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Private GP Services

Family, children, advice, schooling, finance for children, all things kids.
Mike4
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Re: Private GP Services

#497410

Postby Mike4 » April 29th, 2022, 8:27 am

scotview wrote:Interesting discussion....BUT why do GPs continue to receive an average salary of $130K plus astonishing DB pension benefits ?


You hold that GPs are paid in US Dollars?

But more seriously, they have been covering the reasons for the crumbling of the UK GP service in some depth on R4 "Today" programme this morning. One Bristol GP said (I think) they spend 5 hours a day on administration after seeing patients.

Edit to add:
I do wonder if some of it is self-inflicted. When I was first prescribed blood pressure medication many years ago ISTR getting three or six months-worth of tablets at a time. A few years ago my prescriptions were cut back to four weeks at a time so whereas 20 years ago I needed two repeat prescriptions a year, now I now need 13. I wonder if this is a "GP led" change as they get paid I imagine per prescription written, or if the GP actually disagrees and it is a government imposed requirement to reduce wastage of expensive medication. Either way it is a massive increase in GP admin.
Last edited by Mike4 on April 29th, 2022, 8:33 am, edited 1 time in total.

Lootman
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Re: Private GP Services

#497413

Postby Lootman » April 29th, 2022, 8:31 am

servodude wrote:
bruncher wrote:osteopathy of course not even recognised by NHS

Are you sure? I thought it was considered a peer of physiotherapy these days; complementary rather than quackery.

kempiejon wrote:I too thought the osteopathy was not recognised by the NHS but found this
Osteopathy is available in some areas on the NHS. Your GP or local clinical commissioning group (CCG) should be able to tell you whether it's available in your area.

https://www.nhs.uk/conditions/osteopath ... 20together.

In practice the issue is not whether it is theoretically covered by the NHS but whether and when you can see such a specialist when you need to.

A couple of years ago I had a foot issue and went to see my (part-time, working mother) GP. Without even barely looking at my foot she said that I needed to see a podiatrist. She said she could refer me to a NHS one but the wait time was about 3 months. Or you could go private, she said, which I did and got seen the next day.

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Re: Private GP Services

#497432

Postby abisgran » April 29th, 2022, 10:23 am

Reply to Mike-re 1month prescriptions .This is one of the regulations I referred to-No GPS do not get paid per prescription but pharmacists do and pressure to prescribe short length comes from Government and managers to avoid waste-GP and patients time and inconvenience is not considered!

BullDog
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Re: Private GP Services

#497440

Postby BullDog » April 29th, 2022, 11:22 am

It's a little off topic, but I have suffered steadily deteriorating jount pain for more than 30 years. The last year it has got far worse. I have been unable to persuade the GP surgery that I needed a proper face to face appointment for a real, final diagnosis. Instead I got four telephone appointments one after the other each with a different GP. Without exception, none of them considered the previous 30 plus years of deteriorating joint pain that was there on my records and I tried to tell them about. Every one of them decided after about 30 seconds that I had gout despite my protesations otherwise. All blood tests were normal and their in house physiotherapist suggested fibromyalgia in his report to the GPs. In the end, I had no realistic choice but to make a paid for self referral to a consultant in order for him to write to the GPs and tell them to stop insisting I had gout.

I think this is what I am going to do in the future if I ever need a diagnosis again. Self refer to a consultant in the appropriate discipline and have the consultant tell the GP how to treat or otherwise.

How sad the NHS has degenerated to this. When I was growing up the family GP knew you and would often visit at home whether you requested it or not. How things have changed?

AF62
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Re: Private GP Services

#497501

Postby AF62 » April 29th, 2022, 3:59 pm

scotview wrote:
bruncher wrote: Perhaps things are better in rural areas?


Most people I talk to, in rural Aberdeenshire, have generally seen a huge deterioration in GP services since Covid.


Small market town in England here and things are absolutely fine - for me. My belief is whether you consider the service to have deteriorated is down to your expectation.

Going back ten years or so I was registered to a traditional GP surgery with half a dozen doctors who had all been there for years.

They were useless.

