Re: patient choice

[Guest guest]

Fingers crossed nne - let us know what happens.

Gill

Re: patient choice

That is the biggest IF you have every seen in the case of my PCT and I will not be waiting until April to take it, I shall be taking it with me on the 17th as I have an appointment to discuss the PCT's refusal for me to go outside of the area!!! How timely was that LOL.Luv nne

You're welcome nne. Ive found that a lot of GPs arent very knowledgable about this sort of policy so taking it with you could be a good idea - but maybe he will have got the message by April anyway!! If the PCT have done their job!!

Gill

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[Guest guest]

I have an appointment with a different doctor when my blood tests come back (blood test tomorrow morning) - is there anything in particular you would recommend taking to him - I would need medical references so that he cannot say these are opinions. I do not want to give him too much as I am sure that will put him off of reading it, but today he said that he was impressed with my thyroid knowledge - (after he said that T4 was the active thyroid!) and he wants to give me a complete hormone review he says. Now I do not want to start getting excited, and I feel sure that he will not prescribe armour as he is in the same practice, but this is the first interest I have ever had from a GP.

Val

[Guest guest]

But will these doctors actually prescribe armour, rather than ask the GP to do it? I say this because mine will not even if asked by an endo.

Val

[Guest guest]

Thanks Gill, will do.

Luv nne

Fingers crossed nne - let us know what happens.

Gill

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[Guest guest]

My dr is very happy to prescribe armour Val, he just has a problem with how much because they have been trained to believe that all thyroid meds will cause osteoporosis if the TSH is suppressed. I was getting 3 grains a day but have just had this last prescription (picked up this week) reduced to 1.5 grains a day. I need to get a good honest dr who will tell them that my TSH is fine and that I am actually being protected from osteoporosis by the armour (calcitonin) and then he will happily prescribe the 3.5 grains per day that I need.

Luv nne

But will these doctors actually prescribe armour, rather than ask the GP to do it? I say this because mine will not even if asked by an endo.

Val

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[Guest guest]

Are you wanting references for why doctors should be prescribing T4/T3 combinations Val, either synthetic or natural (Armour).

Luv - Sheila

I have an appointment with a different doctor when my blood tests come back (blood test tomorrow morning) - is there anything in particular you would recommend taking to him - I would need medical references so that he cannot say these are opinions. I do not want to give him too much as I am sure that will put him off of reading it, but today he said that he was impressed with my thyroid knowledge - (after he said that T4 was the active thyroid!) and he wants to give me a complete hormone review he says. Now I do not want to start getting excited, and I feel sure that he will not prescribe armour as he is in the same practice, but this is the first interest I have ever had from a GP.

Val

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[Guest guest]



That is why I am buying the Armour myself nne.

Lilian

not a lot but I refuse to pay a Private Dr £240 for that privilege and a letter - I can buy my meds for less than that so no point at all.

[Guest guest]

I think you are probably right Gill - it is ignorance of what is happening. It is only recently that our one PCT which covered a vast area has now been made into three I think. There was talk about making it into 5 PCTs but I think they settled for three. So they have all that to contend with as well.

One of the reasons I think scares them a bit is that our local hospital has such a bad reputation that everyone would choose another hospital - so the other four for our choice have also got bad reputations lol. At the moment it is pointless choosing as there is in fact no choice of a better hospital. I think they are thinking more about people who need to stay in hospital rather than the type of thing we are looking for.

Lilian

[Guest guest]

Lilian (I should go to bed!!) - I think I know where you live now! In these circumstances I can understand that things will be difficult - PCTs have a responsibility to not destabilise their local acute trusts - so if there are major contractual changes the hospital (acute) trusts do have to be given notice - so if a PCT want to stop sending 50% of patients to the trust for endocrinology (say), then they have to give notice that they are going to do this. And there are 'penalty' type clauses in the contracts that the PCT will pay a proportion if the amount contracted for is much lower than agreed (and pay a premium if its much higher as well). (so if all the hypoT patients didnt go where they were expected to it would cost the PCT more that year, but they wouldnt contract for so much activity (ie referrals) the next year.

