Performance Indicators in the NHS - Just one example

So I had a gp consultation a couple of months ago about my worsening allergies. She referred me on to a clinic in Liverpool. So the practice get tick in the performance indicators for closing my case quickly. White check mark

Prompt email reply from the allergy clinic saying the have triaged (considered) my case and determined Im not seriously enough at risk  to see them, sent some leaflets and closed my referral. Which means they can tick White check mark  their performance indicator for great speed of the case and done under the target waiting time. 

End result for me is a few leaflets and with still worsening allergies. End result for NHS is manipulated statistics to show them in a better light. 

So when the nhs and government say they have reduced waiting times have this weaze in mind, they can now effectively triage cases where one possible outcome is no action, yet this counts as a referral dealt with. I think this is fairly new as triage didn’t previously to my knowledge have “no action” as possible outcome, and that this counts positively towards waiting times averages going down which is deceitful in my opinion.

  • The accupucture done by the NHS isn't traditonal accupuncture, but the one developed after the cultural revolution to be more like Western Mediciine, it treats symptoms not causes mostly.

    I'm having another accupuncture session today, so I'll let you know later how I get on.

    I can't have amitryptaline, the lable on the packet said don't operate machinery or drive if you feel woozy, I couldn't operate a dustpan and brush, I sat in front of the stove for about 20 mins wondering why I was there and what I was supposed to be doing. Why are so many treatments as bad of worse than the condition you're taking them for and were expected to take them for years?

  • I don't really understand why they say, you can have a 6-8 weeks, then that's it, you don't get more sessions even if you need it, or if what you are dealing with takes longer to address.

    The NHS says:

    "If you get counselling on the NHS, you’ll usually have between 8 and 16 sessions."

    NHS - Counselling

    Based on (their assessment of) my needs, my own course of post-diagnostic NHS counselling was extended several times - eventually going beyond 16 sessions.

  • I'm glad you've had that at least and the outcome was good for getting diagnosed, but definitely, you don't just fix deep traumas in a few weeks.

    I don't really understand why they say, you can have a 6-8 weeks, then that's it, you don't get more sessions even if you need it, or if what you are dealing with takes longer to address.

    They don't do that with physical medicine. Imagine how absurd that would be 'oh that rash came back, sorry we treated you for it already.'

  • I contacted the clinic that my GP had referred me to but they said they didn’t know of anything about my referral or the letter.I suppose that could be, but somebody sent that letter.

    I received around 6 or 8 weeks counselling at the GP surgery.  The counsellor picked up that I could be ASD which ultimately lead to the GP’s referral and diagnosis, so that was a good result. I could really do with something further.

  • It sounds like by not putting down any contact details they pretty much guaranteed they could say you hadn't engaged with them, as they didn't give you any means to. Anywhere method of keeping the books clear, it wouldn't surprise me if the manager gets a bonus for that.

    I hope you have managed to find something since, support seems to be so thin on the ground.

  • If waiting times are being manipulated in order to create a different impression from reality, I agree it’s deceitful and potentially harmful for patients.

    My GP referred me to mental health services over two years ago. I received a standardised response on partially headed paper and three leaflets. The letter heading showed the name of the Health Trust to which my GP had referred me, but no address or contact details and the letter wasn’t signed. The text was very blurry (a photocopy of a photocopy X multiple).

    The text said that I should contact one of the agencies named in the enclosed leaflets. These were voluntary agencies and charities. I contacted all three agencies. Two had closed several years earlier, but a very nice man at the third agency telephoned me and said they weren’t set up to deal with me as they dealt only with victims of certain types of trauma. He was furious with the Trust and he said that I and others in the past had been referred to him because the Trust couldn’t do its job and it couldn’t be bothered to deal politely and properly with people. The man hadn’t even received a courtesy call from the Trust.

    Some time later, my GP received a letter saying that I hadn’t engaged with the Health Trust service and that I had been discharged. That was untrue. I did my best to follow this up but everybody I spoke to passed the buck and told me different stories. It’s really shocking because it feels like an assault on my character, it’s lies and I’m powerless.

  • I sooooo relate to you. I am diagnosed with fibromyalgia and Im fairly sure because of the mis firing nervous system my allergies are made worse. We had a pain team in our town but they discharged me after three token sessions with a young nurse. No disrespect to the young, or nurses, but she couldn’t have appreciated what I was going through, and had no answers when I asked her for more in depth explanations. I had been diagnosed by the rheumatologist at a clinic my gp referred me to, fortunately on a bus route from me. 

     I can take painkillers, have been on tramadol with paracetamol for a couple of years, but Im reducing the tram gradually as the amitryptalene (an older anti depressant (spelling ?)) and duloxetine (SNRI) are improving things. The pain is less frequent, less widespread and less debilitating.  I do though get hit with a wall of exhaustion most days early to mid afternoon. 

    My spatial awareness is very poor and coupled with suicidal ideation which can coincide with meltdowns Ive lost my driving licence  


    Like you I don’t think people believe me a lot of the time, I just cant find words that can objectively describe such a subjective bundle of sensations and feelings and pain. However my current gp does and we get on well. 

    oh yes, 100% agree about physio.  But I know acupuncture works for (scientifically based not woo woo), so why can I be offered physio which doesn’t work, but not acupuncture which does! Thats a sort of rhetorical question as I know the answer having worked at on time public sector accounting, its just ridiculous  

    Hope your day is going well, its very cold and windy here in the north west  

    best wishes 

    AnA

  • I know what you mean, I had a similar thing when I was having some GI problems the GP did her part of requesting a bowel cancer test and a referal to hospital. I did the test and it came back negative, case closed, no problem. I had a similar experience with the Pain Clinic, I spoke to a nasty nurse who asked "what I expected of them this time", they weren't interest that I was going to them for a different problem to the one they couldn't help me with before. The sum of thier advice was take painkillers, which I'm alergic too, have phsyio which was crap and exercise. I was told they don't deal with fibromyalgia and I'd have to go to a seperate group for that, the one she recomended had closed and I'd have to go to Llandudno, 40 odd miles away and not easily accessable.

    I've never had proper allergy screening for all the things I'm allergic too or react badly to or are intolerant of, I've had to work it all out myself, I asked my GP if he could refer me to a specialist and there are so few allergy specialists he said he wouldn't know where to refer me too. When you've multiple allergies people get fed up with you and start disbelieving you and treating you like you're attention seeking and a pain in the bum, it never occurs to them what a massive pain in the bum it is for me, the things they stop me doing, the amount of money they cost me, does it not occur to them that I don't want to be the person spending mega bucks on laundry products and toothpaste and that I'd rather buy the cheap stuff from aldi like everybody else?