Creeping Privatisation of our NHS?

GrannyGravy, I realise it’s not cost in your case, in some others it may be. However it is not difficult to take your own blood pressure using one of these extremely simple machines. You certainly do not need to be a doctor to do this, and normally the one of the practice nurses will do this very simple check if required. In fact in many surgeries across the land the care assistants are the ones who do the blood pressure checks, this includes my own surgery. Unfortunately with insufficient GPs in the country, if we want to keep this valuable service, we need to be proactive with our healthcare. The skill of a doctor is not needed to take blood pressure, nor even the skill of a nurse. We are responsible for keeping ourselves healthy and checking our blood pressure as we age should be part of this. I’ve checked mine today by the way. I check it every week. I know the acceptable range for my age and I would request a phone consultation if my blood pressure was to become higher than acceptable for two or three weeks.

We have a blood pressure monitor. Over the last couple of years I’ve had to check my blood pressure for a variety of reasons. It’s easy. I set up a chart and record the results for a week and then email it to my GP.

I find it very difficult to take my own blood pressure! I had to take it for several 8 day cycles recently while my blood pressure tablets were being adjusted as my bp was sky high when the nurse checked it at my flu jab. It was so high the gp told me over the phone that if it went any higher I should phone 999!

I cannot get the cuff on straight with only one hand even though I bought a second one for fat arms. It twists up then I end up using my teeth to try to pull it around my arm! I ended up buying a new one from the pharmacy which goes around the wrist but I’m not sure it is as accurate.

I’m sure my bp was raised considerably with the difficulty I had getting a phone consultation with the gp when he asked me to. I had to complain to the practice manager on one occasion as I had tried on three consecutive days and not been lucky in the “appointment lottery”.

maddyone

GrannyGravy, I realise it’s not cost in your case, in some others it may be. However it is not difficult to take your own blood pressure using one of these extremely simple machines. You certainly do not need to be a doctor to do this, and normally the one of the practice nurses will do this very simple check if required. In fact in many surgeries across the land the care assistants are the ones who do the blood pressure checks, this includes my own surgery. Unfortunately with insufficient GPs in the country, if we want to keep this valuable service, we need to be proactive with our healthcare. The skill of a doctor is not needed to take blood pressure, nor even the skill of a nurse. We are responsible for keeping ourselves healthy and checking our blood pressure as we age should be part of this. I’ve checked mine today by the way. I check it every week. I know the acceptable range for my age and I would request a phone consultation if my blood pressure was to become higher than acceptable for two or three weeks.

I am extremely proactive regarding my healthcare, I have severe asthma which needs to be consistently monitored. I have not had a face-to-face appointment with my GP for 22 months.

I also have a hernia, which will need a major operation in the near future, my assessment for that every six months is also by phone.

I totally appreciate that GP’s are busy however, I have stayed at home to protect the NHS now it’s time they protected/treated me…

GrannyGravy you may be proactive regarding your health, but as I said, there is absolutely no need for your GP to take your blood pressure. It is easy to do it yourself, as many of us do. Asthma reviews are not done by doctors either, practice nurses do them. I have an asthma review on Wednesday this week. I haven’t had one since before Covid. My review is by telephone. Any ongoing asthma problem might need to be seen by the doctor or the asthma nurse. Asthma nurses are extremely highly trained and are often more aware than the doctors, because they go regularly to asthma training courses, which doctors do sometimes but not as often as they have many other things to be up to speed on.

I have been crunching numbers again.

We have a UK population of 67 million.

Approximately 25% are age 50 or over and eligible for the flu vaccine. Say 17 milliion.

For the 2020/21 season, take up of the flu vaccine was high at 75%. Say 13 million people.

Let’s say take up will be the same for 2021/22, that everyone requests it be done at a GP surgery and that each vaccine needs an appointment time of five minutes. That’s 65 million minutes - roughly a million hours of GP practice nurse time.

I believe band five and six nurse are paid between £26000 and £41000 a year. If we add in employers costs; NIC, pensions, sick and maternity pay, let’s say it costs on average £35000 in total to pay a practice nurse for a 40 hour week

1,000,000 hours / 40 = 25,000 nurses * £35000 = £875 million in staff costs to vaccinate 13 million people.

Last season, pharmacies delivered 2.7 million flu jabs. That’s only 20% of the 13 million administered. At say 5 minutes per appointment, that equated to a saving of 225,000 hours of GP practice nurse time or 5625 nurses working full time delivering vaccinations at a staffing cost of £200 million.

For 2021/22, pharmacies will be paid £9.58 per vaccine delivered which, if the number of vaccines delivered is similar to 2020/21, 2.7 million vaccines will earn them £26 million from which they must pay their own staff costs.

