# NHS cost cutting



## Happydays (Feb 23, 2018)

Hi to everyone i am new on here. Just to advise that the NHS are in a cost cutting process at this time. I was referred to the hospital diabetic section about 3 years ago. The hospital have had to look after my meds in that time the meds were changed 4 times till they found the correct meds that worked and agreed with my system. Now the hospital have said to go back to the GPs that referred me to the hospital in the first instance. That instils a lot of confidence in me as the GPs could not get it right in the first place. Happydays


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## Robin (Feb 23, 2018)

Happydays said:


> Hi to everyone i am new on here. Just to advise that the NHS are in a cost cutting process at this time. I was referred to the hospital diabetic section about 3 years ago. The hospital have had to look after my meds in that time the meds were changed 4 times till they found the correct meds that worked and agreed with my system. Now the hospital have said to go back to the GPs that referred me to the hospital in the first instance. That instils a lot of confidence in me as the GPs could not get it right in the first place. Happydays


Hello, Happydays, and welcome to the forum. I'm afraid this is nothing new, I was discharged back to my GP for all my care about 7 years ago, after being seen by the hospital for the first three years. ( and my GP surgery nurse was just doing her training to be a nurse with a special interest in Diabetes,,and hadn't got on to learning anything about Type 1 at the time. She learnt quite a bit from me!) 
It's a case of saying 'well the hospital said this...' if your GP tries to change anything that you consider to be for the worse, and insisting on a referral back to the hospital if your condition changes.


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## Sprogladite (Feb 23, 2018)

It is quite normal to be referred back to the GP once the hospital team feel you have stabilised.  If you run into problems in the future you are able to ask to be referred back to the hospital, so I wouldn't worry too much about it


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## Ralph-YK (Feb 23, 2018)

Welcome Happydays.  If I may ask, are you T1 or T2.
I was diagnosed just over 3 years ago.  I was never under the hospital for my diabetes.  I saw my GP once, with the one thing she said about my diabetes was to make an appointment with the nurse.


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## Happydays (Feb 24, 2018)

Ralph-YK said:


> Welcome Happydays.  If I may ask, are you T1 or T2.
> I was diagnosed just over 3 years ago.  I was never under the hospital for my diabetes.  I saw my GP once, with the one thing she said about my diabetes was to make an appointment with the nurse.


Hi Ralph-YK, I am T2 but when i was diagnosed i was put on meds that did not work so they got changed to the point i am at now, My concern was/is that the GP who referred me to the hospital as the GP did not know what to prescribe me, now the hospital are sending me back to the same GP. Hence the cost cutting statement. As stated here i will ask to go back to hospital if GP wants to change any of the meds, I have no faith in GP for reason stated. Last HBA1C was good so do not see a need for any changes by GP


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## Happydays (Feb 24, 2018)

Robin said:


> Hello, Happydays, and welcome to the forum. I'm afraid this is nothing new, I was discharged back to my GP for all my care about 7 years ago, after being seen by the hospital for the first three years. ( and my GP surgery nurse was just doing her training to be a nurse with a special interest in Diabetes,,and hadn't got on to learning anything about Type 1 at the time. She learnt quite a bit from me!)
> It's a case of saying 'well the hospital said this...' if your GP tries to change anything that you consider to be for the worse, and insisting on a referral back to the hospital if your condition changes.


Hi Robin, Took your remarks on board and will certainly ask to go back to hospital who know best IMHO


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## trophywench (Feb 24, 2018)

Can you see a different GP at your surgery - or even change your surgery to ensure you see a different one?

The point is though - no GP is an expert on everything and to my mind the important thing about all of them is that they admit when they don't know enough 'in depth' about some medical problem whatever it happens to be and they therefore admit they don't know, and refers patients to someone that does have that expertise asap instead of trying to bluff their way out of it and cause harm.  After all the most important words in the Hippocratic Oath are the opening ones of it - 'First, cause no harm'.