Their opening hours were 10am to 3pm Monday to Friday which was distinctly unhelpful for someone commuting to London and needing an appointment for a routine issue, not something that would keep you off work. And as for making an appointment, well god help you if you wanted one that day.

Then a new surgery opened in the town. It was operated by a company that ran a number of surgeries and all the doctors were locums, but it was open 8am to 8pm Monday to Saturday and 9am to 4pm on Sunday. Sure you could make an appointment, and even do that online, but if they didn’t have one that suited you then you could just turn up at 6pm and sit and wait until you were seen.

When COVID hit then obviously it went through the same changes as all the other GP surgeries, but it has reopened in pretty much the same format as before. There have been some changes, such as generally a telephone appointment with the GP followed by a face to face appointment if they believe it is needed, but the 6pm ‘sit and wait’ service is still there if preferred.

Does everyone like it - no. For the elderly they still seem to prefer the old 10 til 3 surgery because they see the same GP and the time constraint is irrelevant.

Me, even though I am now retired I prefer the flexibility of the new surgery, and a constant change of doctors is irrelevant as I would prefer to see someone newly qualified than someone who qualified decades ago and who’s knowledge of current procedures and options is limited and out of date.

Am I happy to have a pre-face to face triage phone call with the GP - sure. Am I happy for the annual review of medications to be carried out by phone rather than in person - sure. Are others - possibly not.

bruncher
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Re: Private GP Services

#497787

Postby bruncher » April 30th, 2022, 11:57 pm

abisgran wrote:.Ever large practices staffed by a few doctors and many alternative clinicians(nurses,paramedics ,pharmacists and physiotherapists)seems to be the future -those clinicians are good at what they are trained to do but if you need a diagnosis you need a doctor -


My GP practice has a huge range of new staff e.g. people doing 'social prescribing'. I can understand that there may be holistic thinking behind this, that someone might need encouragement to take exercise (so prescribe swimming or gym), but to have a holistic view you need to know someone: their medical history, what kind of work they do, their living conditions, whether they eat well, sleep well, are happy in their family life etc. If the services are too specialised they are fragmented with no-one having a full picture. This is what we need GP's for IMHO.

MDW1954
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Re: Private GP Services

#498428

Postby MDW1954 » May 4th, 2022, 1:24 pm

BullDog wrote:It's a little off topic, but I have suffered steadily deteriorating jount pain for more than 30 years. The last year it has got far worse.


For over a year, now, I have been taking these, after suffering six months of debilitating knee pain:

https://www.healthspan.co.uk/shop/turmeric-10000-with-bioperine-black-pepper-extract/

No affiliation, etc, just a very satisfied customer.

MDW1954

Dod101
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Re: Private GP Services

#498437

Postby Dod101 » May 4th, 2022, 1:53 pm

abisgran wrote:Reply to Mike-re 1month prescriptions .This is one of the regulations I referred to-No GPS do not get paid per prescription but pharmacists do and pressure to prescribe short length comes from Government and managers to avoid waste-GP and patients time and inconvenience is not considered!


To avoid waste no doubt but it should also give the GP the chance to check whether ongoing prescriptions are really necessary. That is what a GP is supposed to do. The patient’s time and inconvenience? Well it is her/his life after all. I was briefly on pills for high blood pressure some years ago and changing lifestyle/habits meant I was taken off them after a few months. That is what is supposed to happen.

Dod

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Re: Private GP Services

#498444

Postby ReformedCharacter » May 4th, 2022, 2:18 pm

MDW1954 wrote:
BullDog wrote:It's a little off topic, but I have suffered steadily deteriorating jount pain for more than 30 years. The last year it has got far worse.


For over a year, now, I have been taking these, after suffering six months of debilitating knee pain:

https://www.healthspan.co.uk/shop/turmeric-10000-with-bioperine-black-pepper-extract/

No affiliation, etc, just a very satisfied customer.

MDW1954

I too have had knee pain, on and off for decades. Of course knee pain can be caused by different things but I'll mention my experience just in case it may help someone else. I'm not an exercise fanatic but have for most of my adult life kept fairly active, running, swimming, badminton, cycling etc. As I've got older I don't do so much but I'm by no means idle. Sometimes my knee was OK but then I'd do something as simple as getting off a set of steps slightly awkwardly and then I'd have weeks or months of discomfort.

