# Shared GP appointments



## trophywench (Oct 6, 2018)

Apparently because of the time we take at our GPs, the NHS are testing shared appts for up to 15 patients.  Apparently these 2 hour sessions will be lead by eg an HCP and a nurse, with a GP attending for an hour to discuss test results and other health queries.

Oh - come on!  It can take several minutes to get some people shoeless and up on the couch with bare feet to have their toes tickled depending on what they're wearing and their mobility - let alone do that test so if you allow a scant 5 minutes each for that there's not enough time to have a meaningful discussion with the group anyway.

If I saw a GP for any part of my annual review at his surgery, I'd be gobsmacked !  Always just see a nurse and don't discuss anything about my diabetes since nobody t my surgery including the 'special interest' docs has more than a scant understanding of Type 1.  The pharmacist has a far better understanding of it - and often asks me to do a show and tell session for the trainees!


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## Pumper_Sue (Oct 6, 2018)

Must admit to being a bit more than gobsmacked by the suggestion and will not be participating. Just proves mine and many others views that having diabetes makes you a 2nd class citizen as far as the NHS is concerned thus not worthy of an individual GP apt.,


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## Robin (Oct 6, 2018)

It's not just diabetes, it's a range of long term health conditions, including osteoporosis, arthritis, and ...wait for it...erectile dysfunction. Are men really going to want a group appointment for something that they might feel is rather private?
I don't discuss my diabetes with my GP anyway, I see her once a year for my medication review, which takes about 30 seconds, after which she says, Oh good, I can get on with some paperwork now! (that's not a criticism, if I had any concerns, she would take the time to talk to me, it's just that I usually don't, and the nurse has already done all my checks and discussed blood results)


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## Hepato-pancreato (Oct 6, 2018)

Sounds like an a.a meeting my name is .....and i’ve Got piles.


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## Amigo (Oct 6, 2018)

trophywench said:


> Apparently because of the time we take at our GPs, the NHS are testing shared appts for up to 15 patients.  Apparently these 2 hour sessions will be lead by eg an HCP and a nurse, with a GP attending for an hour to discuss test results and other health queries.
> 
> Oh - come on!  It can take several minutes to get some people shoeless and up on the couch with bare feet to have their toes tickled depending on what they're wearing and their mobility - let alone do that test so if you allow a scant 5 minutes each for that there's not enough time to have a meaningful discussion with the group anyway.
> 
> If I saw a GP for any part of my annual review at his surgery, I'd be gobsmacked !  Always just see a nurse and don't discuss anything about my diabetes since nobody t my surgery including the 'special interest' docs has more than a scant understanding of Type 1.  The pharmacist has a far better understanding of it - and often asks me to do a show and tell session for the trainees!




It all gets dafter and dafter doesn’t it?


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## AndBreathe (Oct 6, 2018)

Oh, I'm sure half of the population of my town is keen to expect my nasty little rash......

My GP is using telephone consultations where plausible these days.  Where something doesn't require an examination I quite like those.  I had a 20 minute discussion with her on Wednesday, sitting at my own desk.  As it was only a feedback from some queries she had raised with the Endo, it wasn't necessary to see the whites of each others eyes, and a minimal interruption to my day.


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## Matt Cycle (Oct 6, 2018)

First thing, shared appointments....really?  The next thing 2 hour sessions - what?!?!  So they think we've all got 2 hours to hang around at the doctors with a load of other people. If I want to see a doctor I want to be in and out as quickly as possible.  Some of us work for a living.  If it's aimed at coffin dodgers then send them to the local luncheon club for a gossip.


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## Robin (Oct 6, 2018)

Matt Cycle said:


> First thing, shared appointments....really?  The next thing 2 hour sessions - what?!?!  So they think we've all got 2 hours to hang around at the doctors with a load of other people. If I want to see a doctor I want to be in and out as quickly as possible.  Some of us work for a living.  If it's aimed at coffin dodgers then send them to the local luncheon club for a gossip.


I must admit, my first thought was 'and why is our time less valuable than the Doctor's?'


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## trophywench (Oct 6, 2018)

Who knows whether anything like this will be offered to us personally (it's being trialled in about 4 areas one of which I noted was Newcastle so no doubt @HOBIE will be able to tell us if he gets wind of it locally) or if so what form it will take?  It isn't a new idea for education and a certain amount of more personal info - eg DAFNE type courses - but no idea how much further it would go.

I would think once a bloke with ED gets to realise that he isn't the only chap with it and there are some forms of help available, plus there are people - the blokes and their wives - who are willing to talk about it to him - he might find that helps.  others my not have ED for the same reason as him - but I wouldn't think that happens.  OTOH there will be things any of us don't want a peer group view on thanks very much so it firstly needs to be acceptable to decline.