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## Ralph-YK (Feb 24, 2018)

My GP practice (both old and new) seemed quite prepared to go along with recommendations from hospitals, and put the meds on repeat straight away.
I've been to the hospital for several things. Both A&E and scheduled clinics, seeing consultants.
Of course, continuing care is another issue


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## Happydays (Feb 28, 2018)

Hi everyone, Just had blood tests done the good ol HBA1C is at 45, Had to have blood tests done due to impending operation next week, Notes recommend I see a consultant about this, guess where............. At the hospital that have told me to go to GP for further care, This is like that old song "the wheels on the bus go round and round" Gonna wait a few days to get the phone call from GP to see how alert they are. Happydays


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## grovesy (Feb 28, 2018)

45 is a gooď result.


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## Lilian (Feb 28, 2018)

"cost cutting" - "patient culling"


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## Ralph-YK (Feb 28, 2018)

My lowest HbA1c had been 46. I've been just as likely to get 47 and 48.
Medical people I'm dealing witj are not bothered by this figure at all.


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## Matt Cycle (Feb 28, 2018)

When I was diagnosed in 1986 both T1 and T2 were seen at the hospital clinic and it was bad enough then in terms being busy.  In the years that followed and the subsequent skyrocketing increase in T2, care, especially for T2 was shifted to the GP's as presumably hospital clinics couldn't have coped.  There is also the argument that does a specialist consultant really need to see all these people.  Most T2 and a number of 'stable' T1 have their care at the GP.  I wouldn't describe it as cost cutting but any GP staff need to have the relevant training.  If things aren't working and the GP care can't deal with it then presumably you will be referred to a specialist.  In my case I found most of the GP doctors and nurses had minimal experience of dealing with T1 when I moved to GP care and I have now transferred back to the hospital clinic a couple of years ago when I was thinking of going on the pump.


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## mikeyB (Feb 28, 2018)

I agree, Matt. A GP can’t get the presumably standard treatment to succeed, so refers to hospital. So far, standard practice. Hospital changes treatment, which works, so refers back to GP for continuance of therapy. Standard practice. Pre op checks - done in hospital. Standard practice. 

This thread is a perfect demonstration of that. Nice to know the system works, I suppose. 

If every T2 were seen regularly in hospital clinic there would be queues outside and round the car park.


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## Amigo (Feb 28, 2018)

I’ve only seen a GP once in 3 years about my diabetes and that was at diagnosis. The rest of the time I see the Practice Nurse who isn’t a specialist. Seems to me that if you stay under the 48 mark, they don’t bother much and that suits me fine but wouldn’t work for everyone.


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## robert@fm (Feb 28, 2018)

Lilian said:


> "cost cutting" - "patient culling"


It's a pity this forum only has a simple "like" facility; there are times (such as this post) where Farcebook's "love", "amazed", "sad" or "angry" would be more apt.  In response to this post, I would have liked to use the "angry" response (at the NHS, not at Lilian).


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## Happydays (Mar 1, 2018)

I know 45 is a good HBA1C due to it being 102 in the past. What grinds my gears is being told to go back to a GP who did not know what to do in the early days. Now back with said GP (the only one for miles) the result said refer to hospital who put me back to GP. Yes NHS is under funded but to have this merry go round does not help, Just moving the funding from one area to another IMHO. Happydays


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## trophywench (Mar 1, 2018)

Happydays said:


> Hi everyone, Just had blood tests done the good ol HBA1C is at 45, Had to have blood tests done due to impending operation next week, Notes recommend I see a consultant about this, guess where............. At the hospital that have told me to go to GP for further care, This is like that old song "the wheels on the bus go round and round" Gonna wait a few days to get the phone call from GP to see how alert they are. Happydays




I don't understand why anyone thought you needed to see a consultant about an HbA1c of 45 ?


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## Happydays (Mar 3, 2018)

trophywench said:


> I don't understand why anyone thought you needed to see a consultant about an HbA1c of 45 ?


My medical record said a referral will be required. Not an actual Doctor. So i think levels are set in the medical reports when and if you need to see a specialist, That's the way i see it. Happydays


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