Unpopular opinion - NHS is useless

[KobayashiMaru86]

joshcowin said:

KobayashiMaru86 said:

I want to start looking into private options as I can't even get an appointment for a checkup now. Want to see if everything is OK as Dad died a few months ago so want to test myself should there be any concerns. Not been to a doctor in ages so naively phoned up thinking I could book for a few weeks time when I'm off. Was told quite aggressively "no, that's not how it works!". Well excuse me for trying to plan ahead! I have to phone at 8:30 every day in the hope there's a slot for someone to ring you back who then may decide to see you and if they do, being a group practice, they could send you miles away from your home town surgery. It's farcical. I want to do preventative maintenance and check on some pre-existing things and they don't want to know. Even if I rung up for a prescription I get the third degree and they want to know why and why for.

Its not farcical, you sound like you don't need any medical attention at present so why would you go to the NHS? You want to chat about your concerns and run some basic checks, yeah book a private consultation with an appropriate doctor.

I think you are a sensible person who is concerned with their health and wants to keep on top of things. FWIW

There are things outside of the checkup I'd want seeing to which is what I'll have to get appointments for and I'll bring up about a checkup then. But it's just seems such a game to try and put you off ever going. I gave the hayfever example as that was the last time I asked for their help. It took months until they gave me what I wanted.

[pavarotti1980]

KobayashiMaru86 said:

There are things outside of the checkup I'd want seeing to which is what I'll have to get appointments for and I'll bring up about a checkup then. But it's just seems such a game to try and put you off ever going. I gave the hayfever example as that was the last time I asked for their help. It took months until they gave me what I wanted.

Not using your circumstances as an example but this can be why there are large access issues within the NHS. Managing patient expectation. There is the believe that some should receive whatever treatment they want and not what the NHS is able to offer. In fairness a lot of things are available and the others can be had via the private route who will give you anything within their license no matter the cost as the patient is paying

[KobayashiMaru86]

pavarotti1980 said:

KobayashiMaru86 said:

There are things outside of the checkup I'd want seeing to which is what I'll have to get appointments for and I'll bring up about a checkup then. But it's just seems such a game to try and put you off ever going. I gave the hayfever example as that was the last time I asked for their help. It took months until they gave me what I wanted.

Not using your circumstances as an example but this can be why there are large access issues within the NHS. Managing patient expectation. There is the believe that some should receive whatever treatment they want and not what the NHS is able to offer. In fairness a lot of things are available and the others can be had via the private route who will give you anything within their license no matter the cost as the patient is paying

What I wanted was a solution. I'd already tried all the paid over the counter options and they weren't touching the sides. Their approach was to give me the basic stuff and work up slowly so the fix was the cheapest. When I mentioned Bilastine, because I knew it worked for a friend, they'd never heard of it. When they looked it was on the list so I got it. If I'd not know of it, I'd have had to go through every type of medication until they found one that worked. They did this with family members too who were on medication for various things to find the next time they'd get a prescription it would be substituted for the cheaper one, they'd try it, it wouldn't work as well then it would have to go back.

I've seen there are more tests you can get done at home for a fee. I'll do some of these to try and get some answers that way.

[Wadeski]

KobayashiMaru86 said:

pavarotti1980 said:

KobayashiMaru86 said:

There are things outside of the checkup I'd want seeing to which is what I'll have to get appointments for and I'll bring up about a checkup then. But it's just seems such a game to try and put you off ever going. I gave the hayfever example as that was the last time I asked for their help. It took months until they gave me what I wanted.

Not using your circumstances as an example but this can be why there are large access issues within the NHS. Managing patient expectation. There is the believe that some should receive whatever treatment they want and not what the NHS is able to offer. In fairness a lot of things are available and the others can be had via the private route who will give you anything within their license no matter the cost as the patient is paying

What I wanted was a solution. I'd already tried all the paid over the counter options and they weren't touching the sides. Their approach was to give me the basic stuff and work up slowly so the fix was the cheapest. When I mentioned Bilastine, because I knew it worked for a friend, they'd never heard of it. When they looked it was on the list so I got it. If I'd not know of it, I'd have had to go through every type of medication until they found one that worked. They did this with family members too who were on medication for various things to find the next time they'd get a prescription it would be substituted for the cheaper one, they'd try it, it wouldn't work as well then it would have to go back.