Eventually, I went to see my GP again. The GP was not very helpful but sent me for a knee X-Ray. When I went back to see my GP I was told 'no problem with your knee'. As far as she was concerned that was it. I said 'OK, glad the X-Ray shows my knee is good but it still hurts.' She said 'What do you want me to do?' and I said 'I'd like to see someone who knows a bit more about knees, please'.

So I got an appointment with someone who knew a bit more about knees. The knee doctor had a look and told me that one of my knee muscles had atrophied and I needed to exercise it more. This came as something of a surprise because I'd been doing 3 sessions a week on an exercise bike which I assumed would have kept the muscles reasonably developed. So I bought some 2kg weights that can be strapped around the ankles and most days I sit on the bed and do knee-straightening exercises. I could see that the muscles around the knee were getting bigger but more importantly I haven't had a trace of knee pain ever since - about 5 years. I could have saved myself years of discomfort if I'd seen the knee doctor earlier and followed his advice.

My conclusion is that as we age muscles deteriorate and that can be a cause of joint pain. I also have a dodgy shoulder and some moderate weight lifting (shrugs) have greatly helped with that.

Good luck with your knee.

RC

scrumpyjack
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Re: Private GP Services

#498446

Postby scrumpyjack » May 4th, 2022, 2:34 pm

abisgran wrote:Reply to Mike-re 1month prescriptions .This is one of the regulations I referred to-No GPS do not get paid per prescription but pharmacists do and pressure to prescribe short length comes from Government and managers to avoid waste-GP and patients time and inconvenience is not considered!


It is unlikely that shorter prescriptions waste much GP time. The normal way this works is that it is set up as a repeat prescription with a specified review date (eg one year). I then simply log onto the GPs system, request the items I want (it won't let me order unless near the due date), the prescriptions go automatically to the nominated Chemist (no paper involved) and I collect them. The GP will not normally be involved.

MDW1954
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Re: Private GP Services

#498458

Postby MDW1954 » May 4th, 2022, 3:41 pm

ReformedCharacter wrote:So I got an appointment with someone who knew a bit more about knees. The knee doctor had a look and told me that one of my knee muscles had atrophied and I needed to exercise it more. This came as something of a surprise because I'd been doing 3 sessions a week on an exercise bike which I assumed would have kept the muscles reasonably developed. So I bought some 2kg weights that can be strapped around the ankles and most days I sit on the bed and do knee-straightening exercises. I could see that the muscles around the knee were getting bigger but more importantly I haven't had a trace of knee pain ever since - about 5 years. I could have saved myself years of discomfort if I'd seen the knee doctor earlier and followed his advice.

My conclusion is that as we age muscles deteriorate and that can be a cause of joint pain. I also have a dodgy shoulder and some moderate weight lifting (shrugs) have greatly helped with that.

Good luck with your knee.

RC


At the erisk of taking this slightly off-topic, I want to add three things.

First, my knee pain vanished within three days of taking the turmeric tablets. It was miraculous. I couldn't believe it.

Second, I'd seen a physiotherapist twice, and she had each time prescribed exercises that sound similar to yours -- except that they made little difference!

And third, since 2018 I've been going to a Metafit exercise class aimed at seniors, usually once a week. That two has been helpful on lots of fronts.

MDW1954

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Re: Private GP Services

#498504

Postby mc2fool » May 4th, 2022, 6:52 pm

scrumpyjack wrote:It is unlikely that shorter prescriptions waste much GP time. The normal way this works is that it is set up as a repeat prescription with a specified review date (eg one year). I then simply log onto the GPs system, request the items I want (it won't let me order unless near the due date), the prescriptions go automatically to the nominated Chemist (no paper involved) and I collect them. The GP will not normally be involved.

