just something I am puzzled about

Are GPs paid extra for dealing with certain ailments? I know personally of folk who are almost getting red carpet treatment for their conditions. Example - man who had cancer twice, prostate and secondary's, maximum dosages of chemotherapy given 2nd time resulting in heart problems which led to by passes. one of which failed. Type 2 diabetes. Now gets what he calls aerobics - cardiac nurse one to one and physiotherapist standing by , feet done regularly, eye test yearly and blood tests till they are coming out of his ears plus dental check ups. He is a walking chemical factory poor chap. Not griping about his care package or others I have heard of but it has me wondering is it the perfume I am using do you think?

40 Replies

  • Busterboy,

    There is extra funding for conditions like diabetes to be treated in primary instead of secondary care. If feet aren't properly cared for infection can ensue causing gangrene which leads to amputation, and diabetes can also lead to blindness.

  • Doctors get paid extra for diagnosing and dealing with certain ailments thanks to the Quality and Outcomes Framework (QOF) payments.


    They used to get a tiny amount for every case of hypothyroidism they diagnosed and for keeping a disease register of all patients who are hypothyroid. But that was removed from QOF in about 2014.

  • busterboy - yes is the answer, we seem to be the poor relation to everything. A friend of mine is undergoing treatment for cancer, he's had umpteen speedy appointments with consultants, prompt treatment and follow-up appointments. Whilst appreciating that he's had a tough time of it and wouldn't wish the disease on anyone, it nevertheless leaves a bad taste in that I've been failed by too many doctors and, to boot, have to pay for my own lifelong medication as well as managing the condition myself.

    Injustice and inequality in health care. Who'd have thought it ...

  • :) No. it is because it is thought by those in 'power' who make the Guidelines that levothyroxine and hypothyroidism are soul mates.

    The fact that the doctors must get so many patients complaining and have been instructed into believing that clinical symptoms should not be considered (they don't know them nowadays and don't have the expertise of doctors who were trained before the 50's) due to the whereabouts of the TSH alone being considered the 'rule' and for diagnosis alone: we end up being given prescriptions for the symptoms which haven't eased (and cannot do so) as we are in need of optimum hormones and don't get to an optimum and decent dose of thyroid hormones to eliminate them.

    They'd rather diagnose you as having a mental health condition rather than realising it's due to lack of thyroid hormones. One doctor said we were in a 'parlous' situation due to the low doses given and relying upon the TSH rather than the patients symptoms.

  • That is it in a nutshell, unfortunately :(

  • Well thank you one and all - it seems we are the Cinderella's after all. Wonder if there is a prince charming lurking in the wings - in our case more likely to be the wicked stepmother!! Do appreciate diabetics need constant check ups but so do we but then the main stream public have no idea what our conditions are like nor that they are equally life threatening if left untreated. Ah! well we shall just have to soldier on and I thank God for forums like this - would be a raving nut case by now but for you all.

  • Busterboy,

    It's cost related. Poorly controlled diabetes can cost the NHS a fortune if the patient requires surgical amputation/s or treatment to prevent blindness.

    Hypothyroidism is not life threatening when adequately treated or even if suboptimally treated.

  • That's correct Clutter:

    Hypothyroidism is not life threatening when adequately treated or even if suboptimally treated.

    But when our symptoms are dismissed life can be pretty terrible and painful otherwise we wouldn't have so many of this forum with the following headings. Who do they turn to when ill if not to the GP - it seems to be this forum and TUK who try to help in the best way we can. If you don't have internet access........?


  • Shaws,

    I'm not saying hypothyroidism and other conditions which also ruin people's wellbeing aren't deserving of better attention. I was just 'splaining that diabetes, for example, gets more attention due to the potential surgical and eyesight financial burdens.

  • Of course, Clutter, I do know that :) Many could all be a lot better if the guidelines were more helpful (not me as I'm fine by not going by the guidelines ) and let the doctors use their judgement. So many are struggling as we know.

  • And yet they are more than happy to treat our 'depression' by prescribing anti-depressants, and our fibromyalgia with evermore powerful painkillers, etc. etc., all of which could be avoided if they would just treat our thyroids seriously... Surely that must be just as costly?

  • Zephyrbear,

    Apparently not.

  • Hmmm... but then again, doctors get paid to prescribe anti-depressants et al, don't they?