If anyone spots errors in these numbers or finds fault in my reasoning, please do let me know.

I understand all your reasoning, Candelle but at a time when NHS services are stretched to the limit and struggling to catch up with the backlog of work caused by Covid shutdowns and with the 2021/22 flu vaccination programme due to start in September, paying 26 million to allow the equivalent of 5625 full-time nurses to get on with other work seems a bargain to me.

Surgeries will still be vaccinating 80% of those eligible.

I see pharmacies as essential supplementary and indeed backup service to the NHS. Their contribution to healthcare is vital, never more so than in the last eighteen months. Yes, the big chains are part of international companies not unlike many of our essential energy, transport and utility networks which were once public companies. I would much rather all of these services be publicly-owned and run but unless we have a sea change of political allegiance in the UK, it isn’t going to happen.

maddyone

GrannyGravy you may be proactive regarding your health, but as I said, there is absolutely no need for your GP to take your blood pressure. It is easy to do it yourself, as many of us do. Asthma reviews are not done by doctors either, practice nurses do them. I have an asthma review on Wednesday this week. I haven’t had one since before Covid. My review is by telephone. Any ongoing asthma problem might need to be seen by the doctor or the asthma nurse. Asthma nurses are extremely highly trained and are often more aware than the doctors, because they go regularly to asthma training courses, which doctors do sometimes but not as often as they have many other things to be up to speed on.

My asthma review was indeed done over the phone by one of the practice nurses.

My issue is asking me to take my blood pressure over the next couple of days and we will ring you for the numbers I have no expertise in this, as they have no expertise in my occupation.

The population hasn’t increased in our postcode, our vaccination centres (two) are mainly out of surgery hours and vaccines are not given by GP’s but trained volunteers.

The practice nurses are not having face to face consultations, the GP’s are not having face to face consultations. Sometimes it is only when you see a health care professional face to face that it’s possible to a open up about issues/concerns that are bothering you.

maddyone my GP did my flu jab last year. I’ve got my invitation to book for this year.
Our surgery is generally excellent.

Jaxjacky

maddyone my GP did my flu jab last year. I’ve got my invitation to book for this year.
Our surgery is generally excellent.

Pre-Covid I had nothing but praise for my GP practice, have been with them for 50 years (3 GP’s over that time)

I feel let down as do many others using the same practice (AC and friends)

5 minutes for a flu jab appointment at the GP surgery?

You must be joking, they are booked in one every minute at ours!

I have never had a flu jab administered by anyone except a GP or a practice nurse and only once did a GP actually give the vaccine to me. That particular year there was a shortage of vaccines and my practice couldn’t get any more. My daughter arrived at my house at about 7.00pm after she finished her evening surgery. She brought a vaccine with her and administered it then. She said I particularly needed the vaccine because I have asthma, and flu could be very dangerous to me. She gave me exactly the same warning about Covid. She was right, I was seriously ill with Covid and hospitalised.

The blood pressure machines are so simple to use, and often recommended by doctors as patients can monitor their own blood pressure at home, and email the results in once a year as part of the BP review, or alert the doctor if the readings are particularly high. I don’t believe anyone who can reasonably competently use the internet would be unable to use a blood pressure machine, nor do I understand why anyone would not want to be proactive in monitoring their own blood pressure when it is so easy. GPs have been trained for many years to encourage patients to be involved in their health and care.

Jaxjacky I’ve had an invitation to go for a flu jab too, but it came from the pharmacy that supplies our medicines. I will wait for the text from my GP, but in any case it is far too early to go for a flu jab yet. My son in law, also a GP, told me some years ago to delay getting my flu jab till October or even November, because the efficacy is best for three months after the jab, which will give the required protection during Dec, Jan, and Feb, which just happens to be when flu is most active. I normally delay until about early November, then two weeks for immunity to develop, after which we’re into flu season.

It would cause the flu programme massive logistical problems if everybody wanted to delay getting their vaccination until November though maddyone. The programme starts in September so that everybody who is eligible can be offered it before Christmas. It offers protection for at least six months, probably longer.

What about when they run out of vaccines maddyone which seems to happen? As someone mentioned upthread, if there’s a shortage later on, it might be rather late when you finally get your vaccine.
I prefer to have mine ASAP, when they at least have some.

