to be a tad pissed off with the GP for demanding £10 pound for a sick note for DD3 having swine flu<<argh>>!!

[psychomum5]

rant rant rant.

school and dancing reqire sick-note with regards to DD3 having swine flu. school because she is down to 80% attendance already this term due to this and also contracting norovirus 2wks back and having a week off.

dance school are asking as she was supposed to be doing dance exams on saturday and obviously can;t, and for me to get money back they need a note (completely reasonable).

what is not is that the GP said it it will cost £10 as she is a child not an employee, and besides, the governmnet has decreed that anyone suffering swine-flu should not need a note.................all another way of taxing us IMVHO as IME employers do still require sick-notes so they can pay sickpay properly.

tis soooooooooo not fair.

GPs are not directly funded by the NHS. We are small businessmen/women. The NHS only pays us for the services it commissions; this does not include any sick notes or other certicates, other than the official sickness certificates for employers.

Do you know many businesses who work for free? Try getting anything from a lawyer for £10! We have to cover all the costs of our business, not just our own time.

Think of it from the patients' point of view too. Most GP surgeries struggle to offer patients the appointments they want at the best of times, let alone during a flu epidemic. Appointments for this sort of note are not a good use of doctors' time.

PS I do agree that the dance school should pay though. Parents and GPs should be uniting to tell schools to get lost when they ask for this sort of certificate.

So, let me get this right, because I thought that gps get paid a salary:

you have, for instance, 20 appointments a day. Do you have to explain to the NHS, what they were for, and if it's not for something they fund, then you don't get paid for it? So you get paid on an appointment basis?

BTW, this is not an attack, just honest curiosity

YABU I'm afraid although I do think the school should stump up. GPs have to charge for reasons given by jybay - & if they didn't they'd be swamped by virally sniffing kids whose schools are demanding sicknotes!

Piffle - possibly that may be the case south of the border (though I'd imagine GPs are still busier than average for the time of year) but in Scotland they are dealing with all the swine-flu workload as there is no flu-line.

www.ganfyd.org/index.php?title=Get_a_note_from_your_doctor

Can't receptionists organise such sick notes? Why are GP writing them anyway?

ok, I am quite shocked at what you get paid for then, seeing as from the media, most GPs are on wages, not working as mini-businesses

((aware I sound pretty ignorant about the workings of GPs here))

Because it has to be a GP who signs you off sick not a receptionist .

difficultdisisions, going on that, the school are duty bound to accept the hosp note, as would be dancing.

but also, the GPs are able to issue notes without charging......

mummygirl
Gps have, for instance, 50 appointments per day.
They also probably have, for instance, 100 people wanting those appointments.

It is better to see the people who are ill then those who want notes (for whatever purpose).

Most GPs are paid an amount per patient on the practice list. This has to cover the salaries for every member of staff, all the utility bills, equipment etc.

It doesn't matter if a patient consults once a year or twice a week the amount they bring into the practice is the same.

The person who is insisting on the sick note should pay for it. This is a stupid use of a GPs time and tax payers or the GP shouldn't be paying for this. The school, dance class or the parent should.
The child doesn't "need" a certificate the school and dance class just want one, and I presume the parents don't want to upset the dance class. State schools don't ask for GP notes because they know GPs charge for them for kids and don't have to do them. If you think it's too much then don't pay for it.
This has nothing to do with improving her health and isn't an NHS issue so the NHS shouldn't be funding it. Same with notes from GPs to join gyms, get golf buggies, go on sponsered this that and the others, able/unable to go on holiday to exotic locations/.
GPs offer free assessment and treatment and certain certificates if too ill to work after 1 week. Anything else you pay for.

The GP can give you a note without charging, in the same way that Tescos can give you your shopping without charging.

I fully understand the need to see sick people over people that need notes, however you're saying that the gp will still be paid on the amount of appointments, not WHAT happens in them, right?

Paid extra! Yes, we get paid, but no more than seasonal flu and it is more work. Different groups to invite, contacting them (letters etc), booking in clinics, updating records, making sure people come back for the 2nd dose etc etc. Vaccines are in multi vial not single use pre filled syringes so take longer to prepare.

All taking nurses time so they are not available for normal smears, imms, dressings, diabetes & asthma checks etc.

Most clinics are Saturdays & evenings - overtime needed for nurses, GP has to be on premises, receptionists etc etc.

Oh, and no matter HOW many pts we have, we only get 500 vaccines to start with!

Rant over from frazzled NHS worker..

We get £63 per patient per year as basic income. If we meet all our performance indicators (good diabetic care, for example), we can get our income up to about £100 per patient per year. The average patient visits his/her GP 5 times per year, so we get £20 per appointment on average. Out of this we have to run the business - staffing, utilities, equipment etc etc. The figures you see in the Daily Mail are for our income before these costs are subtracted.
(I want to stress though, that I think I am very fairly paid - this is not a whinge, am just trying to answer mummygirl's question)

We do not have to account to the PCT for how every appointment is used. However, we are penalised if patients are unable to get appointments when they want them and also if we don't meet the performance indicators. The more time we spend doing non-NHS work, the more our risk of these penalties.

PS psychomum, you are quite right that we are paid for the swine flu immunisations but tthey are a burden on our time - it is impossible for us to recruit temporary staff to do them (in most areas, anyway), so we will do them ourselves together with our practice nurses.

No, not paid per appointment. GPs are commissioned to provide general medical services to "those who are ill or believe themselves to be ill".

This includes providing enough appointments for people to be seen within 48hrs or whatever new rule comes in. So if they are seeing a lot of trivia they will need to add in extra appointments so that everyone can be seen.
So staff costs will rise.
So it costs more money.

Mummygirl: Yes, we have to provide a no. of appts, BUT we won't get paid if we don't meet targets eg 90% Diabetics/Asthmatics had an annual review, 90% COPD pts had a lung function test. If appts are used up with sick notes etc we can't fit in those who need seeing, to get their medication reviewd correctly and to make sure we do what we have to to meet the targets.

psychomum "GPs are able to issue notes without charging"

we can (although only a private one not on NHS) - asda could also give you your food for free but I think it's unlikely that's going to happen.

Sometimes I do wave the fee (I'm only human) but in the vast majority of cases I can't justify spending the time doing it rather than dealing with things that actually affect people's health. Even just a handful of extra work that I'm doing for free at the end of the day is time I don't get to spend with my own family and every time I do I know I'm opening myself up to every person that patient knows coming up saying "but you did it for free for so and so"

thanks jybay, I see.

Now, back to psychomum's GP. If a patient, who just wants a sick note, has made an appointment, therefore already wasted the time, then the gp is refusing the note/demanding to be paid, just in order to make a point? So that word doesn't go round?

Or, did you psychomum, just called and explained what it is that you need?

It is not under the umbrella of 'NHS work'. It is therefore something that the GP can agree to do on a 'private' basis and should be charged as such. It is debatable whether the dance class company should be paying for it rather than the OP but the GP is perfectly reasonable to charge.

difficultdecision, I was more stating that from the wiki link you gave, rather than stating it from fact that I believe.

I do still feel shocked at £10 however!!

OP, I think the school HAS to accept something else, make a fuss if they don't, this is not something you should have to pay for, no matter how small the cost

I realise psychomum - the link is correct - we can theoretically but its not advised for all the reasons above.

Could you not photocopy the discharge letter from the hospital? I don't see why you are not allowed to use it - the hospital gave it to you so it is yours.