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NHS - General Opinions


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Like everything else in life, GPs are a bit of a lottery.

GP training consists of a minimum three years post-registration experience in a variety of hospital specialities, usually 6 month rotations in each. Good GPs often do more than the minimum in order to gain experience in other fields before they join a practise, but there's no requirement to do one of their rotations in psychiatry and considerable financial disincentives to do more than the minimum legal requirement.

Most practices demand their new partners have qualifications in obstetrics, paediatrics, family planning and minor surgery, alongside a proficiency in cardiac and respiratory medicine, diabetes, epilepsy and more. Each of these brings money into the practise as part of how GPs are paid. There are currently no financial reimbursements for GPs involved in psychiatry and this is why practises don't require new partners to have training or experience in it.

However, considering 10-20% of GP workload is psychiatry related, not doing extra study in that area has always seemed to me to be a mistake. Especially for a doctor working in a single-handed practise.

These days the trend is for big practises with 6-10 GPs, so I agree there's no excuse for not having at least 1 GP among the group who has extra psychiatry training, or at the very least a special interest in the field.

But until the government treats mental health in parallel to physical health in terms of how they pay GPs, I doubt anything will change.

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I read a great post by the Labour Party, which was saying how each individuals well-being is a complex mix of physical, mental and social care, and how our healthcare needs to be treated accordingly.

http://www.labour.org.uk/issues/detail/whole-person-care

Its not too in depth, but I think it focuses on how mental and social care need to be treated with the same severity as physical health.

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There are currently no financial reimbursements for GPs involved in psychiatry and this is why practises don't require new partners to have training or experience in it.

I never knew that, very interesting and explains a lot :wontlisten:

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  • 2 months later...

The point is, there should be no bad experiences within the NHS. Mistakes, alas, might occur occasionally, we are all human (at present they happen all too frequently because of the lack of dedicated staff) but when it comes down to neglect, and bad treatment, it should never occur. Sadly, almost everyone I know has personal experience where they or a loved one has been treated badly.

I'm not a satisfied customer of the NHS but I have to say, bad experiences can happen without mistreatment having occurred.

A patient can sometimes feel that their experience was negative, simply because the treatment pathway didn't work for them.

I've been waiting a year for a referral to go through and there's nothing I or my consultant can do about it. The section leader of where I've been referred has taken it upon herself, to decide, never having met me, that I need to wait for the effects of another talking therapy which has now finished, to "have their effect". I've been warned that I have at least another 6 months to wait, that's right, 18 months for a referral while I sit rotting on ESA with daily suicidal ideation. But hey, you get what you pay for right?

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  • 2 months later...

I'm not a satisfied customer of the NHS but I have to say, bad experiences can happen without mistreatment having occurred.

A patient can sometimes feel that their experience was negative, simply because the treatment pathway didn't work for them.

I've been waiting a year for a referral to go through and there's nothing I or my consultant can do about it. The section leader of where I've been referred has taken it upon herself, to decide, never having met me, that I need to wait for the effects of another talking therapy which has now finished, to "have their effect". I've been warned that I have at least another 6 months to wait, that's right, 18 months for a referral while I sit rotting on ESA with daily suicidal ideation. But hey, you get what you pay for right?

Shocking , send a message to Ashley for his advice

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  • 5 months later...

 

2 hours ago, Werwulf said:

I have access to half an hour of CBT once every 3 weeks or so on the NHS. It may as well not even be there. Pointless.

I agree Werwulf! 

Where are you in the UK?  I am happy to advise on treatment options if I can.

Ashley.

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9 minutes ago, Ashley said:

 

I agree Werwulf! 

Where are you in the UK?  I am happy to advise on treatment options if I can.

Ashley.

Hi Ashley, I'm in north Devon. I've emailed all the accredited CBT therapists in my area and am currently awaiting replies. 

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The NHS is underfunded, poorly run, and - from one local rag I was reading today - hives off profitable bits to outside providers.And Mental health is an exceedingly poor relation in the service. 

Locally here in Waltham Forest they are looking at reducing the number of GPS - WHAT? there are loads more people in the borough now due to loads of new housing - that is just unacceptable.  

Edited by taurean
correction
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  • 3 months later...

Our local NHS hospital Whipps Cross is unfortunately really struggling right now. 

And it doesn't help that it is seemingly impossible to park there - the parks are always full. And there is no bus journey possible to the nearest local railway station. For a fit person, its a 12 minute walk.Otherwise, for us you need to use a taxi or two buses. And this option involves switching to the other side of a very busy main road.

I was spoiled when i was working, as the firm had private medical insurance, and I could get seen almost immediately at a lovely local private hospital where I could park. 

There are legion reasons why the NHS is in a poor state financially and resource-wise, and no government has really ever cracked it in recent times. Health tourism is just one of these. Maybe Brexit will tackle some of these issues, who knows. 

Getting to see a local GP. Well, I am better on that. I can usually be seen  the same day without a fight.

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  • 3 weeks later...

I hadn't realised just how close to capacity so many hospitals are - it sounds dire.

Tackling and providing social care so that elderly or vulnerable people can be safely discharged would help inordinately....but this should have been looked at years ago.....quite how the NHS will go from now is hard to tell. It really sounds as if it is in crisis.

My own experiences of the NHS have been excellent.......but how long will the overstretched staff be able to keep going?

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What would one do if running the NHS? 

I would make realistic appointment times. Last appt I had at Whipps Cross I was met with a sign saying the consultant was s already an hour behind. 

Overbooking appts just creates pressure.

I would write off some of the debt and bolster up essential services. 

I would insist on ID evidence  before treatment unless referred by a GP. Anyone not eligible for free treatment must be insured or pay - same as in many countries, and private hospitals. 

I would increase national insurance charges. 

I would simplify the management structure and look at eliminating unnecessary duplications. 

That would make a start. 

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  • 4 weeks later...
On 09/02/2017 at 09:15, taurean said:

I would simplify the management structure and look at eliminating unnecessary duplications. 

This is the area that needs most sorting out.  Also, I would put a cap on salaries and pension packages for these senior executives.  None of them should be earning well in excess of the Prime Minister.  Until this is sorted, neither will the problem be

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26 minutes ago, Caramoole said:

This is the area that needs most sorting out.  Also, I would put a cap on salaries and pension packages for these senior executives.  None of them should be earning well in excess of the Prime Minister.  Until this is sorted, neither will the problem be

Brilliant assessment Caramoole :goodpost:

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