Tag Archives: general practitioner

How to waste your time visiting the GP

CCGs find a use




Someone has finally found a use for CCGs (Clinical Commissioning Groups);  the extra layer of quangos




set up by the last Minister of Health. They are generating so much paper-work, etc., that  Pulse, the doctor’s magazine, says up to  25% of GP appointments could be avoided.




At last someone is realising what a waste of time so many of these appointments are, but how else are we to get our referrals to Consultant for treatment we know we need, without going via GPs for the obligatory ‘referral letter’ and other time-consuming procedures?  Unlike appointments in European hospitals, whee they assume their patients have some brain and know what’s needed. Continue reading

Patients DO know best

Now doctors agree

Pulse is THE magazine that goes out to GPs.  A recent issue had a fascinating article about letting patients refer themselves to Physiotherapy.

English: NHS logo


The article came up with the conclusion that doing this had “slashed care costs by almost a third compared with referral through a GP, a study by one NHS primary care service has found”.

Apparently the sensible folk in Barnsley introduced a self- Continue reading

NHS thinks we are stupid

Fuss about patients going to A & E –

NHS says we should be seeing GP

BUT Patients Association says most patients are ‘right to go to A&E’

The Fraser Centre, Milngavie (Glasgow) where t...

Ninian Reid

saying “New research published by the College of Emergency Medicine (CEM) has revealed that just 15% of attendees at Emergency Departments could have been seen by a GP in the community without the need for Emergency Department assessment”.

In other words, they know better than the Dept. Health, NHS Continue reading

Aussies provide good after-cancer care

NICE approves Australian products

– Cancer survivors take advantage

flexitol_prescription_hand_balm_75g_carton_tube_right_0Flexitol Heel Balm and Hand Balm is medically approved treatments for dry, cracked feet and splitting nails and hands. These were recently reclassified as a medical device by the NHS BSA pricing prescription division, and are part of a range of skincare products developed to help patients ‘Down Under’.

This means YOU can get these on

prescription – FREE!

Continue reading

People Power Works!

A landline telephone

A landline telephone (Photo credit: Wikipedia)

0844    0844   O844    0844    0844    0844    0844    0844 

Company to stop marketing 0844 numbers to GPs

The latest issue of PULSE MAGAZINE, the Doctor’s in-house journal, has a very interesting story proving that ‘people power’ still has clout. It says “A major supplier has promised to cease marketing 0844 numbers to NHS organisations, due to public opinion over the use of premium numbers by GP practices.”

Now The Daisy Group, which owns the Daisy Line Surgery telephone service,
installed in more than GP 2,000 practices, has said it will stop marketing 0844
numbers to NHS-related organisations due to public pressure. Mr Andrew Goldwater, commercial director of system services for the Daisy Group said that they will bow to public opinon and stop proactive marketing 0844 numbers to practices. So in future, once there is no incentive to keep patients hanging on, you might even find you get through quicker. However, be warned!  The Daisy Group has announced they will “continue to work with our GP customers to develop
alternative solutions, supporting them by providing them with the products of their choice.
Mr David Hickson of campaign group Fair Telecoms said the Daisy Group should go
further and assist all practices currently using 0844 numbers to switch to the
equivalent 0344 number.
In which case, those of you who have BT Option 3, or similar packages, will get
these calls for free.

NHS shoots itself in foot – again

English: NHS logo








My Heart Surgeon leant over the desk: “now I have to tell you the risks”.   (Having just been told I needed a 7-hour heart operation, surely I was savvy enough to realise that carried a huge risk?)

“If anything happens, will I know anything about it?”

“No – you will be under anaesthetic” he told me.

“Right – then it’s your problem”, was my reply, and we went on to more sensible questions.

What Doctors are For

Drugs had produced my heart problems, and I relied on my doctor to choose the best person to operate and repair the damage.  I SO did not need ‘Choose and Book’;  faced with a list of possible surgeons, I wouldn’t have had a clue whom to choose;  but a sensible doctor would know which surgeons had a good record for survival, because they had accepted ‘last hope’ cases whom no-one else would help.

NHS Interferes

 LaLaLite (the new Health Minister, Jeremy Hunt) is showing  just as much grasp of essentials as his predecessor,   LaLa Lansley.  Latest dictat info from Richmond Towers says “surgeons will be ranked by how many people die in their operating theatres”. 