I've seen there are more tests you can get done at home for a fee. I'll do some of these to try and get some answers that way.

To be fair, working your way up from the most common treatments is how fully private healthcare works too. Patients reporting what does / doesnt work for them is unfortunately unreliable.

[joshcowin]

KobayashiMaru86 said:

What I wanted was a solution. I'd already tried all the paid over the counter options and they weren't touching the sides. Their approach was to give me the basic stuff and work up slowly so the fix was the cheapest. When I mentioned Bilastine, because I knew it worked for a friend, they'd never heard of it. When they looked it was on the list so I got it. If I'd not know of it, I'd have had to go through every type of medication until they found one that worked. They did this with family members too who were on medication for various things to find the next time they'd get a prescription it would be substituted for the cheaper one, they'd try it, it wouldn't work as well then it would have to go back.

I've seen there are more tests you can get done at home for a fee. I'll do some of these to try and get some answers that way.

You can obviously appreciate that in the scheme of things hay fever is a low priority. I know you didn't have a runny nose and itchy eyes, but still the NHS are not going to change processes for individual cases of hay fever, so going through the process like everyone else is your road to better/effective medication.

You can get an injection which stops your body fighting against the pollen, did you try that?

[Paul Dishman]

joshcowin said:

You can obviously appreciate that in the scheme of things hay fever is a low priority. I know you didn't have a runny nose and itchy eyes, but still the NHS are not going to change processes for individual cases of hay fever, so going through the process like everyone else is your road to better/effective medication.

You can get an injection which stops your body fighting against the pollen, did you try that?

If you check the Hayfever thread you’ll see that that injection is no longer available because of side effects

[pavarotti1980]

KobayashiMaru86 said:

What I wanted was a solution. I'd already tried all the paid over the counter options and they weren't touching the sides. Their approach was to give me the basic stuff and work up slowly so the fix was the cheapest. When I mentioned Bilastine, because I knew it worked for a friend, they'd never heard of it. When they looked it was on the list so I got it. If I'd not know of it, I'd have had to go through every type of medication until they found one that worked. They did this with family members too who were on medication for various things to find the next time they'd get a prescription it would be substituted for the cheaper one, they'd try it, it wouldn't work as well then it would have to go back.

I've seen there are more tests you can get done at home for a fee. I'll do some of these to try and get some answers that way.

But that is how healthcare works. use the most minimally invasive, cost effective approved treatments first and work up if they don't work as part of a pathway. this is irrespective of how it is funded. For comparison (not including dispensing fees that the pharmacy attracts) this is base monthly cost for common oral antihistamines

Loratadine 10mg daily £0.81
Cetirizine 10mg daily £0.72
Fexofenadine 180mg daily £1.78
Bilastine 20mg daily £6.00

Your family members got generic instead of branded drugs? That will be because the GP is prescribing correctly in the generic form.

[KobayashiMaru86]

pavarotti1980 said:

KobayashiMaru86 said:

What I wanted was a solution. I'd already tried all the paid over the counter options and they weren't touching the sides. Their approach was to give me the basic stuff and work up slowly so the fix was the cheapest. When I mentioned Bilastine, because I knew it worked for a friend, they'd never heard of it. When they looked it was on the list so I got it. If I'd not know of it, I'd have had to go through every type of medication until they found one that worked. They did this with family members too who were on medication for various things to find the next time they'd get a prescription it would be substituted for the cheaper one, they'd try it, it wouldn't work as well then it would have to go back.

I've seen there are more tests you can get done at home for a fee. I'll do some of these to try and get some answers that way.

But that is how healthcare works. use the most minimally invasive, cost effective approved treatments first and work up if they don't work as part of a pathway. this is irrespective of how it is funded. For comparison (not including dispensing fees that the pharmacy attracts) this is base monthly cost for common oral antihistamines

Loratadine 10mg daily £0.81
Cetirizine 10mg daily £0.72
Fexofenadine 180mg daily £1.78
Bilastine 20mg daily £6.00

Your family members got generic instead of branded drugs? That will be because the GP is prescribing correctly in the generic form.