I take your point Casdon, it could cause difficulties in getting everyone through. But even if I was to get my flu jab earlier, I would still go to my GP. The GP I went to previously did flu clinics every Saturday morning for about a month, usually October, and they were extremely efficient, masses of people getting their vaccinations. However under Covid I don’t think the way they were run would be appropriate. In any case, I changed GP about five years ago and they did flu clinics too, but somewhat less efficient as they only had one nurse vaccinating, so caused quite a long wait. Last year, with Covid we could make our appointment any time at all, and go to the practice to see the nurse who vaccinated us. No problems, it took slightly longer as even my husband was not allowed in at the same time as me. I went in, when I came out, he went in. We had our vaccinations during half term (end of October) which I remember as we had one of our grandchildren with us. He couldn’t go in anyway, so the system suited us, just took a bit longer.

Calandergirl as I mentioned up thread, there was one year when the vaccines were in short supply and I couldn’t get one at my GP Practice. I kept ringing, but they were having trouble getting them. I wasn’t old enough to get an NHS vaccine at that time, but I qualified because I have moderately bad asthma. As I said, my daughter is a GP and they had vaccines, so she brought one home and vaccinated me. I do realise that isn’t a solution for everyone. However, with the Covid situation, I don’t think there’ll be a vaccination shortage as the government (like last year) will want to vaccinate more rather than fewer people and will order sufficient vaccines. They’ll probably advise everyone over fifty to get one as they did last year.

try getting an appointment now?

Pharmacies and GP's get the same amunt per jab. GP's are not part of the NHS, they are contractors and they do what they like with the extra money they get for doing flu jabs. I am amazed that the OP is not better informed given that she says that her daughter is a GP.

Our GPs surgery did not contact us for the flu jab (despite a letter from the NHS saying we should have been contacted), we had to contact them. Presumably this year will be the same.

Maybe I will continue to use Asda or Boots and would even if I had to pay. Last Flu jab at GP surgery was given in the outside porch covered in spider webs. My partner had his and I refused and went to Asda, professionally done and even insisted you wait afterwards for safety.
I am also not buying this 'busy GP' nonsense. The only thing mine is busy with is avoiding patients.

'....my daughter is an ordinary GP (in her surgery or at NHS meetings 7am to 9 pm four days a week, on her computer or on the phone at home the other three days)...'

Surely this is hyperbole??!
My sister is a GP......

Just to add my own thoughts. I used to have a ‘well woman’ check offered regularly by my GP surgery; it was obviously nurse led. In the last few years this has ceased to be offered yearly (before Covid) due to ‘surgery pressures’. As I am very concerned about blood pressure and cholesterol levels, my parents having extremely high levels in both and my father having died from vascular dementia, I like to monitor my levels regularly. I have this done at my local Lloyds pharmacy and am happy to pay; luckily I can afford it at present, it is by ni means expensive. I am concerned that it is no longer offered as a matter of course, especially to patients such as myself with such a strong family history. I am happy to pay if it means that other people can receive it at the surgery for ‘free’ but fear this is not the case. The same could be said for testing/screening for other illnesses such as the female cancers (again common in my family). My son, who is a physiotherapist and my niece who is a modern matron, both agree that the NHS should move away from its current model of illness based care and focus more on the advances in preventative medicine which could save millions of lives and perhaps billions of pounds in the long run. Early detection of potential problems is essential and we are really not very good at it compared to other countries with similarly developed healthcare systems. Privatised? If you can afford private care, I would say go for it. I see the NHS falling further and further behind without radical investment and reform and even the nation being prepared to increase their contribution a little and /or pay privately if they are able. I know this is an unpopular view but the idea of ‘cradle to grave’ is one that I feel is becoming more and more outmoded and in any case we are ultimately all responsible, to a lesser or smaller degree, for our own health.

My GP still offers the nurse-led annual Well Woman thing. I had mine last month.

greenlady102 I cannot comment on the internal accounting of GP practices but isn’t the thrust of the OP’s argument that by having your flu vaccination at Lloyds or Boots, the money is going to overseas corporations and not into the NHS.

I don’t accept the OP's argument that vaccine will be wasted. Practices will know how many jabs they have delivered in past years, know the age profile of their patient list and order accordingly.

My argument - see long post above - is that GP practices already deliver 80% of flu vaccinations and question NHS staffing capacity to deliver 100%.

Flu vaccination is now recommended for people age 50 and over, some 17 million people in the UK.

At a time when practices are stretched to capacity and patients are still struggling to access services for other aspects of health care, using pharmacies to deliver 20% of flu vaccinations seems the sensible option. It’s no different to private hospitals carrying out relatively minor day surgery for NHS patients and being paid for the service.

It spreads the load in a system which will never have capacity to treat everyone in a timely fashion unless there are fundamental changes in the way the NHS is managed, funded and staffed and that needs a political sea change.

Regarding privatisation of the NHS, the only way to stop this is to make sure you vote for Labour councillors and MPs. I’m on a basic pension and last week had to pay for Chiropody and ear syringing (£80) in total which used to be NHS.