Explanation of treatment suppliers: When I... - Pain Concern

Pain Concern
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Explanation of treatment suppliers


When I picket up my script for over Christmas I was given a leaflet regarding the use of GP, Nurse and Chemist Services and the use of those services. I have not looked at the paper yet as my condition seems to be flaring. When I get the chance I will come back and discuss these, known changes. What I was wondering has anyone else been given ihis instruction. Basically it sets parameters on when you use the GP, Practice Nurse, Pharmacist. Dentist. This I suppose will release the NEED OF GP APPOINTMENTS.

What I did notice however was people failing to attend GP Appointments, three strikes and you are taken of that GP Practice List. Mind this has been the case for quite a long time.

The paper seems quite complex,for me at this time

Comments, ??


7 Replies

Not attending appointments is called Did Not Attend or DNA. There has been a lot of research into this, and there are many reasons why it happens. Anywhere up to 15% of the DNAs are the fault of the system. That is letters arriving after the appointment, the appointment being booked under the wrong name and so on.

One comprehensive bit of research in primary care started with the hypothesis that these DNAs were probably the busy people who weren't that sick in the first place. That turned out to be false, it was the elderly, those with mental health problems and those with disordered lives, that is the long term unemployed, those with drug and alcohol addiction and so on. One surgery slashed their DNA rate by identifying the people that DNAed, finding out why, and then offering them only same day appointments. It worked really well.

There has been some proper analysis of the cost of DNAs to the NHS, something that is often put on the posters, and it turns out that it is wrong. It would only cost that amount if doctors and nurses sat around throwing bandages and medicines in the bin when there was a DNA and they don't. they use that time to catch up on other work, or bring their clinics back on time if they had been running over time. This was dealt with in an understandable way by Tim Hartford on Radio 4's More or Less bbc.co.uk/programmes/b09l2351

And yes, all the rest of it, the seeing the different health professionals for different things is very confusing for the patients. I used to be chair of our surgery's Patient Participation Group and I tried to tell them that the way they were explaining it to the patients was very confusing. So I sat down with the practice manager and we looked at it from the point of view of the patient and developed a talk to give to patients about it. I blogged about it here. Maybe that might help a bit? It is still confusing and complex but I used to go out to patient groups and explain it to them and they realised that once it was explained to them from the patient point of view rather than the clinical or NHS point of view it made more sense. And yes, it should mean that GPs will have more time for the patients that need it, but it doesn't always work like that because there are still not enough GPs.


We live in countryside and failed DNAs as you call them correctly are a real problem. Waiting times for appointment are upwards of three weeks and the practice brings in a GP who deals with Patients on a daily basis, when people call in on the day. Sad to say this GP is now sick so the Surgery is undermanned,

We are talking in the region of near on two hundred or so failed appointments and this does cause a real backlog when the patient does not cancel, and fails to attend on the day.

However this is only part of the problem, this sheet covers conditions that do not need the GP, just the Nurse or knowing when you can get away with over counter medications. Sometimes the need of a chemist is the best way to go.

Have you seen this paper yet, I do not now attend PPG or Healthwatch now also CCG so I am a little out of touch



I am in a rural area too, and we had a rash of DNAs one week. The practice was really worried and brought it up at a PPG meeting. The social prescriber was there too and pointed out that the week of the highest DNAs was when the road into town was closed and no one could get through. The practice hadn't twigged that most of the patients lived on that side of town! We also pointed out that there wasn't an easy way of cancelling appointments so they couldn't blame the patients.

The move away from always seeing a GP to seeing the chemist or others has been going on for a few years now. Each CCG is responsible for implementing it. Our surgery could see the writing on the wall and hired an Advanced Nurse Practitioner early on to try to get a good one before all the other surgeries started hiring them in stead of GPs. Many surgeries have waited for the CCG to tell them to do this. So it is being rolled out differently all over the country.

in reply to cyberbarn

Our surgery reminds the patient of their appt by text. Sometimes a bit too many reminders for the same appt. My dentist also reminds by text. Charged if late for appt/miss appt.

in reply to karools16

Yes, there is a lot of evidence that text reminders work well. They also found that for hospital outpatients if the patient actually make the appointment themselves they are more likely to keep it, rather than the hospital sending out a pre arranged appointment. So many trusts now send a letter to the patient asking them to ring up and make the appointment. By letting the patient choose the time, they are more likely to keep the appointment.

We get reminders for most appointments including dentists and some optics as well.

All I know is this list was given to me a day ago and that explaining the salient points explained. Three strikes and you are out has been going on for a long time now.

Practices are having problems retaining GPs. It is worse in the countryside where Surgeries have two Practices upwards of ten to fifteen miles away, this restricts the number of appointments and can cause distress.

I have been ill for the last few days and have only read the list very quickly, I will list what the form says when I feel more capable. Never shoot the messenger you will most probably get a copy yourself in the not to distant future.

The other form that is spreading out from Practices at this time is to do with Medical Records and Emergency Treatments, where a Patient can prevent emergency staff to have access to your medical records, a form is knocking around where you decide who has access to your papers. You have the chance of Opting out, we had the forms and did not fill them in so now we carry on and services keep access. Possibly everyone should get these at reception as well.

If there are changes people need to discuss any changes in service. Especially if in some instances an Emergency GP may have problems accessing a Patient Records. When called out if the form is filled in


I am by no means shooting the messenger. Our monthly newsletter, from the surgery, lists how many people fail to turn up for appts. Shocking! 3 strikes and you're out, seems a good way to deal with it.People abuse the NHS because it's free. We have already had all those forms concerning access to records, etc.

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