Where are those prices from? The drugs would've been a mix. The frustration was, when someone is on dozens a day, they'd find a balance where it all worked, then one would change because it was cheaper. But they found it didn't work as well or there would be some side affect. So they've revert the next month, only to change something else.

[otolith]

pavarotti1980 said:

KobayashiMaru86 said:

What I wanted was a solution. I'd already tried all the paid over the counter options and they weren't touching the sides.

But that is how healthcare works. use the most minimally invasive, cost effective approved treatments first and work up if they don't work as part of a pathway. this is irrespective of how it is funded. For comparison (not including dispensing fees that the pharmacy attracts) this is base monthly cost for common oral antihistamines

Loratadine 10mg daily £0.81
Cetirizine 10mg daily £0.72
Fexofenadine 180mg daily £1.78
Bilastine 20mg daily £6.00

But if the patient has already tried Loratadine and Cetirizine at their own expense and determined that they don't work, providing the same OTC drug at the expense of the NHS (or at £9.65 a pop to him instead of £5.50 OTC) is just wasting time and money. If I were see my GP about pain relief and report that OTC painkillers aren't working, a prescription for paracetamol is not helpful.

[pavarotti1980]

KobayashiMaru86 said:

Where are those prices from? The drugs would've been a mix. The frustration was, when someone is on dozens a day, they'd find a balance where it all worked, then one would change because it was cheaper. But they found it didn't work as well or there would be some side affect. So they've revert the next month, only to change something else.

Prices are from the Drug Tariff which is the reimbursement price for community pharmacies

otolith said:

But if the patient has already tried Loratadine and Cetirizine at their own expense and determined that they don't work, providing the same OTC drug at the expense of the NHS (or at £9.65 a pop to him instead of £5.50 OTC) is just wasting time and money. If I were see my GP about pain relief and report that OTC painkillers aren't working, a prescription for paracetamol is not helpful.

Which is exactly why it is bumped back to the pharmacist until over the counter preparations are not suitable and a prescription is required. GP would not prescribe cetirizine etc for an adult anyway

[otolith]

pavarotti1980 said:

otolith said:

But if the patient has already tried Loratadine and Cetirizine at their own expense and determined that they don't work, providing the same OTC drug at the expense of the NHS (or at £9.65 a pop to him instead of £5.50 OTC) is just wasting time and money. If I were see my GP about pain relief and report that OTC painkillers aren't working, a prescription for paracetamol is not helpful.

Which is exactly why it is bumped back to the pharmacist until over the counter preparations are not suitable and a prescription is required. GP would not prescribe cetirizine etc for an adult anyway

In this case, he says that he has exhausted the OTC options?

[pavarotti1980]

otolith said:

In this case, he says that he has exhausted the OTC options?

I know.....

[KobayashiMaru86]

otolith said:

pavarotti1980 said:

KobayashiMaru86 said:

What I wanted was a solution. I'd already tried all the paid over the counter options and they weren't touching the sides.

But that is how healthcare works. use the most minimally invasive, cost effective approved treatments first and work up if they don't work as part of a pathway. this is irrespective of how it is funded. For comparison (not including dispensing fees that the pharmacy attracts) this is base monthly cost for common oral antihistamines

Loratadine 10mg daily £0.81
Cetirizine 10mg daily £0.72
Fexofenadine 180mg daily £1.78
Bilastine 20mg daily £6.00

But if the patient has already tried Loratadine and Cetirizine at their own expense and determined that they don't work, providing the same OTC drug at the expense of the NHS (or at £9.65 a pop to him instead of £5.50 OTC) is just wasting time and money. If I were see my GP about pain relief and report that OTC painkillers aren't working, a prescription for paracetamol is not helpful.

This. They did try and give me cetirizine (think I could still order it now). I was paying for Allevia 120mg, I asked for 150mg or 180mg and they weren't authorised to do it for hayfever that high. I get pain relief for tendonitis as it flares every few weeks. They initially said buy ibuprofen which doesn't do a lot. They then prescribed a few other things which also didn't do much. Now on Cocodamol 15/500s which could be stronger but better than nothing. But because it's codeine and can be addictive, every time I want it I have to explain why, even though it's on file why.