Then why does ordering a repeat prescription online wait for a working day or two before being marked as "Approved" (NHS App) and saying "Approved by your GP"? (NHS App and Patient Access) :D

scrumpyjack
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Re: Private GP Services

#498522

Postby scrumpyjack » May 4th, 2022, 8:06 pm

mc2fool wrote:
scrumpyjack wrote:It is unlikely that shorter prescriptions waste much GP time. The normal way this works is that it is set up as a repeat prescription with a specified review date (eg one year). I then simply log onto the GPs system, request the items I want (it won't let me order unless near the due date), the prescriptions go automatically to the nominated Chemist (no paper involved) and I collect them. The GP will not normally be involved.

Then why does ordering a repeat prescription online wait for a working day or two before being marked as "Approved" (NHS App) and saying "Approved by your GP"? (NHS App and Patient Access) :D


I suspect it is being checked by an admin assistant or nurse at the practice rather than a doctor. After all they have already decided how long you should have the repeat prescription for before your meds are reviewed

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Re: Private GP Services

#499341

Postby scotia » May 8th, 2022, 8:02 pm

bruncher wrote:Scotland has significant differences I believe, such as free social care/home care. Also Sturgeon recently announced free dentistry, but I don't know if that has happened.

I'm afraid it is not that simple in Scotland. If you require care in a nursing home (as did several of my family) then the responsible local authority is supposed to make a modest contribution which was (in my parent's time) larger than the attendance allowance provided in England. But getting the local authority to pay could prove difficult. In my mother-in-law's case, it took the MP to persuade them. In my father's case the MP was useless, and it was only after a report from the Ombudsman that they coughed up. Both required us to carry out many communications with all relevant sources before the advised contributions were paid. I hate to think what happens if there are no relations capable of pursuing the authorities.
Currently our neighbour is attempting to live out his remaining time at home, with both his wife and self in extremely poor health conditions. He is paying £1000 per week for a live-in help.
I haven't heard any reports on free dentistry in Scotland. I certainly paid on my last visit to an NHS dentist a couple of weeks ago.

ayshfm1
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Re: Private GP Services

#499788

Postby ayshfm1 » May 11th, 2022, 10:37 am

I have found that my local GP practice has something of an attitude, as far as it is concerned we should be grateful for their presence and my time is definitely not something that figures into their thinking.

Not something that really matters, but worth a chuckle. I went to get my medical details onto the NHS app, I was going on holiday and wanted to be able to prove I'd have my cov 19 shots. The receptionist viewed me a rather frosty manner and told me to fill in the online form. I asked for the URL, since I already combed their web site and knew no such URL was publicly available, she handed me a printed form, this is not an online form I opined. Yes it is she contradicted. I smiled sweetly at the old battle axe and filled in the form.

More pertinently they decided they wanted to see to take my blood pressure. They texted me and asked me to ring and make an appointment. Good luck with that.. could not get through. Eventually managed to do it by email. A nurse? did the blood pressure and requested I keep taking it and submit them the reading. I bought my own machine and did as I was asked. Again I was texted - could I make an appointment to see the GP? Again it's fine for them to text, I however have to ring. I ring them up and miracle I get through. I said I'd been asked to make an appointment. They aren't any today was the reply. Good I said, I'm busy today and it's not urgent, next week will be fine. No she said, You need to ring up on the day you want to see the GP and should do it early as they go very quickly. Thus I realised why I got through it, was in the afternoon and why I'd not managed before, it was mid morning, lots of people trying to get appointments for that day, fruitlessly one suspects.

I'm not seeing my GP as providing a viable service in any sensible way. So I too started wondering if there are such a thing as private GP's and how you go about finding them.

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Re: Private GP Services

#499790

Postby BullDog » May 11th, 2022, 10:44 am

ayshfm1 wrote:I have found that my local GP practice has something of an attitude, as far as it is concerned we should be grateful for their presence and my time is definitely not something that figures into their thinking.

Not something that really matters, but worth a chuckle. I went to get my medical details onto the NHS app, I was going on holiday and wanted to be able to prove I'd have my cov 19 shots. The receptionist viewed me a rather frosty manner and told me to fill in the online form. I asked for the URL, since I already combed their web site and knew no such URL was publicly available, she handed me a printed form, this is not an online form I opined. Yes it is she contradicted. I smiled sweetly at the old battle axe and filled in the form.

