To think this health test is pointless for me³

[Muchtodoaboutnothing]

I have been invited to my GP surgery for a health check with the practice nurse, for patients with long term health conditions such as Heart Disease, COPD, Asthma, Stroke, Kidney Disease, Epilepsy, Rheumatoid Arthritis and Mental Health problems.

My condition is epilepsy. I am however still under a hospital consultant and have regular reviews with them.
I am fit, within my bmi and healthy. I know my height and weight, blood pressure. I don't have cholesterol issues, and have a healthy blood sugar level. It seems to be a generic appointment, and apparently it is a new system.
AIBU not to attend?

They are ticking a box so they can get funding. GP surgeries receiving additional funding for most long term conditions - they either have to see you or you decline or dont respond they can exception report you (providing they have asked you a set number of times). It is worth a lot of money to the Practice and it is the end of the financial year next week so they will be madly getting their QOF (Quality Outcome Framework) points up. (Its what I do as part of my job - recalls and QOF). Last two weeks of March are the busiest time of the year for me as I am going through checking that the system hasn't missed anyone and inviting them in. (It is also best practice so not just about the money - at least for me it is).

I am surprised they are doing it for epilepsy though as that figure is usually protected financially wise. I rarely call epilepsy patients in as they aren't generally dealt with through primary care.

Same as the NHS health checks you get invited for over a certain age - if you are eligible they will invite you. If you come they get paid, if they invite you twice and you dont come they will also get paid, just not as much.

GP surgeries at the moment are completely underfunded so they will be doing everything possible to get as many QOF points as possible.

Also - this isn't new so I am surprised that if they do include epilepsy in their QOF recalls that you haven't been invited before.

Unless they have taken someone new on to do their QOF and recalls.

The long term conditions include range from asthma to heart disease to hypertension. Off the top of my head I think there is about 20 LTC we get funding for depending on the amount of points you get.

And yes - I know its frustrating that you cant get a GP appt without a battle but they are offering appointments to people to come in for their checks but believe me, without the QOF funding the practice would probably be bankrupt and the appointments system would be even worse.

I sympathise. Epilepsy is a bear of a condition for making you feel as if you've no control over your life and your sense of autonomy matters. That said, you're on medication for epilepsy. Many of these medications are processed by the kidneys and can affect how the kidneys work. I'm on Tegretol (carbamazepine) which has diuretic effects and am monitored with annual blood tests by my GP. According to the NHS website, Tegretol can also increase your tendency to osteoporosis and osteopenia (low bone density. On the one hand, I have an array of factors that put me at much higher risk than you for all sorts of things. On the other, I don't currently have a neurologist keeping an eye on me because my condition has been stable since I went on Tegretol in the 1980s. That means I'm dependent on the GP for monitoring in a way that you aren't. If your hospital doctor discharges you back to the care of your GP, you may decide to have a rethink.

nurse here. I agree it may be pointless for you if all monitoring is done by your nurse specialist and consultant team. It may be that because you fall into the “long term condition” category you’ve automatically been sent and invite for routine checkups. It could also be that your consultant has asked for the gp to monitor bloods (U+Es and LFTs for kidney and liver) due to medications you are on etc, this wouldn’t be uncommon for consultants to star to medications and ask gps to monitor for side effects. I would just phone and ask, tbh they may be quite happy to have a quick conversation on the phone to hear you are doing well and don’t need to be seen.

@Muchtodoaboutnothing "They flippantly start these schemes, and invite people for basic tests who don't need to go. No wonder the service is absolutely rammed"

yes it drives me nuts

I moved home and am hiding from the new GP. They - GPs surgeries - are so unpleasant when you say no to anything. Didn't realise they might get financial incentives for this kind of testing as well.

I thought the state of things would mean they'd stop this and make more time for people who need the doctor.

Call and discuss with your GP surgery, hospital and GP records not always as well synced as you'd expect them to be.

I’m with you there, I don’t go to mine. I have M.S and they know fuck all about it. I also have Chronic Kidney Disease and one of the nurses suggested I have a big drink of water and that would basically change the blood test results. Absolute bullshit, no amount of water will change where I am, I don’t drink or smoke, not overweight, unlike some of the nurses at our surgery. Honestly, one is as wide as she is tall, ironic that they are commenting on overall health aspects?!

