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Diabetes and liver - online access.

DavidGrahamJones

Well-Known Member
Messages
3,262
Location
Hazlemere
Type of diabetes
Type 2
Treatment type
Other
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In England only, all surgeries were asked to put these on-line from April 2016. Not all surgeries have complied, but most seem to have.

I started my missive on another thread and it was so far off topic, I've started another thread, because the workings of our surgeries needs a bit of looking at.

Using the word "complied", seems to imply that the surgery hasn't done what it's supposed to do. It's not always that they haven't bothered, there's a lot of work involved in setting up online patient access, there is also some resistance not by doctors but by practice managers. Online systems are available so there's no systems development, but some surgeries, like my wife's have found that although they thought they were ahead of the game by getting into it before 2016, they now find the powers that be wanting them to use a different system which is adding to their costs. These systems generally also allow patients to make appointments online which you'd think was a good thing. It is for patients, although at my wife's surgery 4% of the patients are making 20% of the appointments and now they can do it without any form of triage. This is not fair on the other patients.

I've mentioned this before but getting involved in a surgery's Patient Participation Program, something else surgeries are encouraged to set up, is a real eye opener and allows insight into what really goes on in a doctor's surgery. My wife has spent a couple of days at her surgery encouraging patients to provide eMail addresses and mobile phone numbers so that the surgery can more easily provide appointment reminders to overcome the ridiculous number of "no shows". They managed to get 100 lots of details out of 11,000 patients, so obviously a better method of getting the details is required. Seems the receptionist believe that they are too busy, but I think it just needs a piece of paper for you to write name/D.O.B/eMail/mobile, nobody sees your details except the person at the surgery who enters the details. There is a problem with most elderly patients who have PCs, Tablets, mobiles, but don't use them.

It's worth baring in mind that when a surgery does start putting results online it may not put all of your old results online. My GP has told me categorically that only results received after a certain date will be available online. Th cost of digitising all the old records (mine go back to 1952) would be horrendous, well outside the budget of most practices. There's only 4,500 patients at my practice and three part time doctors, I understand the difficulty in getting everything online.

There are organisations that help with this "setting up" of digitised records. They look after all the paper records for a surgery and when somebody actually makes a request for their records online, the organisation digitises all of their records and makes them all available within a matter of days and therefore from then on. It costs money, obviously and not all surgeries have chosen that route, including mine, it's a business decision. I can still access my records, just not online before a certain date.

If you look at a document called "Patient list size and GP count by Practice" (should be available at https://www.nhsbsa.nhs.uk/prescript...practice-list-size-and-gp-count-each-practice), you will see that some practices have less than 1,000 patients per doctor whereas others have 2,000 patients per doctor.

If you take a typical surgery in large towns with 10,000 patients and 5 doctors, you can imagine the problems digitising all the records of 10,000 people. If you then consider old geezers like me, it's probably only the last 20 years that are relevant to my current medical conditions anyway. Making records available online isn't a case of waving a magic wand and hey presto, it's done.
 
I appreciate that there are time and cost implications for cash strapped GP surgeries in maintaining online medical records. But I would have thought that all GP surgeries do use computers these days to keep current patient information, even if they haven't been able to input historical data. Access to this would be better than nothing as it should give information about current or recent test results.

I got access to my records after requesting it for 6 months. In my case I don't think it was the fault of the Practice Manager, but due to the general incompetence of the GP to who I am registered, though I haven't seen since my first appointment with, 17 years ago. As a result of which I never made an appointment with that GP again. Reading online reviews of my GP surgery, that GP has almost entirely negative reviews.
My GP surgery does seem to be in the pre-internet era. There is no email address or internet access, apart from the ability to get repeat prescriptions and make appointments online. And that isn't generally made known to patients. I only found out I could do that from this forum. I can't even speak to the GP or practice nurse on the phone, or if I call in to the surgery. The only communication is by letter.

They could actually save time and money by having internet and email access. As it is they write to me to tell me when test results come back. Surely an email would be quicker and cheaper.
 
My practice is one of those that hasn't put results online. I can order prescriptions and book appointments - although only 1 at a time, which is frustrating when I book a routine appointment in advance and then need to go in for another reason.