More pertinently they decided they wanted to see to take my blood pressure. They texted me and asked me to ring and make an appointment. Good luck with that.. could not get through. Eventually managed to do it by email. A nurse? did the blood pressure and requested I keep taking it and submit them the reading. I bought my own machine and did as I was asked. Again I was texted - could I make an appointment to see the GP? Again it's fine for them to text, I however have to ring. I ring them up and miracle I get through. I said I'd been asked to make an appointment. They aren't any today was the reply. Good I said, I'm busy today and it's not urgent, next week will be fine. No she said, You need to ring up on the day you want to see the GP and should do it early as they go very quickly. Thus I realised why I got through it, was in the afternoon and why I'd not managed before, it was mid morning, lots of people trying to get appointments for that day, fruitlessly one suspects.

I'm not seeing my GP as providing a viable service in any sensible way. So I too started wondering if there are such a thing as private GP's and how you go about finding them.

I could have written that word for word. I have the exact same story.

Pre covid, I could make an appointment on line up to two weeks in advance. That really useful feature has disappeared and apparently isn't coming back anytime soon. Disgraceful.

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Re: Private GP Services

#499796

Postby XFool » May 11th, 2022, 11:04 am

scrumpyjack wrote:
abisgran wrote:Reply to Mike-re 1month prescriptions .This is one of the regulations I referred to-No GPS do not get paid per prescription but pharmacists do and pressure to prescribe short length comes from Government and managers to avoid waste-GP and patients time and inconvenience is not considered!

It is unlikely that shorter prescriptions waste much GP time. The normal way this works is that it is set up as a repeat prescription with a specified review date (eg one year). I then simply log onto the GPs system, request the items I want (it won't let me order unless near the due date), the prescriptions go automatically to the nominated Chemist (no paper involved) and I collect them. The GP will not normally be involved.

Same here, just a couple of points.

I think the GP is still involved, as the request first goes to the GP for them to approve (or authorise?) the prescription before being transmitted to the pharmacist. I take it by "GP's system" you mean something like Patient Access.

My medication prescription is still in three month batches rather than monthly as mentioned.

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Re: Private GP Services

#499810

Postby XFool » May 11th, 2022, 12:08 pm

BullDog wrote:
ayshfm1 wrote:I have found that my local GP practice has something of an attitude, as far as it is concerned we should be grateful for their presence and my time is definitely not something that figures into their thinking.

Not something that really matters, but worth a chuckle. I went to get my medical details onto the NHS app, I was going on holiday and wanted to be able to prove I'd have my cov 19 shots. The receptionist viewed me a rather frosty manner and told me to fill in the online form. I asked for the URL, since I already combed their web site and knew no such URL was publicly available, she handed me a printed form, this is not an online form I opined. Yes it is she contradicted. I smiled sweetly at the old battle axe and filled in the form.

More pertinently they decided they wanted to see to take my blood pressure. They texted me and asked me to ring and make an appointment. Good luck with that.. could not get through. Eventually managed to do it by email. A nurse? did the blood pressure and requested I keep taking it and submit them the reading. I bought my own machine and did as I was asked. Again I was texted - could I make an appointment to see the GP? Again it's fine for them to text, I however have to ring. I ring them up and miracle I get through. I said I'd been asked to make an appointment. They aren't any today was the reply. Good I said, I'm busy today and it's not urgent, next week will be fine. No she said, You need to ring up on the day you want to see the GP and should do it early as they go very quickly. Thus I realised why I got through it, was in the afternoon and why I'd not managed before, it was mid morning, lots of people trying to get appointments for that day, fruitlessly one suspects.

I'm not seeing my GP as providing a viable service in any sensible way. So I too started wondering if there are such a thing as private GP's and how you go about finding them.

I could have written that word for word. I have the exact same story.

Pre covid, I could make an appointment on line up to two weeks in advance. That really useful feature has disappeared and apparently isn't coming back anytime soon. Disgraceful.