This means a junior doctor, newly qualified and only trusted with the most basic procedures, will be top of the tables;  an experienced surgeon with patients queueing up from around the world, who will operate on many ‘no hopers’, will probably be way down the bottom of these silly, time and money-wasting statistical tables.

Can we please get back to sensible health care, where one’s GP is trusted to do their best for their patients, not waste valuable time and money having to compare paper statistics?

 Does anyone listen?

After shooting itself in the foot, today’s dictat is called

 Everyone Counts.

Well, if the bean counters in Richmond Towers haven’t noticed, is there any hospital really operating ‘7  DAYS A WEEK’?

LaLaLite obviously inhabits the same Alice in Wonderland country as his predecessor.

Wonder how much this latest exercise cost us? 

Has anyone thought if they got down to actual work, instead of writing Fairy Stories (even though it is Christmas) they could go a long way to saving the money the NHS needs.

But I suppose this will mean a lot of ‘Consultants’ will be out of work.  Well, if this is the standard of their work, a good thing too.

Enhanced by Zemanta

Warning on taking medicines

Dr. Grumpy’s latest warning

Grumpy Bear in the Nelvana episode "Home ...




Dr. Grumpy is an American GP (or MD as they are known in the States).

He records the weird observations made by his patients – latest is one about which he says “I have a bad feeling about this

Dr. Grumpy: “What medications are you on?”

Mr. Scattered: “I don’t know. Whatever my girlfriend puts in my pill cup.”

Dr. Grumpy (to girlfriend): “What pills does he get?”

Ms. Girlfriend: “I don’t know the names. Whatever his mother tells me to give him.”

Dr. Grumpy: “Where can I reach your mom?”

Mr. Scattered: “She’s in jail.”

Enhanced by Zemanta

How we ran an event – and almost had to close the doors to newcomers


Kensington and Chelsea LINk ran a fun event designed for cancer patients and by cancer patients.

This was probably the first time such a large event had been organised.  But why did they do this?

Several reasons:

  • Cancer Patients often complain of feeling neglected and abandoned
  • When their ‘treatment assembly line’ finishes, they can find it difficult to tie up all the loose ends, deal with side effects, find where to ask advice about benefits, etc.
  •  Often it can be difficult to difficult to  find information, especially on dealing with side effects, as these may not follow a ‘normal’ pattern
  • There are many services available, but patients don’t know how to get information about them
  • They are told to “ask your GP”, but doctors may not be able to keep up with all the latest information

So Kensington and Chelsea LINk cancer group had the idea of bringing helpful services and products together under one roof, as a Wellbeing Day.  Organised by Ijeoma Igwume, and assisted by  Simmone Hall who MCed the event, it turned out to be so popular that at one time organisers wondered if  ‘Elf ‘n Safety” would make them close the doors because so many were queuing to get in!

This is my unofficial account of how we planned the day, and what happened.  I work on the cancer group, and was delighted to see how an idea mentioned in a committee meeting became a wonderful reality.  This is my slant on the day – NOT an official account.

With many thanks for photos by Barrie Leyshon of Cancer Voices, and others.

End Result

The Event was an incredible success;  many of the visitors asked and emailed to say ‘run it again’.  People were going round with big smiles on their faces.

Speakers such as Mark Davies (who wrote ‘ Saving My A*’) had standing room only for their talks;  the companies who generously provided goodies and took stands were asking “when is the next event?”, and two of them, Urban Retreat at Harrods and The Organic Pharmacy, have already said they are going to carry on offering more services for cancer patients.

Stop PressPaul’s Cancer Support Centre in Battersea has just announced they are planning on running not one but two similar events, copying the format.

So K & C LINk’s trail blazer proved that there is a need to have information available for cancer patients, of the kind that medical staff are often too busy to provide.

The Event must have been interesting.  Having come to open it, the Mayor, Councillor Julie Mills, enjoyed herself so much she came back again in the evening!  This is her on the stage; also in the photo is Paula Murphy (left), in charge of the hard-working LINk team.


Anecdotal evidence showed that about 50% of the visitors were from the BME community – which LINk are keen to contact.

