Local surgery bombarding with BP requests...

[Zanshin]

I`ve recently started receiving letters from my local GP requesting that I go in for a blood pressure check. One even threatened to withold my medication if I didn`t oblige...

As I have my blood pressure checked at my annual diabetic review at the hospital, why is it that the GP surgery can`t just access it online (isn`t it a shared medical record between the two, now that most of the world has started using computers?)

Anyway, as I have a job which requires me to not be at home during surgery opening hours (how strange), I wrote to my GP, providing 3 BP readings over the last 6 months, and advising my annual review is due in the next few weeks. I got a reply, requesting that as I am on medication for hypertension (this annoyed me - I take a very small dose of ACE inhibitor because there was once a kidney function reading during my annual review that nobody understood), would I be able to write to them every now and again to let them know what my blood pressure reading was.

Fast approaching full rant now....I don`t understand in these tough economic times why the GP surgery can`t do their job more efficiently. The information is there, why can`t they see it? It seems ludicrous to ask the patient to let them know.

What d`you think?

 

[hallii]

First off you should be grateful that your Doc. cares enough to want to monitor your BP.

I think it is a reasonable request and you really should make the time to go to the surgery for a check up.

Hypertension can cause many problems not least heart attacks.

To obtain any meaningful readings to show your Doc. you need to take, say, 20 readings over a couple of consecutive days noting the time and date they were taken. Also note the time you took any medication or excercise. Then put it all in a nice table and work out the average.

Also get your meter calibrated against a surgery one, they can be way out.

Why not ask for a morning or afternoon off for "medical reasons" any reasonable employer will be happy to oblige, if not I would simply book a "sickie".

H

 

[Lisa21]

I have the same problem, but with HbA1c requests. My GP's prescription renewal requests always fall at exactly the same time as my diabetes reviews at the hospital (every 6 months).

This means that whenever my prescription is up for review, I get a letter saying that I need to come to the GP's surgery to have my HbA1c done. My GP's surgery doesn't have a HbA1c machine and so sends the blood test to the hospital anyway! This requires anyone with diabetes at my GP's surgery to visit twice - once for the blood tests, and then again, once the results come through. At the hospital, I receive the majority of the results there and then so I'd rather go to the hospital. I too have a job so it's more convenient, plus trying to get a diabetes appointment at the GP's surgery is difficult to say the least!

I've tried to explain to my GP that I go to the hospital for my tests and check ups and don't need (or want) them done twice. On receiving a prescription review notice, I therefore have to write to tell my GP that I am going to the hospital and then they provide my prescription. When I submit my next prescription, I get a letter saying that they have no evidence that I have been to the hospital. I then write and say that I have been but the consultant hasn't written his report yet and that provides me with a prescription for another month. Then the next time I submit a prescription, I get another letter (in big bold writing) saying I still need to come for my prescription review!!

Needless to say, you're not the only one who has this issue!!

 

[Patch]

The absolutely LOVE sending out letters asking you to come inn and "HELP YOURSELF". This is to cover their own a$$es if you fall ill and have not attended after they've prompted you.

The thing is, even if you do attend, they are not likely to provide you with great help anyway! It's just another tick in the box to confirm you are attending and being a compliant patient.

 

[RussG]

A cynical person would point out that GPs get paid by activity. If you go in to see them for something they get a fee. If you go elsewhere, they don't get paid...

 

[noblehead]

As I have my blood pressure checked at my annual diabetic review at the hospital, why is it that the GP surgery can`t just access it online (isn`t it a shared medical record between the two, now that most of the world has started using computers?)

I have often wondered why they can't myself, unless the hospital writes a letter to my gp then there is no record of my annual visit.

It's strange why they won't accept your own readings, I take along my home record of my recent bp readings which my gp is more than happy to accept.

Nigel

 

[ebony321]

I thought all GP's sent out letters so ask if they could link up your information to hospitals as they are now aiming to have the same databases to prevent this from happening?

I have my blood tests at my GP, my diabetes then calls me and tells me what it is when it's linked up and she can see it from my GP.

Although my GP does ask that i have check ups at my GP 3 monthly even though i'm seen closely by my team at the hospital.

I'm trying to get it so they will accept seeing me every 6 months instead as i feel it's a waste for them, but they won't and still send me appointments, sometimes it can land within weeks before, so i book a blood test and when i go i say the bloods are for my hospital appointment and i would like to cancel my check up with the GP as i'm due one with the hospital. They always seem pretty happy with that.