  • Zephyrbear,

    Doctors are paid whether they prescribe or not. Practices may be incentivised with additional funding for some medical conditions especially when there is a push to move treatment from specialists in hospitals into primary care. Maintaining a register of hypothyroid patients qualified for extra QOF points until a year or two ago.

  • shaws - thanks to being left unmedicated for 18 years I've ended up with osteoporosis in my spine and pelvis.

    We can end up costing the NHS/country an awful lot of money for being inadequately diagnosed/treated/ resulting in multiple conditions. This can lead to unemployment and financial difficulties contributing to the country paying out more in benefits.

    Cutting off one's nose to spite one's face as far as the NHS is concerned.

  • It would be interesting to know if a survey could be done - if someone is hypo or has been diagnosed later on, a while after they've been complaining, if they've developed 'other' diseases i.e. cancer, diabetes or heart ailments or other serious disease . Also how many prescriptions are issued.

    I'm sorry you have osteo and you must be quite angry - a normal response.

    I hope you have reasonable doctors now.

  • Facts always speak for themselves - well done Shaw brilliant idea.

  • Thanks shaws. Good idea for a survey as so much is being missed. We need to have a complete rethink of NHS healthcare and feel that education should start in the classroom.

  • Ah! but add into the mix advanced PA with irreversible symptoms and then Hashi and long standing hypo - then you do have a serious health prognosis. They do know what they are doing but like I said we are the hidden folk whilst diabetes is very obvious. After all it is in our minds, so just pop some happy pills for years on end till plenty of damage done whilst we are still able to be kept under the radar. If sell by date even worse.

    Been following and researching the bigger agenda for over 30 years, watching UN and many others, wading through their laws and treaties, mostly unknown to general public, till they were coming out of my ears. I used to wonder on how earth do these oligarchs think they can implement and get away with these proposals. I sit with awesome horror as I watch them do it. This is down to the lowest level and hey presto it works. Diabolically clever but absolute wickedness. Heaven help them.

    Thanks clutter - enjoyed your input this end.

  • @Clutter, it has just cost them a couple of stay in hospital and an operation because my Levo has been so abysmal over the past 6 years. My son has T2 Diabetes and I am now borderline. I understand badly treated Hypothyroidism can cause other things which need treating also. After taking ferrous fumarate for 4 weeks my new GP is now not sure what my Ferritin levels were. Heaven help us, because the NHS and most doctors won't or can't.

  • Complex and very informative-----

    • Pay for doctors Find out about the different doctor pay grades in 2016.


    • A simple guide to Payment by Results gov.uk/government/uploads/s...

    • NHS payment system england.nhs.uk/resources/pa...

    • PAY bma.org.uk/advice/employmen...

  • Have downloaded the links and will look at them later. Thanks a lot for sending them to me.

  • Also I think another reason being there is only so much in the 'pot' and so many now not working,for some genuine reasons of course,but very many could but choose not too! Therefor the most serious,life threatening must take priority. Not a great situation for us but only seems right to me.

  • The thing is that type 2 diabetes is reversible if caught in time so many GP surgeries are at last starting to prescribe walking, physiotherapy and other dietary and holistic therapies to prevent prediabetes becoming full blown. This can only be a good thing.

    As far as the NHS is concerned autoimmunity of all types is chronic and progressive and therefore not reversible so less is invested in non drug interventions. Thyroid diseases are not the only invisible ones.

    I have been diagnosed with RA and Sjogrens as well as Hashis and don't even get asked to come in for a flu jab - not that I want one - but I note that it says on the info everywhere in my practice that anyone with a chronic condition should have one. But the Praxtice nurse yesterday, testing me for diabetes and taking my thyroid bloods, said I'd need to ask a GP and would probably only warrant one if I was starting a new immunosuppressant drug. As I say, in my case I don't mind as don't want one anyway, but it does seem to me that only diabetes and cancer warrant real preventative measures sometimes.

    And yes I think it's all about longevity and avoiding expensive procedures, rather than improving the quality of life for those of us living with debilitating chronic diseases.

  • I was diagnosed with type 2 diabetes in July 2015. Since then I have followed all the advice, lost weight changed my diet and improved my general health. I have also had two full check up with GP practice nurse and have appointment with Virgin Care for a retinopathy test in two weeks time.