Getting blood test results from the receptionists is very difficult so I end up booking an appointment with the GP, who will happily give me a print out. Now that my diabetes is fairly well controlled, this is a waste of an appointment and it would surely be more effective for me to be able to see the results online and book an appointment if there is something that needs discussion, or for the receptionists to just give me a print out.
 
They could actually save time and money by having internet and email access. As it is they write to me to tell me when test results come back. Surely an email would be quicker and cheaper.

Obviously I can't speak for every surgery in England, as you say eMail would be quicker and cheaper which is exactly why my wife's surgery is trying to get the relevant bits of information. The PPG at my wife's surgery is trying to help the practice manager to get this information and has been demonstrated, 2 people in 2 days have got 100 eMail addresses out of 11,000.

The thing with results also is that the doctor has a right (for want of a better word) to see the results first and at least they tell you that the results are available. What size of practice do you go to, GPs and patients? Have you had the opportunity to discuss your thoughts, eMail is obviously quicker and cheaper? There are issues with the Data Protection Act to be considered, has your surgery held back because of and concerns in that area?

I don't believe that it's as straight forward as it seems.

I haven't seen since my first appointment with, 17 years ago.

They were probably wondering who you were? LOL
 
I have seen other GPs at the practice in the 17 years after seeing that GP.

I don't know how many patients there are registered at the practice. I would guess there are a lot as it's in a busy densely populated inner(ish) London borough. I think there are six GPs.
Having finally got online access to my records, which are only from when I registered there 17 years ago, I saw my last test results before i got the letter telling me to make an appointment to see GP to get them. I didn't make the appointment as I already knew the results, and I knew the GP would only tell me I should go back on statins, and I would decline again. So the GP's time (and mine) was saved.
I don't know why they are not more accessible online. From posters on here some GP surgeries are excellent at online communication.
They do have a suggestion box, and I will drop in a note next time I go there suggesting more online accessability, but I doubt that anything will come of it.
Don't get me wrong, I do really appreciate the NHS, and the GPs I usually see, but I do think they could fairly easily improve the way they communicate.
 
The on line system at my surgery is not user freindly and it is time sensitive. I have tried to copy out my test results and firstly they are separated by date parameters and 'hidden' in lists such as 'coded information'. I gave up after I timed out twice and decided to ask the dn for a printout at my next appt.
I joined this practice just a few months ago but my paper records are still not there so the doc is working blind, so to speak.
 
I phoned my practise couple of weeks ago to see if I could have Mays blood results and was told I need to fetch a letter detailing why I want them, some ID and it would be 30p a sheet for them. Going to see if I can get them on my three months review in a couple of weeks. How did you guys get yours?
 
Stockport CCG has now got all their GP on the same software, however, it was painful for some GP who had to change software vendors. Now the "out of hours" services can see and updates all records, and the local hospital have access to all GP records - when the patient gives approval for them to access them.

They wish to get all chemists having access to full medical records when the patient agrees (for drug reviews etc) but are finding that harder as each chain of chemists has a different national wide policy on the software to use, along with issues with data protection and pharmacists often doing a few shifts in the CCG area but mostly working outside the area, hence training issues.

There is a national shortage of GPs, but it is claimed its easy to find pharmacists to fill jobs, hence the CCG is trying to make better use of pharmacists - so maybe soon someone will be able to get a 30 minutes appointment with a pharmacist to have their test results etc explained to them along with the doctors comments that are on the on-line records.

When I changed GP, I confirm by email with the practice manager what they policy was with on-line access to test results etc. Within 24 off completing the form to change GP and setup on-line access, I had full access to the last few years test results. (My old practice was still in the dark ages making it hard for people to get on-line access.) Paper records take a lot longer to transfer, but most digital records can be transferred between the common vendors of GP software within a day.
 
If you take a typical surgery in large towns with 10,000 patients and 5 doctors, you can imagine the problems digitising all the records of 10,000 people. If you then consider old geezers like me, it's probably only the last 20 years that are relevant to my current medical conditions anyway. Making records available online isn't a case of waving a magic wand and hey presto, it's done.