In circumstances where the acute trust or pct have a problem (MRSA for example!) and they know that a lot of patients may choose to go somewhere else, it will be very difficult for the PCT to know the level of 'activity' to contract for - while not destabilising their acute trust (as they will still need a hospital). I would think that this would cause problems and they will want to try and maintain some stability with referrals. But still the DoH guidance applies - its up to the acute trusts to demonstrate to patients that they are safe and of good quality so patients will choose to go there. This is how the Choice agenda is meant to drive up quality because it brings in the element of market competition - same as in business - competition drives up quality as the different providers strive to be better than the next provider - and if they dont they will go under -and now it applies to hospitals.

I dont know if the Strategic Health Authority will be involved and tell PCTs what they need to do in these circumstances which arent normal. Im not sure what they can/cant do.

It must be a difficult balancing act for the PCTs just now and if they have just been reorganised then that's unsettling too and people will have changed jobs etc - not easy.

The whole contracting/commissioning bit is a difficult area and not easy to understand and there is no one straightforward document that tells you exactly what is what!

Ive gone on a bit havent I!!

Bedtime!

Gill x

Re: patient choice

I think you are probably right Gill - it is ignorance of what is happening. It is only recently that our one PCT which covered a vast area has now been made into three I think. There was talk about making it into 5 PCTs but I think they settled for three. So they have all that to contend with as well.

One of the reasons I think scares them a bit is that our local hospital has such a bad reputation that everyone would choose another hospital - so the other four for our choice have also got bad reputations lol. At the moment it is pointless choosing as there is in fact no choice of a better hospital. I think they are thinking more about people who need to stay in hospital rather than the type of thing we are looking for.

Lilian

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[Guest guest]

Lilian

You should bring this problem up when you next have your meetings at the surgery with a representative from the PCT. If everybody complained about all the bad hospitals in your area, surely, they should look into this problem. If it has been brought up before and nothing has been done, it should be taken further. Surely if a doctor can be reported to the GMC for not bad practice, then so should the managers of these hospitals be brought to buck! They are putting lives at risk.

luv - Sheila

Re: patient choice

I think you are probably right Gill - it is ignorance of what is happening. It is only recently that our one PCT which covered a vast area has now been made into three I think. There was talk about making it into 5 PCTs but I think they settled for three. So they have all that to contend with as well.

One of the reasons I think scares them a bit is that our local hospital has such a bad reputation that everyone would choose another hospital - so the other four for our choice have also got bad reputations lol. At the moment it is pointless choosing as there is in fact no choice of a better hospital. I think they are thinking more about people who need to stay in hospital rather than the type of thing we are looking for.

Lilian

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[Guest guest]

Disgusting isn't it Lilian, I cannot understand how it takes 1 hour to write a simple letter stating that my bloods are all within the right range for being on armour and that I am on the correct dose, need to up my dose etc., but that is what she wanted and also, even though I had been checked regularly by an endo, had a complete diagnosis and was going a long very happily, she still insisted that I would HAVE to have an hour consultation with her so that she could DIAGNOSE me as well. Absolute absurdity and just a con to get our money as far as I can tell - after all, it took my endo just 10 minutes each time I went, why should it be so much longer just because I am paying!!!!

That is why I am buying the Armour myself nne.

Lilian

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[Guest guest]

This has been brought up many times. It has been discussed in the local newspaper. The answers we keep getting is that they are doing everything they can to improve matters. Well one improvement they have made is to get a new endo

A friend's baby grandson who was extremely ill and waiting to go to Great Ormond Street but had to wait in our local hospital until they had a bed, finally went to GOS hospital with dehydration and MRSA. As you can imagine GOS were extremely angry and complained about it to the hospital and our PCT. The PCT said they were dealing with this but my friend 's family have heard nothing further. When I mentioned this to the PCT rep she said that someone should be contacting the family - but that was a year ago and they haven't heard anything. They are so concerned about the child as he is still ill and until he gets a heart transplant will always be, that they just cannot be bothered now to follow it up.

This child was born with half a heart working and it was only after 4 months and him being at deaths door that any of the medics found out. Surely they would have put a stethoscope on his heart and heard something. What about when they check new born babies. When she kept telling them there was something wrong they all told her everything was alright and not to worry. They have a tendency to put any worry a new mother might have as 'all in the mind' . Her story was actually told in Take a Break magazine in August.