Have found a few places doing tests for various things so I've ordered one and see how it goes.

[pavarotti1980]

KobayashiMaru86 said:

This. They did try and give me cetirizine (think I could still order it now). I was paying for Allevia 120mg, I asked for 150mg or 180mg and they weren't authorised to do it for hayfever that high.I get pain relief for tendonitis as it flares every few weeks. They initially said buy ibuprofen which doesn't do a lot. They then prescribed a few other things which also didn't do much. Now on Cocodamol 15/500s which could be stronger but better than nothing. But because it's codeine and can be addictive, every time I want it I have to explain why, even though it's on file why.

Have found a few places doing tests for various things so I've ordered one and see how it goes.

Fexofenadine is only licensed in hay fever up to 120mg which is why they wont have prescribed it. 180mg is licensed for idiopathic urticaria so its use as you wanted was off-label.

This is not 100% a dig at you but this is what I meant by managing patient expectations. Patients regularly will ask for drugs on prescription (prime example is antibiotics for a cold) and then when told no for whatever legitimate reason, then think the NHS is not very good or don't do anything to help

Edited by pavarotti1980 on Wednesday 17th April 16:35

[272BHP]

GPs are not really helping themselves here are they?

https://www.theguardian.com/society/article/2024/m...

The scheme is a good idea and is much needed.

[Pit Pony]

pavarotti1980 said:

Downward said:

The biggest pressure is the additional cost of agency staff who earn more.
There’s a reason why no Private hospitals offer A&E and Trauma centres because it’s not profitable.
If the NHS solely provided Cataracts operations and other profitable procedures it wouldn’t have any funding issues.

Look at the likes of Spa medical. See Specsavers and the like to offering hearing aids until the CCG’s reduced the funding which meant they couldn’t cover the costs. Where do these patients now go for this care, Yes the NHS who have to cover the costs themselves.

Staff then drugs are the 2 highest costs in the NHS. My trust is going to hit a projected £300m on drugs next financial year...crazy figures

It's almost like they could tool up and make the drugs themselves cheaper.....

[FiF]

Our GP announced the other day as we were arranging a referral for private tests that he has now taken out private health insurance for his family as to quote "The NHS is fked."

Same GP when I saw him over an issue at the previous weekend where consulted 111 as I'd decided it was not a 999 call, then stated that in years gone by it would absolutely have been a 999 call, with an ambulance despatch and straight to A&E. Today though...

[Brainpox]

272BHP said:

GPs are not really helping themselves here are they?

https://www.theguardian.com/society/article/2024/m...

The scheme is a good idea and is much needed.

At a guess: If a GP sends someone to a pharmacist from info gathered during the phone call with reception, then the issue happens to be more complex, who will be liable for any issues that come off the back of that?

I can imagine a GP being more confident giving routine stuff to on site nurses and paramedics, firstly because they are directly employed by the surgery, and also the doctor is available to assist if needed.

[pavarotti1980]

Pit Pony said:

It's almost like they could tool up and make the drugs themselves cheaper.....

What makes you think it would be cheaper?

[Gas1883]

I’ve always been very positive about the nhs , but this latest experience wasn’t good , no-one to take you down to surgery , nurse on phone saying you need to get someone here as he needs to go now , then hours waiting I recovery to come back up as no beds ( strike seemed to be issue ) , unbelievable pain that turned out to be cannula not attached , doctor who basically said all went well , your being discharged today, that was it .
Poor chap in next bay who obviously had mental issues screaming nurse / nurse / I’m going to kill you / I’m dieing / I want to die , don’t think I slept in 2 days ( nurse even said on discharge at least you can sleep now
Discharge was a shambles with doctor saying your being discharged , urine / blood samples done then nurses etc saying they no nothing about me being discharged. , finally discharged at 10 pm , no wheelchair & long walk to car & home for 11 pm
Daughter nurse / wife nhs were not happy , I think issues are trust / area related .