, measurement, injection site checking, Hba1C and a chat about anything that might be concerning us. I'm not sure if the frequency is higher because she is a child? We're lucky that our hospital where the out-patient diabetes clinic is held is very close, not much further in distance than our GP practice. I'd be concerned about being transferred into the care of our GP, as lovely as she is I don't feel that she has a very indepth knowledge of diabetes. All the repeat prescriptions are done through our GP and that works well. After every clinic visit the consultant writes a brief letter to our GP which is CC'd to us summarising the visit and updating her about what doses of insulin Jess is taking.

 

[maryrachel]

I was seen at a specialist centre since I was diagnosed 19 years ago and then, same as you, I was told that I could be seen by the GP. At the surgery I was attached to then they had a very good diabetes nurse so i was happy to be seen there and she was very thorough. 2 years ago i moved to another town and registered with a new surgery and was told again that because my control was good (HbA1C 7.2) I would be seen by the GP and the nurse but neither of then understand diabetes. When I asked to attend a carb counting course I was told I didnt need to. Recently I have been unhappy with the lack of knowledge at my GP surgery so i have asked to be referred back to a clinic. I am waiting for my first appointment now.

 

[tonyrees68]

Re: GP or specialist care?

New postby maryrachel » Today, 6:43 pm
I was seen at a specialist centre since I was diagnosed 19 years ago and then, same as you, I was told that I could be seen by the GP. At the surgery I was attached to then they had a very good diabetes nurse so i was happy to be seen there and she was very thorough. 2 years ago i moved to another town and registered with a new surgery and was told again that because my control was good (HbA1C 7.2) I would be seen by the GP and the nurse but neither of then understand diabetes. When I asked to attend a carb counting course I was told I didnt need to. Recently I have been unhappy with the lack of knowledge at my GP surgery so i have asked to be referred back to a clinic. I am waiting for my first appointment now.

maryrachel

I recently was referred to a hospital (High Wycombe) for my diabetic check ups and was put onto the INSIGHT course and its changed my life its a 16 hour course over 4 weeks and 3 weeks in it was very frustrating then the 4th week everything clicked into place my insulin dose has been reduced by 40% my blood sugar levels are now a constant 6.3 all the time my gp did not have the time or knowledge to do this for me so if you can get referred to a specialist diabetic hospital you wont regret it

 

[totsy]

when first diagnosed type 1 i was seen at the hospital diabetes clinic, but sadly appointments were always being cancelled so i ended up going every 9/10mnths, i was told if i changed to my own gp for care i would be seen more regulary, so now im seen every 6mths and can go anytime inbetween if im worried at my local surgery

 

[Debloubed]

for a while, I went to both appts, at the GP surgery and at the hospital. I have attended the same hospital clinic all my life apart from 2 years when I lived abroad, even when I have lived out of the area, I have always chosen to travel back for the check up. Last GP appt, the nurse asked me why I bothered going to see her as I was so well controlled (she knew this from my notes)?! but then at the hospital clinic I never see the same doc twice and I don't feel comfortable talking to any of the docs really, only the DN's who I can email/call or arrange a separate appt should I need to. Next stop - pump clinic which is run by only 2 specialist docs so I have high hopes!! :lol: