One Medicare NHS GP Surgery Patient Experience at Broad Lane, Sheffield
Local / Sheffield Nov 11, 2011 - 03:03 AM GMTBy: N_Walayat
One Medicare (owned by One Medical) with much fanfare and glossy leaflet drops opened Sheffield's GP Polyclinic or Super Surgery in April 2009 that offered 7 days per week access from 8am to 8pm, situated near the centre of Sheffield, located on the corner of Rockingham Street and Broad Lane. The centre allows any person to walk in off the street and see a GP or nurse without a prior appointment (allow approx 2hr waiting time) and those choosing to register with the surgery receiving full NHS services, thus offering the potential for those stuck in Sheffield's worst ranking GP Surgeries to register with a better resourced GP surgery.
Surgery Performance During First 2 years
After the first full year of operation the new GP Surgery ranked 16th out of Sheffield's 92 GP surveys (Department of Health Funded UK GP Patient Survey 2009-2010) and therefore was purporting to deliver on promises made to newly registered patients.
However by the end of the second year 2010-2011 (most recent data released June 2011), the level of overall satisfaction at the quality of healthcare received has fallen to rank the surgery at just 66th out of 92 Sheffield GP surgeries (See table at end of article).
This year (2011) has seen the major development of the Walk In Centre that treats minor cuts and ailments being moved from the Royal Hallamshire Hospital to the Broad lane GP Health Centre in April 2011 accompanied by extended opening hours from 8am to 10pm, therefore OneMedicare now operates both services out of the same premises, sharing resources such as Locum (temporary) GP's and reception / administrative functions.
Quality of Health Care Delivery - What Registered and Walk in Patients Can Actually Expect to Receive
Having put off using NHS services for many years due to lack of quality of service delivery at what has ranked as Sheffield's worst (bottom ranked GP surgery), I decided that it was time to start making use of NHS facilities that I continue to pay towards through high taxes, where One Medicare offered the only solution given that its open to the whole of Sheffield and promises a broad range of services such as new patient health checks and efficient delivery of service.
This is a summary of my actual experience of using One Medicare facilities following registration on 2nd July 2011, presenting the same symptoms at each consultation awaiting diagnoses.
Consultation 1
Positives
- Seen by a regular in house GP
- Appointment date 4 days in advance
- Length of consultation 7mins 30 seconds
Negatives
- No diagnoses, but referral for blood test.
Consultation 2
Positives
- Appointment 6 days forward
Negatives
- Made to wait 1hr 20mins for a pre-booked appointment.
- Seen by a Locum GP, Informed that the Locum GP is unable to perform a diagnosis and that I need to go to reception and make another appointment to see a regular GP, which is what I had done a week before!
- No diagnosis, no referral, a completely wasted day.
Consultation 3
Positives
- None
Negatives
- Appointment 8 days ahead.
- Seen by another Locum GP, despite making an appointment to be seen by a regular GP, totally unsatisfactory consultation, symptoms not dealt with, no referral.
New Patient Health Check - No New patient health check as promised by One Medicare's marketing literature.
Conclusion
The experience of the past 4 months and 3 consultations has been completely disappointing to the extent that I see little point in making further waste of time appointments. Though the quality of delivery should not be so surprising when considering the Department of Health Funded UK GP Patient Survey which ranks One Medicare's surgery 66th out of 92 as of March 2011.
It appears that the situation has deteriorated further since as a consequence of the integration of the Walk in Centre to share premises and resources, the cost cutting results of which are great for One Medical's profits, but as per actual experience this also means that registered patients could only have a 1 in 3 chance of seeing a regular GP.
A solution would be for separate reception area and staff to deal with the Surgery and the Walk In Centre, else patients will likely continue to experience to be passed on to the Walk In Area locum's to deal with rather than regular Surgery GP's.
The next UK GP Patient Survey Results (due Dec 2011) should clarify the trend in the actual patient experience of health care delivery following the merger of the Walk in Centre with the GP Practice. The best solution would be to completely separate the Walk in Centre from the GP Practice i.e. into separate premises, which given the potential hit to One Medical's profits is unlikely to happen unless the primary care trust takes remedial action to force it to do so.
This real experience clearly illustrates that handing private companies keys to the NHS is not going to work without the fundamental driver for efficient service delivery which is real competition for patients. Until ALL GP surgeries are forced to compete for patients then this is the type of experience patients can continue to expect.
GP Consultation Options
- Potentially waste another 4 months with One Medicare Locum's.
- Register with a Surgery that ranks in the top 1/3rd (highly unlikely as surgeries operate on the basis of locality i.e. no competition between surgeries for patients)
- Pay for private GP consultation and referral which could prove costly (especially the referral and resulting treatment) which also means patients are effectively being FORCED TO PAY TWICE FOR HEALHCARE. Also private medical insurance can turn out to be worthless in many cases given the multitude of small print clauses.
Option 3 is by far the most appealing, if only patient's could to opt out of using NHS GP's and get tax back to in part cover this cost.
Flawed Government NHS Reforms
In terms of the big picture, the One Medicare experience highlights the problem at the root of the NHS that the governments reforms of letting private sector firms to take up GP practice delivery is the lack of a market for patients, and not for services. For if there is no real competition between surgeries for patients then the patient will NOT come first, no matter who is delivering the service.
Sheffield NHS GP Consortia's
The core at the heart of Coalition Government's NHS reforms is to scrap ALL NHS Primary Care Trusts (PCT's) to be replaced by competing GP Consortia's to directly manage patient treatment commissioning (the process could fully take 2 years to implement, subject to revisions).
Unfortunately whilst the aim was for better value for money by means of competing consortia's, the implementation is proving to be resulting in the exact opposite anti-competitive consortia's, as virtually all of the Sheffield NHS 92 GP Practices have signed up with one of of 4 geographically located GP Consortia's in advance of the implementation of the Coalition Governments NHS reforms.
- Central Sheffield Consortium
- HASC ( Hallam & South Consortium)
- North Sheffield Consortium for Health
- Sheffield West Consortium
The flaw in the construct of the consortia's is that there is nothing to suggest that the consortia's and GP surgeries will be competing for patients which therefore means the governments planned reforms will fail and patients could end up with an even worse health services as GP surgeries will be wielding greater power within their geographic constructed Consortia's then they were able to wield under the city wide Primary Care Trust, therefore no competition in GP services will exist and the governments reforms are destined to fail, just as badly as Labours 2002-2003 GP contracts failed as they sent annual GP pay rises soaring into the stratosphere, culminating in pay rises of more than 30% per annum.
NHS GP Doctors Putting Profit Before Patient Care, Channel 4 News Investigation
Earlier in the year, a Channel 4 News investigation charged NHS Doctors with the subversion of the the coalitions governments NHS reforms to result in NHS doctors pocketing all of the cash saved as a consequence of the NHS reforms, which matches my own analysis of a year earlier that the Coalition Governments proposed reforms were fatally flawed in that they allowed GP's to profit from patient care.
"Your doctor making a profit out of your health care, your GP Sending you to a clinic that he or she owns shares in, we are seeing the biggest shake up of the NHS in its history, Channel 4 news can reveal tonight that there is nothing on the legislation currently before parliament to prevent the outcome no one wants, doctors putting profit before the care of patients, in our special report tonight we show how the new arrangements will create fundamental conflicts of interest potentially harming the trust at the very heart of the doctor patient relationship". Channel 4 News
Channel 4 News investigation key points:
- Serious flaws in the Governments NHS reforms legislation, it's failure to protect patients against fundamental conflicts of interest, it allows GP's to put profit before patient care.
- All of the monies saved will go into the pockets of NHS GP's and doctors.
- GP's during patient consultations factoring in the profit they will make on their diagnoses.
- GP's referrals on the basis of how much commission they will earn from the heath institution.
- GP referrals to health clinics that the GP's own shares in.
- New private health clinics being set up with a view to making profits so that they can floated onto the stock market at huge profit for share holding GP's
- GP's get access to dip their hands into the annual £80 billion pot of money meant for patient care.
- GP's draw up the rules themselves on the conflict of interest, akin to writing 100 times, "I promise, I will not fiddle the patients"
Under the previous Labour government patients were treated as credit cards to swipe in and out of door ways as fast as possible to maximise profits. Under the Coalition government patients will now become cash cows to milk to the fullest extent possible, what's best for the health of patients won't even factor into the thought process during GP consultations - "If I send Patient X to Clinic Y for Operation Z, my consortia will earn a commission of £2,000".
The NHS Health Credit Card Solution
The NHS post code lottery which excludes millions from the best health care on offer can only be ended if there is real patient choice, not only for GP's but also hospitals and other health institutions right across the country where treatment is sought which requires real reform of the whole NHS health care system from diagnosis to treatment of all patients . An important element would be to place the power to purchase healthcare into the hands of the patients by means of an NHS Health Credit Card system, that enables patients to purchase health services from any GP practice or hospital regardless of whether it falls under the NHS umbrella or is fully private, so that both patients and health practitioners would be fully aware of the financial transaction involved in the purchase of the health service, which is set against the current system where patients are made to feel that they may be wasting the GP's time so are easily put off by the practiced dismissive attitude of most GP's during initial consultations, which means the medical condition of patients reaches a far more serious state and this proved more costly for the NHS to treat.
Patients would have a choice of covered core treatments for illnesses or injuries, where they would have the option of paying to top up treatments with their own money depending on the institution that they seek to purchase treatment from, or for other extra's including IVF etc. This would have the effect of reducing the cost of the NHS whilst introducing greater efficiency into the NHS as the majority of patients would only choose those health service institutions that are ranked as delivering a good service. The NHS Health credit card would revolutionise the way healthcare is delivered in the UK, much as supermarkets revolutionised food delivery and choice during the 1980's, as heath supermarkets would spring up all across the country that would maximise efficiency and standardise quality of service delivery as they competed to offer a wider range of health services than anything a bureaucratic top down health care system could ever hope to provide.
The health care credit card system could be further enhanced by workers directly contributing to their health care plans that they can claim upon to purchase 'extra' services at a later date, much as workers today contribute into private pension schemes.
The impact of this would be to greatly REDUCE the cost to taxpayers whilst at the same time delivering better health services, a win, win outcome for the people of Britain as opposed the current system of an out of control unproductive £120 billion National Health Service that attempts to mask failure to deliver with phony statistics and propaganda of a "free for all service" that does not match real patient experience.
Results For All 92 Sheffield GP Surgeries Ranked in Order of Patient Overall Satisfaction With Care Received
Data Source - http://results.gp-patient.co.uk/report/main.aspx
Source and Comments: http://www.marketoracle.co.uk/Article31483.html
By Nadeem Walayat
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Nadeem Walayat has over 25 years experience of trading derivatives, portfolio management and analysing the financial markets, including one of few who both anticipated and Beat the 1987 Crash. Nadeem's forward looking analysis focuses on UK inflation, economy, interest rates and housing market. He is the author of three ebook's - The Inflation Mega-Trend; The Interest Rate Mega-Trend and The Stocks Stealth Bull Market Update 2011 that can be downloaded for Free.
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