Type 2 Opting Out of Diabetic Check Ups

[alanfcox]

I have just received my Diabetic Annual Check appointment from my GP Surgery and attached to the letter is a form asking me if I wish to opt out of checkups. I think that this is the "thin end of the wedge" for the patient and not something that I am happy about and I was wondering if anyone else had been asked this?
Clearly, it is a way for the surgery to meet their responsibilities and still get paid for a service that they are not carrying out - any thoughts would be appreciated.

 

[walnut_face]

Just had mine too, no opt out option, but my 'annual' review is just 4 months after my last appt. Was wondering if they were on a 'Gravy Train' as in they get a payment

 

[alanfcox]

My personal view is that someone has suggested this as a "cost saving measure" without fully thinking about the possible consequences for the patient and of course as you have to sign it they can claim there QOF points and get paid into the bargain so I think you are right.

 

[GrantGam]

I've put yes for this. As much as I 100% agree that all diabetics should attend their reviews, if they don't want to then that is entirely their choice.

There is no point in sending out letters with proposed dates for appointments, etc if they have no intentions on attending. It not only wastes time and money, but it makes it harder to schedule appointments for those who actually want them.

I can't see the surgeries getting paid unless the appointments are attended though.

 

[Enclave]

TBH I wish my DSN would get off my back, and would happy opt out of any of the checks. My blood sugars are always tested at my heart failure clinic .. so whats the point of doing it twice when my blood sugars are well controlled !!

 

[alanfcox]

I've put yes for this. As much as I 100% agree that all diabetics should attend their reviews, if they don't want to then that is entirely their choice.

There is no point in sending out letters with proposed dates for appointments, etc if they have no intentions on attending. It not only wastes time and money, but it makes it harder to schedule appointments for those who actually want them.

I can't see the surgeries getting paid unless the appointments are attended though.

Unfortunately, they do get paid - my wife is a GP Practice Manager and as long as they have your signed opt out they get paid as if they had seen you. They also get paid if they have made 3 attempts to contact the patient and the patient has not responded.

 

[novorapidboi26]

If you opt out, how do keep an eye on HbA1c and all the other things we need to look out for.....

 

[alanfcox]

TBH I wish my DSN would get off my back, and would happy opt out of any of the checks. My blood sugars are always tested at my heart failure clinic .. so whats the point of doing it twice when my blood sugars are well controlled !!

There will always be exceptions such as yourself that have tests for other conditions but what you have to be aware of is the fact that when they do bloods they are for specific conditions and that your test might not include those checks for diabetes. Do you know if they include this?

 

[alanfcox]

If you opt out, how do keep an eye on HbA1c and all the other things we need to look out for.....

I agree 100% and as you are aware it is not just blood tests that are important - feet, eyes, neuropathy - as a matter of interest I went to presentation on neuropathy earlier in the week by a local diabetic consultant and he went into great detail about how quick a small problem can lead to amputation.

 

[GrantGam]

Unfortunately, they do get paid - my wife is a GP Practice Manager and as long as they have your signed opt out they get paid as if they had seen you. They also get paid if they have made 3 attempts to contact the patient and the patient has not responded.

Thanks for putting me right there.

It's a shame practices and their partners still make revenue this way (off the back of the taxpayer!), as much as I hold the NHS in high regards, it's a far more privatised industry than a lot of us realise...

 

[azure]

I think it would be useful if they asked why patients were opting out. Some will have a genuine reason like they've already been seen elsewhere, some may have difficulty attending for some reason, and others may not think much of the service offered.

Finding out the reason for an opt out would be most sensible, in my opinion.

 

[alanfcox]

I think it would be useful if they asked why patients were opting out. Some will have a genuine reason like they've already been seen elsewhere, some may have difficulty attending for some reason, and others may not think much of the service offered.

Finding out the reason for an opt out would be most sensible, in my opinion.

Clearly establishing the reason is an important aspect but I wonder what reasons would be acceptable - would reasons such as I don't think much of the service, I don't have any confidence in the service or I don't have the time be acceptable? The other important aspect is who accepts or rejects the reason - would this be a doctor or someone on the admin staff?
I think that the issue should have been put before the Patient Participation Group (PPG) first ( which it wasn't as I am a member and it has not been discussed) and if it was to be put into operation it should have been done on the basis of a risk assessment on an individual basis that could have taken into account individual circumstances.

 

[azure]

I was thinking not so much for accepting or rejecting reasons, but to,try to gain useful information eg if the clinic is being held at a time that makes it hard to attend, or if a number of people comment on the lack of skill/caring nature of the person running it - that kind of thing.

At the moment it sounds like a box-ticking, back-covering exercise.

 

[CarbsRok]

I always sign the opt out so the practice can claim the extra income. It's my choice not to attend thus I see no reason to deprive my GP practice of extra funding which could be used to help someone else.

 

[noblehead]

I have just received my Diabetic Annual Check appointment from my GP Surgery and attached to the letter is a form asking me if I wish to opt out of checkups.

You want to chase this up and ask some questions as it doesn't seem right. people with diabetes should receive regular check-ups as the following article explains:

https://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/15-healthcare-essentials/

 

[Squire Fulwood]

I am a bloke and I think I have been imprisoned by the NHS and would love to opt out but on the other hand who would tickle my feet and take my blood tests and weigh me without me cheating. Attending the headmasters office every six months is my only incentive to behave well. Without that I will go straight off the rails as I have today. Had blood test last week so Yabadabadoo.

 

[alanfcox]

You want to chase this up and ask some questions as it doesn't seem right. people with diabetes should receive regular check-ups as the following article explains:

https://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/15-healthcare-essentials/

I have already raised it with Diabetes UK and the CCG and neither were aware of this initiative.

 

[Enclave]

There will always be exceptions such as yourself that have tests for other conditions but what you have to be aware of is the fact that when they do bloods they are for specific conditions and that your test might not include those checks for diabetes. Do you know if they include this?

My heart failure test include blood sugars and also the regular ECG .. cholesterol and a few others ... far better than the diabetes test .. that also includes cholesterol !!! the heart failure tests are more because of the heart meds I am on .. as they can mess up other organs. I keep an eye on my own sugar via a meter and my blood pressure also via a home meter.

 

[alanfcox]

I always sign the opt out so the practice can claim the extra income. It's my choice not to attend thus I see no reason to deprive my GP practice of extra funding which could be used to help someone else.

With respects I don't think you quite understand how this funding works in GP Practice but what I can say is that it may not go where you state.

 

[noblehead]

I have already raised it with Diabetes UK and the CCG and neither were aware of this initiative.

I bet they weren't.............

I'm a type 1 so get my annual check-up at my local hospital rather than my gp practice.