168 visitors filled out a questionnaire  – a very high proportion of those attending

4 major events are planned for cancer patients as a result of being shown what could be achieved

And as an added bonus LINk said that they picked up new members.

So if you want to run your own event go for it – and here’s some background information to help you run a Wellbeing Day


This web page leads you to articles about all the different companies who contributed;  who won top prizes; and background information about the companies that participated:


Please feel free to copy and write to those contributing.  Many of them are only too pleased to help.  They make products that will help cancer survivors, but often the NHS doesn’t have time to try them out, evaluate them and promote.


Patients, members of support groups, nurses, therapists, physios, members of cancer charities, GP surgery staff and doctors


We worked with Macmillan to target the BME community, and in return they gave us generous sponsorship.



Gives a summary of articles about the various companies that generously gave us fantastic amounts of goodies to pop into bags.

Vikki Ullah invited me to lunch afterwards and I had great fun trying on their wigs (cost £100 upwards and they accept NHS vouchers).  During lunch there was  very positive outcome in a long discussion about various initiatives that they already offer, or are hoping to offer to cancer survivors.

A really positive result!



All these were generously covered by a Macmillan grant, which also provided enough funds to enable us to offer refreshments too – most welcome and lots of people commented on this.

If you can’t get sponsorship to pay for food and drink – think local supermarkets.  Firms such as Waitrose and Tesco often have a policy of helping local charities and will donate tea bags, coffee, milk and often eats as well.  Approach the local Store Manager (not the Head Office).

Just don’t forget you will need volunteers to serve, clear up and wash up!


Aim high.  If a venue, hotel or sports centre is opening, ask if you can ‘use’ their space in return for publicity for the new venue.

Football clubs, racecourses, swimming and health centres etc. often have suitable space.

It helps if you are going to invite a personality that will give the venue  media coverage

In the States many cancer hospitals will ‘lend’ their reception space for the day.  Try your local NHS hospital. However, asking for another event, I sent long detailed emails when hospitals asked for them – only to find I didn’t even receive the courtesy of a ‘thanks but no thanks’  reply.


We found that Macmillan had funds to sponsor events particularly targeted at the BME community;  this was a natural for any major city such as London – so thanks to a generous grant we were able to provide door prizes, refreshments etc. for free, and didn’t have to charge stand holders.


Since Macmillan had provided sponsorship, we didn’t have to charge companies to take part.  So instead firms such as Flexitol and Synergy were incredibly generous, and provided boxes of samples for our Goody Bags instead.  We also had representatives from Age UK, Citizens Advice Bureau and local Advice charity Nucleus, Royal Marsden Hospital, Paul’s Cancer Support Centre, Cancer Charities, Krish Shastri whose stand provided information about travel insurance (another very popular stand), Macmillan, Europa Donna, Organic Pharmacy,  etc.

Particular care was given to providing information to help the BME community;  this is a major concern in this part of London.  Talking to a BME leader, she said that although the Macmillan questionnaire said that 12% were from this sector,  anecdotal evidence suggested we got nearer 50% attendance, but many might not have had time to fill in forms.


I used to run events for the Lifeboats with John Sainsbury (now Lord).  One could see he was going to go far because he got on with the work.  Two of his favourite maxims were

“the best committee is a committee of two – with one person ill”. 

And “if you have a committee, get them decide on the important issues, like the colour of the tickets;   leaving your committee of two to work out the rest of the details without discussion“.

But, we were agreed that you need a committee – a big one – if you have to sell tickets.  Luckily for us, Macmillan gave a grant which enabled us to run the event and not charge visitors.

So Ijeoma Igwana and myself communicating by email, was incredibly effective.   Aided by some special help from Gaenor Holland-Williams, who was brilliant at getting the very popular stands offering benefits advice, such as Age UK, Nucleus, etc.


This can vary: your local cancer centre might be very supportive but not have anyone to spare to help you;  another group will go out of its way to be supportive.  So, realising that these Centres were over-stretched, we asked them to distribute invitation flyers, and had one centre present which has several BME groups in its membership.


We had a separate room with a platform, ideal for various speakers.  We asked representatives of cancer charities and the Prostate Cancer session was full.  Mark Davies spoke, and promoted his book.  Local hospital provided a dietician/nutritionist whose talk was tremendously popular.  Another speaker talked about how to handle the new benefits claims, etc.  Organic Pharmacy had a very popular session;  you will probably find major pharmacy chains such as Boots or Lloyds would be happy to provide speakers.