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## KARNAK (Oct 6, 2018)

Robin said:


> .wait for it...erectile dysfunction.



Hey Robin! now you know how a Gelding feels .


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## mikeyB (Oct 7, 2018)

I could have a meeting on my own with the list of chronic conditions I’ve got. I haven’t heard anything as ludicrous as this. It’s no different to squeezing a dozen Catholics into the confessional to save the priest time. Saves time, but it would be seriously unproductive.

This forum functions quite well as a place for help and advice, including seeing the doc.


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## grovesy (Oct 7, 2018)

Matt Cycle said:


> First thing, shared appointments....really?  The next thing 2 hour sessions - what?!?!  So they think we've all got 2 hours to hang around at the doctors with a load of other people. If I want to see a doctor I want to be in and out as quickly as possible.  Some of us work for a living.  If it's aimed at coffin dodgers then send them to the local luncheon club for a gossip.


My husband was telling me about a work colleague whose surgery is near the local University and the car park only allows  an hour parking and then hefty fee if you go over.
My surgery has no Diabetic Doctor, the last one retired a couple of years ago.


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## Eddy Edson (Oct 7, 2018)

Matt Cycle said:


> First thing, shared appointments....really?  The next thing 2 hour sessions - what?!?!  So they think we've all got 2 hours to hang around at the doctors with a load of other people. If I want to see a doctor I want to be in and out as quickly as possible.  Some of us work for a living.  If it's aimed at coffin dodgers then send them to the local luncheon club for a gossip.



I'm with you. At the moment, I'd be happy with a good online AI automated response for most things. My GP, excellent though he is, is really just following an algorithm most of the time and an AI system might actually do better at it - wouldn't forget things, which he does a bit. And an AI system could do a more efficient job of presenting the evidence base, if you want to delve into it.  

Obviously, that's just for first line stuff and I'd want to also have access to a good doctor for when I'm looking for wisdom, insight etc.


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## Ljc (Oct 7, 2018)

I can see this might suit some people but it’s not for me for several reasons. 
Even though I am retired a two hour appointment is far too long as I do have other commitments and I am sorry to say this but my nurse and GPs who are all very nice and do do their very best just don’t know enough about diabetes . Ie my nurse seems to get very flustered if I mention anything to do with insulin.

I can just see employers reactions to staff having regular lime off for this, I had enough trouble being allowed time off to go to the diabetic clinic at the hospital and I worked for the NHS. 

I think some people would find it difficult to speak about something they consider private or too personal in a group setting.

I much prefer this forum the advise and support is ace.


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## pav (Oct 7, 2018)

When I was in A&E the other day it took ages for the consultant to take off and put my trainers on.

While I don't mind certain things being talked about in groups. Some things I want only to be in private and up to me who I tell, not every Tom, Dick or Harry. 

Got talking to someone in the spinal hospital who had a similar problem, did not mind that as it was a way of seeing how each other worked with the problem.


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## mikeyB (Oct 7, 2018)

I see that patients are required to sign confidentiality forms before taking part.

That’ll work, won’t it.


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## Amigo (Oct 7, 2018)

Let’s hope the vets don’t start group sessions. They’d be more time spent trying to separate the dogs from biting or humping each other! 

I’m not suggesting that would happen in human sessions however but you’d invariably get some gobby git whose condition would have to be bigger and better than all the rest of the group!


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## Ralph-YK (Oct 7, 2018)

I didn't hear the report on the radio properly, and missed some.  I was heading out.

I'm not aware of doctors having any involvement in my diabetes at (except when I made a fuss).  I've seen the practice nurse.  At the old practice it might have been 40 minute appointments; current practice something like 20 - 30 minutes, for diabetic reviews.  I don't see replacing those with a group session as in any way as a good move.  I'm sure the report I heard said one hour to 90 minutes, not even 2 hours.

Now, if it was extra, that's another matter.  There again, I attend a good diabetes support group, and I don't see another group thing adding anything for me anyway.


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## travellor (Oct 9, 2018)

I'd be happy to do it.

We've spent many years saying the only ones who know about diabetes are diabetes.
Now we have a chance to get out there and put it into practice.

I'm also good with who I am, I'm not embarrassed, I find it doesn't take long to break down the taboo's that we have developed, especially when people find out they're not alone.