I take HRT and have a blood pressure machine at home to keep an eye on it, still healthy range. I go for intermittent blood tests for my kidney issue, to be honest they pissed me off about this. I found out by accident, I was reading my medical notes about something else when I discovered this! I complained to my regular G.P who agreed it was unprofessional and apologised for the way that I’d discovered my condition, to say I was upset was an understatement 🥺

Thanks, no it is definately synced. I have access to my surgery record and all of the letters are attached, after being reviewed by a gp.

God, I am so sorry you went through that, that must have been a huge shock. How condescending of that nurse telling you to drink water!
It is so frustrating, isn't it. It is like you're educating them on your condition, and then wondering what on earth you're there for. I am happy talking to the specialist epilepsy nursing team/consultant if I need any advice, which is what I am supposed to do. It is sort of outside of the GP realm. They have all basic test results on my record. If they are so worried about cardio issues than BP is pointless because it is fine, and they should have referred me for an ECG, which I thought would be mandatory with epilepsy.

They don't offer flu shots, the effects of catching this would have a lot more detrimental effect on my condition, so I pay for them. I don't understand urine tests, or why that would be required without any symptoms. I had a recent one anyway.

It is easy now to keep track of basic health these days, like you say with blood pressure monitors, most know their BMI etc. They do height and weight at most appointments now as well. I have it very recently on my record; bmi is 22. I have low cholesterol, and healthy blood sugar.

Like you, I don't smoke or drink either, never had any issues health wise, apart from the epilepsy. Meanwhile dh, who is overweight and has suffered high blood pressure, along with some depression could do with this more. The medications I am on don't look to have any untoward side effects; certainly none that would show now.

A 30 minute appointment is a long time, the letter should say what exact tests they would do as well.

Sorry for the rant, I have PMT, which isn't helping matters.

I'll politely decline, and let somebody else who actually needs this appointment, to go in place of me.

Unfortunately they have to do the reviews to get the money in to continue. Your practice will get just over £100 per patient for every patient registered. They need to pay staff wages, utility bills, etc. They’d go out of business if they just relied on the set amount per patient.

They are basically a private business who has no other way of getting money in other than jumping through the hoops that the NHS set them to jump through to get money. They can’t offset any of their costs to their customer (the patient).

I think an awful lot of people don’t realise that a GP practice is a private business and isn’t paid for like secondary care (hospitals, etc) by the NHS.

Thats one of the reasons why if the hospital wants you to have a blood test done at the GP the GP practice will usually insist the hospital give you the relevant paperwork to bring with you - without that the GP practice ends up footing the bill for your blood test that your consultant wanted you to have.

Quite often GP funding depends on the percentage of people who have certain tests and screening done

It's a funding thing as PPs have said.

@Muchtodoaboutnothing can I offer a slightly different perspective? I too am under care for a.chronic long-term condition - I go to a specialist clinic which is absolutely amazing, all the staff are right on it, up to date with the latest research, really listen to what I tell them and then tailor their advice and management plan to my individual needs.

My GP practice on the other hand don't have a scooby. BUT they are good in other respects, and in the areas where one might expect a GP practice to be helpful. So for the sake of a yearly 30-minute check up which enables them.to tick a.box and get some funding, I play the game. Of course I don't listen to their advice on that particular condition - I have access to experts for that - but I do it because it helps the practice. Just a thought.

My neurologist writes to my G.P if I need any prescriptions. He blatantly said it can come out of their budget, disgusting. I’ve since found out that he shouldn’t do this!

Tell them you don’t want to go, then.

I don’t understand why there’s any dilemma here. They’ve offered you a standard service to which you can simply say no. What’s the problem?

Yep. That happens a lot.

@Muchtodoaboutnothing Your DH is eligible for a health check up every 5 years as he is over 40. Some surgeries send out invitations. Ours doesn't but if you ask for a check up you can have one. Maybe encourage him to ring the surgery and book an appointment. They'll check his height, weight, blood pressure, cholesterol and HbA1c (check for diabetes).