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Rant about diabetes review/ GP surgery madness

debs248

debs248

Well-Known Member
Messages
334
Location
Southampton
Type of diabetes
Other
Treatment type
Tablets (oral)
Dislikes
Hypocrisy, mornings
Not had a rant here for a while about my "special" GP surgery but hubby is sick of me complaining so I'll post here.

My first diabetic review since diagnosis in late April is apparently due on 17th July. Not sure how they figure that out as I still haven't had an initial assessment.

Anyway, having read up for myself about diabetes, here and elsewhere on the Internet, about what they should have provided/ told me, I asked if I needed to arrange blood tests beforehand or take a urine sample with me.

Yes, they want the urine sample, but they will draw blood *at the review* for testing. Unless they've got one of those fancy fridge-sized instant HbA1c testing machines in every surgery, what's the @#*&% point of doing it then?

My FBG is almost always in double digits and i'm on the maximum dosage of Metformin, so I'm pretty sure another medication is needed, but it'll be pure guesswork on everybody's part.

I'm not asking for special treatment or even anything particularly difficult, but really, is it too much to ask for basic common sense?
 
My diabetes reviews are done in two parts. Part one, urine test, blood pressure, foot checks, weight and blood taking with a health care assistant. I then attend a week or so later for part two with GP, nurse or pharmacist to discuss the results of the tests taken and any need to alter medication. I wonder if your surgery works that way too and you’ll have to book the second appt once you’ve had the first appt.
Having said all that it is remiss that you’re only being seen for your first ever appt two months after diagnosis.

Edit for typo
 
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Like @Rachox my reviews are in two parts first in person all the bloods, weight, foot check and blood pressure plus questions about my lifestyle such as exercise routine, alcohol consumption, smoking etc which are all recorded usually by a health care assistant. My second review appointment is made at a date for when results likely to be back around a week or so later. Since COVID this second review of results and medication is done by the DSN by phone at my surgery. Pre covid both appts were in person.
Sorry to hear that you are having to wait for a proper first ever appointment to discuss your diagnosis. Sounds like poor communication and with your anxiety about your high figures and medication I'm surprised that you haven't been seen to discuss your diagnosis.
 
I would say I was surprised but it'd be a lie as my surgery appears to always go about things in the most awkward, unhelpful, inconvenient way they can.

As I only leave the house every 6-8 weeks I'd rather not have to wait until September before starting a new medication. My dad's having heart surgery this week and we're going to Liverpool to scatter my father-in-law's ashes this summer so I can't keep using my limited trips out for medical visits.

Edit: Just remembered it's my brother's 50th in September so that's another non-medical commitment to further delay matters. Sorry, I try to stay cheerful but I am just so frustrated today.
 
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I must of had 50 reviews since diagnosis and they have always followed the same pattern ,bloods / urine /blood pressure weight etc then photographs of the back of my eyes then in with the consultant for a chat and foot examination , this year I was told they do not do the eye photos anymore and that I would be sent to a private eye clinic and because of some data protection they cannot share this information with my clinic , I did sigh a bit but at least they are still looking after me .
 
Rachox said:
Maybe you could have your July appt in person to have all the physical stuff blood test, urine sample etc… then like @shelley262 have the second appt over the phone.
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That may well be the way they want to do it anyway, but they are very cagey with information, never volunteer or explain anything.

I have to guess what questions to ask, then try to navigate their appalling online system (I've seen other people's, this isn't just me being stroppy, the one they've chosen is truly dire), wait for days for a response that answers a different question to the one I asked, and I can't ask them for clarification as they've closed the case...

Perhaps they just want me to give up and go away.
 
Have you considered changing to a different GP surgery, @debs248?
It shouldn’t be difficult, and having HCPs you are confident will support you is important.

www.nhs.uk

How to register with a GP surgery

Find out how to register with a GP surgery in England.
www.nhs.uk www.nhs.uk
 
Pipp said:
Have you considered changing to a different GP surgery, @debs248?
It shouldn’t be difficult, and having HCPs you are confident will support you is important.
Click to expand...

Yes I have considered it, but I'm worried the new surgery won't be any better. Until I meet someone local who can recommend theirs, and has similar conditions, I'm afraid of losing what little support I've got. There's one doctor I trust, she really seems to "get it", and offered me blood tests at home without me asking, but she's semi-retired and only does 2 mornings per week, which is better than no help at all.

My husband loves his surgery, but only because he can walk to the surgery and chat to the helpful person on the desk. We don't know how helpful they'd be over the phone or online or whether they'd be supportive of my various health conditions.
 
debs248 said:
Yes I have considered it, but I'm worried the new surgery won't be any better. Until I meet someone local who can recommend theirs, and has similar conditions, I'm afraid of losing what little support I've got. There's one doctor I trust, she really seems to "get it", and offered me blood tests at home without me asking, but she's semi-retired and only does 2 mornings per week, which is better than no help at all.