Lilian

You should bring this problem up when you next have your meetings at the surgery with a representative from the PCT. If everybody complained about all the bad hospitals in your area, surely, they should look into this problem.

[Guest guest]

Seems your friend should take her complaint all the way. She has obviously complained about what happened previously. The following is taken direct from "How to access your medical records" but I should imagine this is what she should do next.

Complaining via the NHS complaints procedureTo use the NHS complaints procedure you must be a patient or a former patient of the practitioner or institution involved and you must complain within six months of the incident.There are two important stages to the NHS complaints procedure:

Local resolution and conciliation with your local primary care trust.

An independent review that considers your complaint.

To find out exactly how to go through the NHS complaints procedure read the Action Network guides, How to complain about NHS medical treatment in England, How to complain about NHS medical treatment in Scotland, How to complain about NHS medical treatment in Wales, How to complain about NHS medical treatment in Northern Ireland. Complaining to the Health Service Ombudsman If you feel that the local resolution has not dealt with your complaint correctly and are denied an independent review, you can complain to the Health Service Ombudsman. There are four Health Ombudsmen, one each for England, Wales, Scotland and Northern Ireland: England: The Parliamentary and Health OmbudsmanWales: The Welsh Administration OmbudsmanScotland: The ish Public Services OmbudsmanNorthern Ireland: The Northern Ireland OmbudsmanEach Health Service Ombudsman is independent of the government and the NHS. There is no charge for the service. The Ombudsman will not normally become involved unless you have already complained officially to the local primary care trust and are still unhappy. Be aware that the ombudsman will be looking at whether the administration has followed NHS procedure, not at your rights to see your medical records. If you feel that the process was fair but the final decision to deny you access was wrong then you should contact the Information Commissioner.How do I complain to an Ombudsman? Ombudsman are independent bodies who look at complaints about organisations. They allow you to get your case independently reviewed without going to court. You can use the complaints form available from an Ombudsman’s office, or on their website. Complaints must be made in writing, though you may be able to submit them online. Describe what happened in great detail and make sure you have copies of any relevant documents. The Ombudsman will only investigate if you have already suffered hardship or injustice. You must complain within a year of becoming aware of the events which you are complaining about.The Citizens’ Advice Bureau has a useful guide to making a complaint to an ombudsman.

This has been brought up many times. It has been discussed in the local newspaper. The answers we keep getting is that they are doing everything they can to improve matters. Well one improvement they have made is to get a new endo

A friend's baby grandson who was extremely ill and waiting to go to Great Ormond Street but had to wait in our local hospital until they had a bed, finally went to GOS hospital with dehydration and MRSA. As you can imagine GOS were extremely angry and complained about it to the hospital and our PCT. The PCT said they were dealing with this but my friend 's family have heard nothing further. When I mentioned this to the PCT rep she said that someone should be contacting the family - but that was a year ago and they haven't heard anything. They are so concerned about the child as he is still ill and until he gets a heart transplant will always be, that they just cannot be bothered now to follow it up.

This child was born with half a heart working and it was only after 4 months and him being at deaths door that any of the medics found out. Surely they would have put a stethoscope on his heart and heard something. What about when they check new born babies. When she kept telling them there was something wrong they all told her everything was alright and not to worry. They have a tendency to put any worry a new mother might have as 'all in the mind' . Her story was actually told in Take a Break magazine in August.

Lilian

You should bring this problem up when you next have your meetings at the surgery with a representative from the PCT. If everybody complained about all the bad hospitals in your area, surely, they should look into this problem.

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[Guest guest]

>>> you must complain within six months of the incident.<<<<

The Great Ormond Street Hospital complained to the local hospital and the PCT but I do not think they would have taken it further. During the six months the parents were either staying in a cramped parents room at the GOS hospital whilst the baby was having a series of operations or they were running back and forth to London for a change of clothes, a bath etc. no time or energy for making formal complaints.

The doctors want the child to get a lot older before they do the transplant and periodically have to give him operations to do this. Also, he is still being fed through a tube in his stomach which is another time consuming effort for the parents. He has to be watched all the time (one does night shift the other does day) as he needs oxygen at times.

And of course they need the hospital and doctors so dare not make a complaint.

Lilian