No idea why you think I should change my GP or practice as they are excellent.Perhaps you might think about changing your GP practice or putting your thoughts on the NHS Choices surgery review site - if enough people complain the CQC will almost certainly see it.
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 also got asked this whilst in an appointment. Howerver due to attending the hospital appointments every 3 to 4 months a year, I have opted out of attending the GPs for Diabetic Reviews. The reason being I have so many other health issues and going to the GPs for general appointments, I felt constrained in the amount of appointments I was attending. But everyone has their own choice and opinion on this situation.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.
I entirely agree - in principle! However I can't really see that people who're not prepared to attend a checkup are particularly going to be prepared to fill in such a form and return it.
I entirely agree - in principle! However I can't really see that people who're not prepared to attend a checkup are particularly going to be prepared to fill in such a form and return it.
Can I assume that they think you're managing your diabetes well and can be left to get on with it?
If so, their ignorance of diabetes is frightening.
Of course you need regular checks....3, 6 or 12 monthly is normal. Must say though, I had to ask my surgery for an HbA1c test after 9 months. The hospital eye clinic are much more on the ball and invite me in for checks.
Serious issues can arise quite quickly....feet, eyes etc.
I've not heard of any plans to cut check ups for diabetics. Hope this isn't a growing trend.
I perhaps wasn't clear enough about what I actually meant - I was thinking of people who don't or can't be bothered to turn up for an appointment rather than someone who would make it known that an offer of an appointment was not required.The apt and form is sent to me in the post, I look on line cancel the apt so it's left free for someone else and return the form declining the offer to waste my time.
I opted out as I don't need the regular check-ups with the GP as the clinic handles those. It seems sensible that I do it that way as the practice gets the money any way.
And besides, the Diabetes specialist GP works his ass off to do the Diabetic reviews, often in the office till 10pm making phone calls for the review. As a result, I do not begrudge the practice the QOF payments one iota. They are working hard for them, and that, in my book, is a virtue.
I opted out as I don't need the regular check-ups with the GP as the clinic handles those. It seems sensible that I do it that way as the practice gets the money any way.
And besides, the Diabetes specialist GP works his ass off to do the Diabetic reviews, often in the office till 10pm making phone calls for the review. As a result, I do not begrudge the practice the QOF payments one iota. They are working hard for them, and that, in my book, is a virtue.
Sorry, I wasn't clear. This isn't the calls to set up appointments. Due to being the prescribing surgery, even with care being run under the clinic, they do have to do an annual prescription review. Those of us who have opted out have the option of doing this over the phone as it doesn't require any physical checks. That's what he was doing at 10pm.If the GP is the person "often in the office till 10pm making phone calls for the review" then this is a poor use of his time because this is something that should be done by admin staff. I know that my wife (GP Practice Manager) has often said to doctors "you doctor - I manage" which of course is how it should be.
I am all of a dither on this one.
Ignorance is definitely NOT bliss and denial is self destructive.
But if we are monitoring closely at home, then personally I take my bg readings as a far better indication of how things are going than the HbA1c which seem to bear little relation to my home readings across time!
By opting in, the surgery gets a bit of income, and spends it on me, which I don't need because I am self monitoring.
By opting out, the NHS still keeps the money, and presumably it will get spent somewhere, hopefully more usefully, if I am already monitoring my own situation well at home.
People who don't turn up, or who don't respond to the letter, are very unlikely to be self monitoring, but at least the surgery has shown willing, and can prove that deterioration in the patient's condition isn't due to negligence by the surgery.
If T2 is (as the NHS believes) an ongoing deteriorating condition leading inevitably to complications, then regular checks are VITAL, even if they may only slow the downward spiral.
If T2 is (as I believe) hugely controllable, with care, diet, monitoring and NHS assistance (when needed), then those regular checks may not be nearly as necessary.
Can't really see a clear path.
Sorry, I wasn't clear. This isn't the calls to set up appointments. Due to being the prescribing surgery, even with care being run under the clinic, they do have to do an annual prescription review. Those of us who have opted out have the option of doing this over the phone as it doesn't require any physical checks. That's what he was doing at 10pm.
It may be, but when you are receiving a twice annual or annual check from the diabetes clinic, and your only medication is diabetes related, they don't need to have you in the presence of the GP to do it. As an aside, the clinic notes that are provided to the GP by Guys are very thorough, so they are happy (and able) to allow the secondary care team to manage that aspect.I am informed that it is normal practice for the patient to be in attendance with the GP for this to be carried out in case any additional checks are required.
I monitor at home as well but what about the other functions that are tested as part of HbA1c, cholesterol, kidney function, feet and eye examination - do you do these? I know that you said that you feel that your bg readings are a far better indication but how do you know that your meter is accurate - have you had it checked?
I agree with Brunneria. Before this thread was started, after my most recent annual review (another thread) I felt I didn't need to be seen by the nurse for Review, although would still expect the usual blood tests to be done. If I had any queries regarding my diabetes, or any indications that all was not well, I would make an appointment to then see the nurse, or the GP, whichever was the most appropriate at the time.Is this some kind of brainwashing by interrogation? Where you try and wear people down to your way of thinking by asking endless questions on the minutiae of their opinion?
As I said, I am in two minds as to whether it is necessary/appropriate for me to attend the checks.
I did not say which decision I had made.
Besides, your original question was 'Should patients be asked to opt out of Diabetic Checks'
Which is a very different question from the ones you now seem to be pursuing.
However to answer your latest dogged queries:
I place no reliance on my cholesterol tests having any relevance to my health
I have a home bp monitor
Eye exams are done at a clinic, not in the surgery, so they are not relevant to this discussion since the discussion has focussed on gp care
I don't see any special skills needed for the foot checks that I can't do myself when I bathe, clip my nails and apply foot cream
And as for the meter, I have a Freestyle Libre which I compare with a normal glucometer. And since I am T2, I am looking for trends and overall control, not the kind of accuracy needed for insulin dosing.
If I detected any issues I would straight round to the surgery.
Is this some kind of brainwashing by interrogation? Where you try and wear people down to your way of thinking by asking endless questions on the minutiae of their opinion?
As I said, I am in two minds as to whether it is necessary/appropriate for me to attend the checks.
I did not say which decision I had made.
Besides, your original question was 'Should patients be asked to opt out of Diabetic Checks'
Which is a very different question from the ones you now seem to be pursuing.
However to answer your latest dogged queries:
I place no reliance on my cholesterol tests having any relevance to my health
I have a home bp monitor
Eye exams are done at a clinic, not in the surgery, so they are not relevant to this discussion since the discussion has focussed on gp care
I don't see any special skills needed for the foot checks that I can't do myself when I bathe, clip my nails and apply foot cream
And as for the meter, I have a Freestyle Libre which I compare with a normal glucometer. And since I am T2, I am looking for trends and overall control, not the kind of accuracy needed for insulin dosing.
If I detected any issues I would straight round to the surgery.
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