My husband loves his surgery, but only because he can walk to the surgery and chat to the helpful person on the desk. We don't know how helpful they'd be over the phone or online or whether they'd be supportive of my various health conditions.
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Would it be possible for your husband to phone or try online next time with his surgery - at least that way you'd have a way to gauge how helpful they are when you're not stood in front of them?
 
Spoke to helpful GP today, it is a 2 part review, bloods etc then after results in, discussion re: meds

Would have been nice if they'd told me that or had it on their website to look up but at least I can prepare. It does mean it'll be a very long time before I get any more medication, that seems crazy.
 
Oh and apparently I can no longer use the home phlebotomy service because I left the house when the surgery *insisted* I come in immediately, back at diagnosis. It's like living in a novel cowritten by Orwell, Heller and Monty Python.
 
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jaywak said:
I must of had 50 reviews since diagnosis and they have always followed the same pattern ,bloods / urine /blood pressure weight etc then photographs of the back of my eyes then in with the consultant for a chat and foot examination , this year I was told they do not do the eye photos anymore and that I would be sent to a private eye clinic and because of some data protection they cannot share this information with my clinic , I did sigh a bit but at least they are still looking after me .
Click to expand...
They do at least for type 1. They aren't necessarily every 12 months but hare every 18months for the most part. Yearly is usually reserved for patients with background retinopathy or othe eye problems like cataracts and glaucoma.
Who told you you they weren't doing the eye tests?
 
It seems to me that different surgeries have different ideas about "reviews". A few years ago, my surgery started doing reviews like the one the OP describes. Blood was taken during the review, so the results couldn't possibly be discussed at the time. Follow-up consisted of a brief telephone call with a GP, who usually didn't do anything.
However, everything has now changed and I can't believe my luck. I believe I now have what I would call "gold standard" treatment. I receive a reminder every 6 or 12 months to book a blood test and a review. So I have a blood test and take along a urine sample. A couple of weeks later I have a face-to-face review with a diabetic nurse, who is an absolute star - she really knows her stuff. I wasn't surprised to discover that she has an MSc in diabetes management and is on the board of a national diabetes organisation and publishes peer-reviewed articles. She's campaigning for better diabetes care, so I guess she uses the care she offers as a "model".
I haven't seen a GP about diabetes for years. The advantage of the care I now have is that I get longer appointments with the nurse than I would with a GP (nurses are cheaper) and I can discuss all sorts of related problems. For example, I have a history of depression and insomnia (which have an effect on diabetes), so she always asks me about my mood and takes action if needed. I also have problems with a hip (which affect how much exercise I can do), so she arranged X rays and physio. She couldn't prescribe painkillers, so made me an appointment with a GP, who did prescribe them. In other words, I feel as though my diabetes is treated holistically.
I suspect part of the problem is that some GPs don't have a specialist diabetes nurse, to whom they can delegate, so have to organise things differently.
My only fear is that she's so good that she'll be snapped up for promotion somewhere, so I always give her rave feedback.
 
I changed practices in January after a string of arguments with the practice manager and GP.
My bloods were quite high at the time, 12-13, and the diabetic specialist sent them a letter detailing that I should be between 6 and 9 and have gliclazide with enough quantity so I could move the dose up and down as required to meet the 6-9 target.
The GP disagreed and said 13 was fine... :mad:

I changed practice and everything was sorted within a week. They've actually gone over the top and I have available to order a month's worth of 80mg tablets and a month's worth of 40mg tablets each adding up to the maximum of 160mg twice a day! Confused much...
 
It seems that everybody has two parts to their "review", except that some practices call the assessments (eg blood, urine, blood pressure etc) the review. To my mind that isn't a review. A review can't take place until all the results are known - and then it should be a proper discussion about more than the paper results.
 
Totally agree. I had my assessments last week and was told the diabetes nurse would call me when they get the results, I'm not holding my breath.
 
My surgery is very good. Each year I ask the receptionist to set-up the blood and urine tests on line so I can get them done at the hospital. I also arrange a surgery appointment which is two stage - one after the other with the GP and HCA (we lost our great db nurse). Works well and I look at my results online before my surgery appointment so I know what questions to ask and they don't need to waste time telling me my results. Do join your surgery Patient Group where we are able to meet with the Practice Manager and often one of the GPs to raise procedural issues. BTW these groups are mandatory so don't let the surgery put you off.
 
I no longer have a review as such just an annual appointment with an HCA who takes blood (inc Thyroid), weight, blood pressure and tickles my feet. Presumably if there is anything wrong they will contact me
 
ShazKnitz said:
Totally agree. I had my assessments last week and was told the diabetes nurse would call me when they get the results, I'm not holding my breath.
Click to expand...
Still waiting for that call. I know they've had the results as I looked in the NHS app
 
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