And the session with a local dance group entertaining was tremendously popular;  just make sure the singing and dancing are contained, as otherwise those in main hall trying to talk to stall holders can’t hear themselves think!

Only time there were spare seats was in-between speakers


This corner was very popular.  Local Spas will often provide mini-massages, make-overs, manicures etc. in return for the publicity they gain.  Make sure it is as quiet as possible, and away from main crowd.


It is vitally important that guests get something, even if just a cup of tea.  You may be obliged to make use of the Venue’s catering company, in which case see if you can get a supplier to sponsor refreshments.

If you are allowed to supply catering, don’t forget you will need people to do serving, washing-up, clearing etc. People will volunteer, but you need plenty!

If you want supplies, local branches of Supermarkets such as Tescos and Waitrose have a policy of helping local charities.

If you need to contact a company, go on the Internet, find out who is their PR company – and approach them. The PR company has to provide exposure, so will love the chance of saying XXX number of people will be present and persuading the company on your behalf that it would be a good idea to donate what you need.  This can often get a better result than you approaching the company direct, unless you are friendly with one of their major executives – or you happen to work for them.

If providing food, remember some will be vegetarians, or have had cancer;  we were offered curries, but had to turn these down as patients often can’t take highly spiced food.  Bland is best!  And ensure food and contents are labelled clearly.


Difficult to get the actual bags;  I had been promised these by a PR company, but they lost their Over-the-counter medicines account just before the event, so didn’t have any to give us.  So it was a mad scramble at the end.

But – filling these was no problem.  Companies were incredibly generous.  See

www.after-cancer.com/category/a-wellbeing-day/  for ideas.

Often it is better to approach the PR agency handling a company’s press, rather than approaching the company direct.  You find out who they are by looking on their website under Press or Media mention.

If you offer any products make sure they aren’t likely to cause controversy.  We handed out cans of a new beverage,  but I made sure this didn’t contain ‘E’ numbers and was ‘pure’.  Same thing with over-the-counter remedies;  Rohto provided samples of eye drops that help with ‘dry eye’, but I checked with an Opthalmogist who often recommends this product.


One set back was caused by Trend-Micro, a company that had been employed by the NHS to filter out Internet spam.  They blocked every single email coming from a major ISP provider – and one happened to be my supplier!  So emails due to be sent out reminding people about the event disappeared into the ether.  However, if we had had more the doors might have had to be closed!We had an unexpected set-back:

The North West London Cancer Initiative group is the overall cancer body for our area of London.  Two weeks before our event, we get to hear they had called a massive conference for the same day, so theoretically all their 400 members would be going to this conference, instead of coming to us.  Several of this group said they were horrified, and were coming to or event as they wanted to know what patients wanted, and what was provided for them.

So much for ‘Patients are at the centre’, etc!


Don’t underestimate the time it will take to organise and confirm arrangements.

But at the end it will be incredibly worth-while.  I couldn’t believe how many lovely congratulations came our way, and at the end I was presented with a plant that is still sitting across the room.

So if you want to organise a similar event, Go For It!  Best of luck!

Enhanced by Zemantas

Understanding NHS jargon

Keeping up-to-date

Peter Carter, British nurse and General Secret...

Peter Carter, General Secretary of the Royal College of Nursing: Wikipedia


You are going to hear a lot about CCGs

(Clinical Commissioning Group)

This is one of the new terms in LaLa’s weird vocabulary.


This week LaLa himself came out of his Whitehall bunker to appear at the RCNurses’ conference;  bet he wishes he had stayed put.

One delegate reported on a comment to the Minister from the general secretary of the RCN, Peter Carter. As LaLa had used his jargon-filled speech to deny there was anything wrong with the NHS, a friend reports  Carter rounded on him and told him:

“Because conference has been polite to you, do not leave here thinking we are happy, satisfied or relaxed about the future. We are not.  We are very upset.” As one, the Congress rose; a standing ovation for their leader.

Other members of the audience used less elegant language;  one nurse calling him “barmy”.  Non-PC in today’s NHS jargon, but very apt.


LaLa and his minions seem to speak a different language to the English I learnt growing up.  Understanding what is being said needs an interpreter to translate the jargon.

