My GP practice is first and foremost a business operation which I’ve been made aware of only too keenly in the last few months and I’ve felt bullied as a result.
Registered for a long time I’ve had little contact with them over the past few years. Just before the start of the new financial year I found a short peremptory message from the practice on my phone on a Sunday afternoon. They had no blood pressure measurements for me in the past 5 years, this was a minimum NHS healthcare requirement and I was to let the practice know in 2 days time, by the lst April 2015 whether I or someone else had taken my blood pressure. The tone of the message was unsettling, ‘do as you’re told’ was the message.
I didn’t want to get involved in talking about blood pressure readings with the Practice and explained this to them and asked whether what this was all really about was meeting financial targets such as QOF (quality and outcomes framework) incentive payments explained so well by Margaret McCartney in The Patient Paradox. ‘Yes’ came the answer, the practice was disappointed I couldn’t help.
Out of the blue I received a handwritten note through my front door last week saying the Practice wanted a written copy of one blood reading and the date taken. I reiterated my views to the Practice but had further emails requesting blood pressure measurements.
Then I was reprimanded in no uncertain fashion – why was I being negative, why couldn’t I supply readings, the Practice had a duty to provide what was deemed good patient care by NHS England and if I was obstructing them doing so, they would have to discuss this with me – they had to reach certain targets and I was stopping them doing so, my refusal to provide a reading could not be accepted without ‘good reason’ If all patients took my view the practice would not reach its targets and that could not be tolerated I was told.
Alarmed and upset I rang NHS England. My questions were am I compelled to give blood pressure readings, could I be struck off for not doing so and did I have to give reasons for my decision? The answers were I was not compelled to give readings, could not be struck off for refusing to do so, did not have to give a good reason let alone any for doing so. I was told the reason I was being chased by the Practice was to do with its financial management.
I relayed all this by phone to the Practice, explaining I was very distressed by the whole business and please could they respect my wishes and leave me alone. Some acknowledgement has now reluctantly been made of that but I’ve been told they need patients to help them achieve their targets and it’s possible I could be asked to de-register if I’m getting in the way of them doing so. What all this has to do with good patient care escapes me. I feel caught in a tickbox system which the Practice says is imposed on them and which is the key to their financial health but the way they operate it undermines the claim that the patient is at the heart of the NHS and puts the financial rewards for the Practice first and foremost. My trust in them has been dented.