    The whole objective of these tests is to prevent worse ailments as a result of diabetes . There are millions of people, especially fat people walking around with diabetes 2 without knowing it. A simple finger prick test at a local pharmacy will detect it, and hopefully lead to prevention . Consequences of not finding out can lead to amputation of legs and blindness .

  • Twitchytoes T2 diabetes can also be caused through having steroid treatment. My son has it caused through having to have Hydrocortisone. This was told to me by my Optometrist not NHS. Also, suspect it could be caused by the weight we put on through having to have Levothyroxine.

  • I know this j_bee. My late dad had a massive heart attack at my age from undiagnosed diabetes. His father and brother both had diabetes too.

    Also I've had steroids on and off all my life and am somewhat overweight- but hopefully I have managed to avoid diabetes so far I eat very healthily and walk about five miles or more a day. I weaned myself off steroids last year because I was concerned these were doing more harm than good re increasing my risk of osteoporosis and diabetes. I am sure more could be done for people who want to get off steroids too apart from people with Addison's who would die without them.

    My point is that's it's great that the NHS is trying to prevent the otherwise healthy population from getting diabetes and some cancers - but there are also lots of lifestyle choices and non drug interventions that could be encouraged or even prescribed for other chronic diseases too. Not instead of preventing or helping diabetes 2 and some cancers, but as well as.

  • Cancer is usually fast -tracked as it is immediately life threatening. And so should it be! Depression is a SYMPTOM of under active thyroid not a seperate diagnosis. Doctors are paid to prescribe certain drugs such as anti-depressants and statins.

  • I am not happy with my local health board or the Welsh NHS. I found what was thought to be a melanoma. I had to wait 3 months to see a consultant, 10 weeks for an op and 6 weeks later, I am still waiting for the results! I have written to the MP, the head of Welsh Health and the local health board, and have been fobbed off by each (resources). The 10 day fast track has been changed to 62 days for suspect cancer here (which they still dont hit). Totally shocking. I was well used to bad care for the thryroid, but it seems my face does not fit for any illness. No patient constitution was explained away as "all hospitals are brilliant". I suspect all those at the top of the NHS have private health care so are not affected by their decisions.

  • I could take a guess as to which Health Board you are talking about serenfach - the one in Special Measures by any chance ? They are beyond a joke......an absolute disgrace.😈😈😈😈 Rant over. 🌻

  • I don't begrudge the Multi Disciplinary Team that my dear husband was under......yes there were bells and whistles if he wanted them, aromatherapy, reflexology, free parking at the hospital etc.. he gets appointments ASAP if he has ANY concerns.............but I think, I hope, that they have cured him of throat cancer which he had the primary treatment for in 2012. We still see them every 3 months or so and hope to get the magic all clear nest year. And for that I am so greatful. They looked after me too and kept me going and were all there to give us both a hug and listen to our woes when you needed it right from the ENT consultant to the nutritionists.

    Mind you, hubby still had to almost scream at the GP to have a scan because he knew that something was seriously wrong and refused a 2nd course of ab's for a "strep throat". *rolls eyes*.

  • Cardiac, diabetes and the prescription of anti-depressants gets extra funding as far as I know - may be others.

  • Wow - didn't know that hence my puzzled. Thank you .

  • Statins is another one busterboy.

    J 🍀

  • My list is getting longer - thought there must be folk on here with knowledge in this area. The ones I have observed are - diabetes, heart, cancer, and mustn't forget obesity not leaving out our dear statins and flue jabs. Don't get me wrong ALL who need medical treatment should be receiving it at point of need and as I have read through different posts on forums my heart ached for those suffering but I got a shock when I realised it wasn't just my age group but the young ones with families and jobs to try and cope with.

    May The lord watch over them all.

  • It makes you wonder how members of the medical profession treat themselves when they have a thyroid illness.

  • We have had occasional doctors on the forum - I imagine there are far more of them than ever identify themselves.

    I remember one of them was an Eastern European doctor who had come to the UK to work for the NHS. She went back home to get treatment because she was treated so badly here. I can't remember now if she couldn't get a diagnosis or was left under-medicated.

  • I wasn't expecting such a response - sussed out sometime back that we had little hidden medics on here, get great advice from them which is all welcome but with what they see written here I am sure I would remain hidden also. Thank for responding humanbean.

  • I don't know of anyone on here who is currently active who has admitted either publicly or privately that they are a medical doctor (at least to me).

  • As I said I am not surprised but for those hidden helpers, God Bless you and a big thank you.

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