To find out more I go on the Dept. Health website for clarification.  And had to give up before they carried me off screaming.  The front page tells me about a raft of pages that will tell me everything from how they get their authorisation papers (don’t ask) through to the adult social care engagement exercise.

In other words, they daren’t explain why LaLa got rid of three tiers of admin to create five.  Nor what the dictats mean.  No wonder the NHS is a massive employer;  they need the minions to think up these jargon-filled slogans.

Interpreting the jargon

So I turn to the invaluable  Roy Lilley of nhsManagers.net, who tells me CCGs “are the new celebrities in the NHS.  I’ve listened to a good few CCG chairs in the last few weeks and I think I’m beginning to get the hang of it”.

Emotions range from schoolboy enthusiasm to downright cussedness. The GP’s who want to commission care so that they can tidy-up some irritations and anomalies in local care pathways and others who seem to have old scores to settle with the local hospital.  (Wish my doctor would copy them).

But your CCG may take some time to get going.  Lilley says, “One CCG chair proudly announced they were having a ‘time-out’ to ‘develop their constitution’. When Lilley asked him why they were not adopting the DH model constitution, there was a pause and he replied; ‘What model constitution? No one’s told us about that”.


However, most CCGs have got their priorities in order. They have bought iPads.  The funny thing is on recent visits to superb Consultants, I notice every one of them using an old-fashioned fountain pen to write up their notes;  not a keyboard in sight.  You could buy a pretty snazzy Mont Blanc for the cost of an iPad.

“We all know these are risky reforms, even in the hands of the experienced they would be a danger. In the hands of the well-intended part-timer they are a menace with the potential to be a hazard to health and a peril to the public purse. LaLa can’t say; ‘No one told me that.”  But as patients we might cast a beady eye over the expensive gizmos that are going to be carried around by all the members of these CCGs, and question who authorised them.  Then ask “what about data protection?”  if CCG members go on about sharing info.

But to ensure that our local CCG gets off to a flying start, ‘my’ GP has been unavailable for three days a week for the past year,  whilst she works at setting up the local group.  I have done my bit to help;  three times I have turned up for appointments, only to be told “Dr. X has cancelled your appointment – didn’t she tell you?”  Instead, I have ended up with the newest drafted-in Locum;  nice chap.  I just need to train him to send off referral letters promptly.

Latest Jargon dictionary

Cancer Pathways  The National Cancer Action Team is supporting a number of initiatives to help develop stronger commissioning of cancer services. Part of this process is to ensure there are clinically effective pathways, accessible through the Map of Medicine, against which cancer services can be commissioned.

Clusters – No, it’s not the nutty ones, although I am beginning to feel like one.  It refers to what happens when lots of quangos join up together to make sure they can have even more meetings together.  Very sociable over the tea and biscuits they are.

Development opportunity  – what’s given to the new Outpatient receptionist who manages to lose all your notes

Mission statement – telling them to devise a mission statement has got to be the best way of giving someone employment to produce a fatuous statement highlighting the blindingly obvious.

moving forward – opposite of what happens after the hospital committee has put in ‘improvements’

NHS Choices – the appointments office whose job it is to confuse you so you are unable to make an appointment that suits you,  With any luck the appointment is so much in the future you go privately, taking you off the list and saving the NHS money.

QA – quality assessment   These are the reports hospitals now have to produce for their local LINks.  Theory is they identify quality of hospital’s service.  Actually, a test in how those who compile QAs manage to ‘overlook’ items of important to patients, such as MRSA, Mixed Wards, etc.

Stakeholder engagement – NHS website explains this is all about “building relationships with people who (sic) you affect through your work, or who could make an impact on your success.  It is the foundation of effective organisational responsibility, and refers to the formal management of the human dimensions of change”.

Er – don’t they mean ‘getting on with people’?

World class –  NHS services on a par with Third world services

LaLa and his minions need to go back to school and learn to speak modern English. Not expect us to swallow the  clap-trap the hierachy spouted to serfs behind the old Iron Curtain.

Enhanced by Zemanta

Health Bill cut backs can be challenged

PCT decisions are NOT final







The Royal Marsden Hospital Pain Clinic was quite definite:  I needed a course of 22 Manual Lymphatic Drainage treatments for my swollen limbs.