That is fair point @DavidGrahamJones , it would be a logistical nightmare for such surgeries, but minus the patients who are not bothered about having access to their medical records and the figure would be more manageable. TBH if I didn't have a life-long condition like diabetes I wouldn't be bothered about patient access in the slightest.

I appreciate that there are time and cost implications for cash strapped GP surgeries in maintaining online medical records. But I would have thought that all GP surgeries do use computers these days to keep current patient information, even if they haven't been able to input historical data. Access to this would be better than nothing as it should give information about current or recent test results.

Agreed @Prem51

Despite 2 letters I can't view my medical records on PA, when I click on Browse Medical Records all I see is a list of my repeat prescription.....................nothing else :banghead:

Only other thing I can see is upcoming appointments, I've now give-up and won't be bothering anymore.
 
My surgery has been excellent. We had Patient Access for repeat prescriptions and appointments a very long time ago. Then we got all vaccinations received and a list of allergies if any. The full service of test results, consultations, diagnosed problems etc was on-line and available before the NHS England recommended date of April 2016. Brilliant service.
 
I've now give-up and won't be bothering anymore.

It seems to be a very usual behaviour when faced with anything offered by a computer. I have worked with computers since 1973 and I detest the horrible things. Even HID gave up using her surgery's online repeat prescriptions facility when it would no longer accept her password. Until one day and with some spare time she decided to tell them and it was sorted out in 10 minutes.

That's a shame that you've not had any replies after two letters and I'm not sure what I'd do if faced with the same problem. Even if they said you can't have it would be better than no reply.

It looks like everyone is having varying experiences depending on their surgery, or maybe Primary Care Trust or whatever it's called. Even trying to find what we're entitled to isn't that clear.
 
I phoned my practise couple of weeks ago to see if I could have Mays blood results and was told I need to fetch a letter detailing why I want them, some ID and it would be 30p a sheet for them. Going to see if I can get them on my three months review in a couple of weeks. How did you guys get yours?
I applied for online access to my medical records and test results after my annual HbA1c test last September.
I had to fill in a request form, and a consent form saying I understood that I might see information about myself that I might not want to know.
I still hadn't heard anything six months later. So I went into surgery again and was told I needed to show photographic ID. I also handed in a letter requesting a printout of the previous HbA1c.
I took my passport in the next day, and they took a photocopy of it. I was given the HbA1c result printout, there was no charge .
Three weeks later I still did not have online access, so I went in to see the Practice Manager who wasn't in.
I rang the next day and was told the Practice Manager wasn't in her office, but would ring me back
She rang two days later, and I asked what was happening with my request for online access. She said she would find out from the GP. She rang me again 15 minutes later, and said the GP had approved access, and my records should be accessible online shortly.
I checked the next morning and they were there.
 
That's a shame that you've not had any replies after two letters and I'm not sure what I'd do if faced with the same problem. Even if they said you can't have it would be better than no reply.

The first letter was to ask that my medical records were made available on PA, I was told to do this by the Practice Manager.

After a period of weeks and not hearing anything I rang the surgery again and spoke with the Manager, they made some excuse that the surgery weren't allowing full access to medical records at that time and it was something they'd be considering doing in the near future, apparently it was a joint decision by the practice Dr's I was told.
 
I checked the next morning and they were there.

Result! Excellent! It should be made easier, but . . . . . . . It's a culture shock for possibly everyone, users and providers and I think that sometimes we forum members might forget that we are exceptional in that we want to know about our health and want to work with our GPs to stay as healthy as possible. We are an unusual breed of people indeed.

I'd like to mention something that my wife saw on her day in the surgery trying to persuade people to use their eMail and mobile for communication. Two different patients with appointments couldn't understand that with an appointment system you will be seen in the same order as the appointments and not when you come in. Some surgeries do operate that system and you might even have a number given to you when you turn up. Both of these patients made a scene accusing the receptionists of favoritism, allowing other patients who came in later to be seen before them, completely overlooking the fact that the other patients had appointments before theirs. Not easy dealing with people, they make customer service so difficult sometimes. LOL
 
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