Firstly, I have to confess I haven't actually made a GP appointment since before COVID (been there for couple of injections) so am not really in a position to comment fully on this. If I need to, no doubt I will find out then. However, some points above did chime with some of my experiences. So I thought I would stick my oar in. :)

My experience - such as it is - and observations are:

Firstly, the whole method for general access to GPs seems to have been changed. You used to turn up and somehow make an appointment, it's not intended to work like that anymore. There is now intended to be some sort of triage system in place between the patient and the GP. This is typically run by a third party and accessed online.

Secondly, while everything was changed - during COVID (and due to COVID) - there seems to me to have been little or no publicity about the large scale changes to the system, leaving many of the public confused and frustrated. I did eventually hear a women GP on a R4 programme outline the changes.

Thirdly, these large changes - involving technology - may well not be even fully understood by staff who work at a GPs practise, such as receptionists.

I am basing the above on my own (limited) experience and observations. I was once in my GPs waiting room (alone) and somebody turned up who had been advised "by the NHS" to go to their GP in order to get "authorisation for their NHS app" wrt COVID vaccination status as he was flying out "within 24 hours". The receptionist wasn't having it: "That's nothing to do with us!"

It banged on back and forth for quite a while (he had more patience that I would!). I nearly intervened since little ole me could see and understand what the issue was, whereas both the GP receptionist and the man were at loggerheads and both just didn't seem to understand what it was about. Fortunately the receptionist did eventually get it and it was presumably sorted without my help. I take it the receptionist had simply been told to say "The NHS App has nothing to do with us" with people trying to get IT assistance at GP surgeries, but didn't understand things well enough to help that particular person. It just goes to show - patients were not the only ones confused.

I am supposed to have regular PSA blood tests. Before COVID I went to the GP, got a prescription for the test then booked an appointment for the blood clinic at my nearest hospital via their website (I have an account to do so). Very convenient. During COVID the hospital website vanished, never to return. Attempts to access the system via my existing link and by Googling led me to just the right sounding link, this led simply to the system producer's website. I concluded the hospital system had been closed down and didn't have any tests for two years.

One day - browsing the local hospital trust for no particular reason (apart from puzzling over how a number of things 'worked' these days) - I followed link after link simply by idle curiosity. I looked at their hospital departments, dropping into 'P' (as I knew 'P' stood for Phlebotomy) and via several more links, down and down. Suddenly I found myself looking at a familiar looking blood test logon screen. Could I log on to this? Yes I could!

I then went to my GPs website, which had been updated and was front-ended by the triage system. I entered a request with explanation (it said I might get a reply in weeks). Next day, got a text from GP to pick up prescription at reception. Picked up prescription, next day logged on to blood test system, made appointment - for same day! Rushed down to hospital not to miss same day appointment (lucky I checked). About three people waiting in clinic (never seen that before) - perhaps most others were still wondering around lost in cyberspace? Seen in five minutes.

All the above was entirely by accident.

Big changes have happened in the health system - somebody seemed to forget to tell the patients.

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Re: Private GP Services

#499820

Postby scrumpyjack » May 11th, 2022, 12:44 pm

I have had a number of GP appointments over the last year or two. One first rings the GP Surgery at 8.30am or soon afterwards. They will either give a same day phone appointment, if reasonably urgent, or a phone appointment in a week or so if it isn't. If the GP decides he/she needs to see you, then a physical appointment is made. It has all worked reasonably well. Sometimes it is a Locum. They have all been fine. It is a very good practice that we have been going to for 38 years (East Hertfordshire town).

ps They have a system for sending in photos that works well, so if you think the doctor needs to see it, photo it on your phone. They send a link to send the pic back to them.

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Re: Private GP Services

#499846

Postby redsturgeon » May 11th, 2022, 2:30 pm

We have opened a private pharmacy, we cannot dispense NHS prescriptions but deal with prescriptions from the local private GP practices and will be dealing with the new local private hospital soon.

Mrs RS is a pharmacist and she will soon be starting a course to qualify as a prescribing pharmacist when she will be able to both prescribe and dispense medicines privately.

It seems like there should be a large demand for this service.

John


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