They had tried the ‘usual’ bandaging, raising limbs (who can do that today?), cut out all salt etc., etc. and nothing worked.  At times I just wanted to get a Stanley knife and plunge it into my swollen skin.

So I went to see my GP to ask them to get authorisation for this exceptional spending, by applying to my local PCT (Primary Care Trust).   They were reluctant to do this, trying every means of sending me backwards and forwards to the Marsden’s Lymphoedema nurses. Eventually, they very nicely said they had told me and told me they couldn’t do anything;  probably because I had other problems that might have been caused by the fact I had had polio, and side effects from cancer drugs had given me such dry skin that wearing tight support hose was painful.

After having kept on and on all last Autumn, asking when I might receive an answer, I received a copy of their reply to my GP at the beginning of April.  My heart sank.

The panel made a unanimous decision to decline funding on the grounds of existing commissioning services available.  

In reaching its decision, the panel followed its ethical decision making framework as well as the evidence you provided in support of the patient’s exceptional circumstances.

No mention of where and how I could obtain these ‘existing commissioning services’.  I knew these did not exist, so someone was prepared to write about a non-existent service to get out of funding treatment.  This needed a lot of thought, as I plotted what to do next.

In London we are finding we are becoming victims of the ‘post-code’ lottery, particularly when it comes to Lymphoedema services.  So I decided that first thing to do was find out what are existing commissioning services available. 

Then things started to get interesting.


For the next week the PCT and I played a game.  I would phone to ask what services were available.  Was told that the ‘ethical’ panel had said that these services were available in my part of London.  I knew that there was one service sometimes available to patients, in a far area of North London, which was vastly over-subscribed. But nothing else.

Several phone calls later, I discovered that this panel had been listening to rumours, and without any justification, had taken these as fact.  I kept on phoning to ask where was the service? whom did I contact?  How did I join it?

The PCT kept on saying “we’ll call you back”.

But never did.

When I would call back to speak to the original person – who hadn’t bothered to call back – I was constantly told “they are in meetings”.

Gradually I teased out the ‘facts’ on which the ‘ethical’ members of the panel had based their judgement.  The service had been talked about, according to nurses at the hospital.  Someone was going to start this, but had left again.  There were rumours that the hospital were about to interview a therapist.

I went to see nurses, receptionists and admin. at the hospital.  Was either met with a blank face, or a nurse telling me they had thought about it ..but …..

All these rumours had formed the basis for the ethical panel members unanimous decision to turn down my application. !!!!!

Blowing my top

Eventually, being sure in my own mind that this service definitely didn’t exist, I started to phone the PCT to speak to the person who had signed the letter.  Surprise, surprise.  Again, she was constantly ‘in a meeting’, but would phone me back.

So I would wait – and then phone back.  She was still in meetings;  this must have been the longest in history.

After a week I blew my top.  And started to mention that I was going to contact my MEP in Brussels.

I knew it was no good approaching any Conservative or Lib Dem MP (even though ours is a very good one) because they have to toe the party line when it comes to Health.

But MEPs – that was a different kettle of fish.  But I didn’t have time to Google ‘Your MEP’ before I was phoned by the official who had been in meetings all week, and told that my application had been approved.

And I am off this week for my first treatment.

Who else can help?

The MedLaw website  is a self help tool for patients to make applications and appeals for NHS funding for treatment. Information and guidance is provided on the processes to follow, the forms to complete, the evidence required and on the law.  It is written clearly, easy to understand, with a lot of sensible advice.

As they say, “many treatments are not routinely funded by the NHS and these include newer treatments for rare cancers, rare disease, and surgery. Consultants and GP on behalf of patients now have to make applications and appeals for funding under what is known as the Individual Funding Request (“IFR”) process.

For cancer patients, the Interim Cancer Drugs Fund acts as a “back stop” so you can apply to them for further funding for cancer drugs only once you have exhausted the application and appeal process”.


Enhanced by ZemantaMoral of the story. 
  • Be sure of your facts
  • Then challenge the PCT.
But suppose I had been an OAP who wouldn’t know how to challenge the PCT?
And why was it that my GP had allowed the PCT to write this letter, and not challenged it?                                                             They should know what cancerservices are available locally – but don’t