This is the first post that uses the “Panic button” Icon.

Most members of the medical profession in the UK are very concerned about changes within the NHS right now.

Patients need to be aware what is happening regarding GP Referral Centres because this is the big jaggy rock that will sink the NHS as we know it.

Let me explain one of the most important aspects of these changes.

THE WAY IT WAS:

I, the patient, go to my GP with a complaint. GP takes a medical history, examines me, perhaps orders a few investigations like blood tests, chest Xray etc. On the basis of this he/she feels I need to see a hospital specialist. i.e. a consultant. The GP discusses this with me, the patient, and if there is more than one consultant in that specialty together we will decide which one the referral letter should go to.

The GP writes a letter to the named consultant, posts it, and it is received by that consultant or his/her secretary. An appointment is posted out to me to attend the chosen consultant’s clinic. It is a confidential doctor to doctor communication.

Yes, there may be problems. There may be long waiting lists, but these have been coming down recently. The consultant will try to prioritise the referral letters according to what he perceives as patient need. The GP can phone any consultant personally at any time and discuss the patient with him/her advising that  symptoms/pain or whatever are getting worse. Advice can be given and the patient prioritised.

So only three people are involved in deciding what needs to be done and when it needs to be done. Common sense and professionalism are working together. The patient is given the central position, and is not seen as a commodity.

THE WAY IT IS NOW IN SOME PARTS OF THE UK – AND SPREADING:

In some regions of the country, a direct referral letter from GP to consultant is no longer allowed. Instead the referral is reviewed by someone other than a consultant. That “someone” will know nothing of the patient. That “someone” may be a faceless committee. They triage the referral and make a decision who the patient may be referred to or whether the referral should be accepted at all. If it is not deemed suitable, the referral is returned to the GP.  Alternatively, the referral may be sent on a “pathway” that does not involve seeing a consultant at all. For example, it may be passed on to another GP called a GP with a Special Interest (GPWSI) or on to a health care worker who is not qualified in medicine at all. Alternatively, the patient may be referred on to a private company that has a contract with the NHS.

There is a serious issue regarding patient confidentiality and a fudging of who takes responsibility for the patient’s care.

Some believe this is the beginning of the end of the NHS and the dawn of commoditisation of health with private companies sitting in the wings to commission health services and vet referrals.

And profit from our illnesses.

But that is another story.

COUNTRY : UK

THE MEDICAL BLOGOSPHERE

Some doctors are so concerned over what has been happening gradually within the NHS in recent years that they have become anonymous bloggers. Here are some of them.

Bad Medicine
http://badmed.net/

Dr Grumble
http://drgrumble.blogspot.com/

Nothern Doc
http://northern-doc.blogspot.com/

The Ferret Fancier
http://ferretfancier.blogspot.com/

The Jobbing Doctor
http://thejobbingdoctor.blogspot.com/

The Witch Doctor
http://witchdoctor.wordpress.com/

The above are all medical practitioners, some with a background in general practice and others from various hospital specialties, They have one thing in common. They are frustrated about many of the changes that are going on in the NHS in England just now and it is worth reading about their concerns. Don’t be fooled by the inimitable writing style unique to each blogger. That is just the bloggers’ way. The underlying messages they give are very serious. Most of these medical bloggers have worked at the coalface in the NHS for decades and really do know what is going on. I suspect most have no allegiance to any political party and therefore speak freely.

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