So i think it's likely they'll keep sending you letters no matter what you do, far better than them showing no concern at all though!

 

[Zanshin]

Thanks for the replies - some interesting points. I am indeed grateful that my GP takes an interest in my condition, and certainly feel it is more wrong that some seem not to. I suppose my point, which most people replying seemed to get, is that it is inefficient and a waste of time to have to tell my GP what other medical establishments have recorded about my health - in this example,blood pressure.

Personally, I try to avoid taking time out of work as I feel it helps feed those who see us as weak or afflicted. By the time I have had annual eye checks, annual diabetic reviews, quarterly (at my request) HBA1C tests, if you have a demanding job it can become a burden to yourself and your employer. Obviously I believe managing my health is more important than managing my career, but paying the bills and feeding my family is high up the list of priorities too.

Judging by the numerous posts I`ve seen relating to varying degrees of GPs` intervention into our diabtetes management, maybe it`s time for some clarity regarding exactly what their responsibility is and how it is shared with our hospitals and specialist diabetes nurses. I use the diabtes unit at my local hospital as the source for managing my condition, and my local GPs as an admin centre - they merely issue prescriptions (based on requests made initially by the hospital/me), and deal with basic "general" health issues. So why can`t they do it more efficiently?

 

[angieG]

I was on an NHS webpage the other day (can't remember exactly where it was) but it was about your local doctors practices. You could look up the name of the doctors etc etc.
Well it had a list of stuff like...
85% of patients have had their BP checked in the last 12 months.
70% of registered diabetics have raised Chlorestorol levels.
65% of patients have had their weight recorded.
etc etc.
(Figures just random and made up for examples)

So it may be a case of hitting the quotas rather than caring for patients...(being cynical of course)
Regards
Angie

 

[CollieBoy]

With my surgery /Consultant set up the flow of data is largely one-way, fueled in the main by me. If I have a reading taken at surgery I note it and file it with my records and pass it to my consultants. If something is noted with my consultants, I pass it to my GP (Hosp will not provide readings to my GP other than the generalities of the consultant letter) They are in neighbouring areas and cannot access data. :evil:

 

[catherinecherub]

Millions of £'s have been spent on IT systems for the NHS and they are still not working correctly. There have been massive problems since 2008.
The system is only as good as the programmers and until it is put right then there will be no communication between some Hospitals and G.P. practices. Some individual Trusts are building their own systems at extra cost because of the problems.

 

[phoenix]

I agree that UK GPs have targets , but surely those targets are there for a purpose. It's better to find that someone at risks BP has risen sooner rather than later.
An annual check doesn't seem very frequent so perhaps an imtermediate check with the doctor might be a good idea. Presumably as he/she signs your prescriptions he has legal responsibility for your care. It's difficult to do that without seeing you.
For comparison, the French schedule for checks is an HbA1c every 3 months, kidney function, lipid tests, ECG, neuropathy check, retinal check every year. Weight/BP/feet at every visit. For a T1 with good control, 6 months is the maximum my doc wants between these visits... and she's not actually allowed to write a prescription for longer without seeing me.

Edited typo(ECG not EEG!)

 

[noblehead]

For comparison, the French schedule for checks is an HbA1c every 3 months, kidney function, lipid tests, EEG, neuropathy check, retinal check every year. Weight/BP/feet at every visit. For a T1 with good control, 6 months is the maximum my doc wants between these visits... and she's not actually allowed to write a prescription for longer without seeing me.

That's what you call taking diabetes seriously! It would appear we have a lot to learn from the French, the sooner complications are spotted the better the outcome.......simple as!

Nigel

 

[Zanshin]

I totally agree, the French system is rigorous in comparison. I was based over there for a short period (working for a pharmaceutical company, ironically), and they are very regimented with regard to diabetics. It is worth adding, given what I`ve already said, that their employment situation is also very different, with much more emphasis on employee rights and working hours.
If I worked long hours as a French employee, in theory I would be sent home after completing a certain number of hours in a week. Not so as an English employee for an American company, but let`s not go down that avenue.

I have my HBA1C checked quarterly ideally at my hospital, if I don`t make that then I get it done twice yearly. But that`s choice.

I totally agree that it`s through poorly maintained IT that surgeries and hospitals can`t share patient data. And of course it is humans behind the maintenance. I suppose I could go back to plodding about with a card all year, getting hospitals to put readings on it, then getting over to my GPs to show it to them (assuming they are willing to let me in to the inner circle ie give me an appointment)