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## Northerner (Oct 9, 2018)

Interesting discussion  I think something like this should be supplemental to individual appointments - anyone who has been to a Forum Meet will know about the benefits that can be felt from just being able to sit and speak freely with other people in the same boat, and with perhaps some answers to niggling questions being answered by those with good knowledge and long experience  People who find an online forum to discuss these things are already highly motivated to seek answers/strategies/reassurance, but not everyone is comfortable online and prefer the face-to-face experience. I'm thinking of something similar to Pine Marten's meetings as discussed here:

https://forum.diabetes.org.uk/boards/threads/first-new-meeting-this-week.74914/

I think it may be better to get feedback from a group on information/advice being given out rather than in isolation or on leaflets - if nothing else it should keep HCPs more on their toes and any gap in knowledge may be laid bare that they may have 'got away with' in a one-to-one consultation.

So I'd say yes as an additional mentoring/peer group exercise, but it certainly shouldn't replace current individual appointments. The saving would be in hopefully better understanding and compliance of how to manage things, and reducing stigma by recognising it can affect anyone


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## mikeyB (Oct 9, 2018)

The stigma won’t be reduced if all have the same condition, surely. 

There are many local diabetic meetings, with guest speakers, occasionally consultants - when I lived round here before I occasionally went. 

I wouldn’t go now. Why not? Because of the stigma of being in a wheelchair. At least, until I get a T-shirt with “It’s not the bloody diabetes” printed on it.


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## trophywench (Oct 9, 2018)

Whyever would such a meeting think that of you?  If I meet anyone in a wheelchair, if I converse with the person and they didn't say, I might ask them just from the interest of knowing about their life rather like asking what they do for a living, if they have any kids or what their interest in diabetes is.


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## Alister (Oct 11, 2018)

i am quite surprised at the reaction. I would have though a workshop type apt where fellow diabetics could share advice would be quite a benefit, especially considering the variable knowledge of the so called professionals (Isn't that why we frequent this forum?). I can see that additional private apts. would also be necessary

Mind you I expect many of us would probably get banned from such meetings for expressing views that go against NHS recommendations


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## Ralph-YK (Oct 11, 2018)

Alister said:


> I am quite surprised at the reaction. I would have though a workshop type apt where fellow diabetics could share advice would be quite a benefit



I didn't get the impression that's what we'd get. And it sounded like it could be a replacement, not some extra.


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## Amigo (Oct 11, 2018)

Ralph-YK said:


> I didn't get the impression that's what we'd get. And it sounded like it could be a replacement, not some extra.



Agree Ralph, that was my impression too that it’s to replace individual consultations not just as an educative process. Nobody has an issue with the latter but I’d like to see my GP for an individually tailored consult first.


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## Lilian (Oct 11, 2018)

The nurse always wants to look at the places where I inject the insulin.    There is no way I am going to pull my skirt and knickers down to show a whole load of people (diabetics or not) the places I inject


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## Northerner (Oct 11, 2018)

Lilian said:


> The nurse always wants to look at the places where I inject the insulin.    There is no way I am going to pull my skirt and knickers down to show a whole load of people (diabetics or not) the places I inject


I'm with you on that one @Lilian !


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## Alister (Oct 11, 2018)

Ralph-YK said:


> I didn't get the impression that's what we'd get. And it sounded like it could be a replacement, not some extra.


I think this needs to be looked in more detail, the media are quite good a sensationalising things (althogh even they start it is not compulsory)
Done correctly this could be a good thing.


> Prof Stokes-Lampard said the idea of group education has been around for many years, including antenatal classes and group cardiac rehab sessions.
> 
> "Those are just about information giving. This is something different. This is a two-way interactive process."
> 
> She said the sessions would never replace private one-on-one consultations, adding: "This isn't going to be something that everyone is going to be offered and it would never be appropriate for huge numbers of people.



done wrong & all the fears expressed here would be valid & make the scheme totally unusable


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## silentsquirrel (Oct 11, 2018)

Lilian said:


> The nurse always wants to look at the places where I inject the insulin.    There is no way I am going to pull my skirt and knickers down to show a whole load of people (diabetics or not) the places I inject


That was exactly what I thought when I saw the press reports that these group appointments would replace individual ones!


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## Flower (Oct 11, 2018)

Having had some previous experience of a similar thing , a small group session -a good few years back -with others with the same diabetic foot complication as my self there is no way I would attend anything similar.

A fellow sufferer of the same complication said "what a $*%&$@g funny foot"  on seeing my foot. I don't want an interactive process, I give myself a hard enough time about it all without others sticking the knife in. Give me a closed door and patient confidentiality please.


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## trophywench (Oct 11, 2018)

I'd have said 'I'm not going to be spoken to like that' and left, possibly after I'd commented that I'd not made any derogatory comments about their face.


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