The Varying levels of care

[am64]

sorry a bit of a long thread but...
One of the sad things i find reading this forum is the varying level of care being recieved .....
i have a brilliant doc and nurse.
I go for blood tests in a little cottage hospital locally, last week because i told them i was a fasting diabetic and feeling a bit strange.. they took me straight in took the bloods gave me 2 digestive biccies and a glass of water and insisted that i stay until i felt better. my eyes were tested some 9 miles away but i was seen straight away and then walked to a small local VERY dark pub had some lunch with my son who came with me, then drove home some 2 hours later
i saw my nurse today and although i wont be called for another 6 months she said i could go in 3 months as she appreciated that i had been feeling a bit down with it all....all my kit was given to me free and i can have strips whenever i want...she was horrified when i told her some of the stories of people not getting kit on this forum ...because the gps get all that kit for FREE from the manufacturers...mine is Bayer.

 

[Steff]

i hate my team there rubbish, if i made no phone calls id get no care, i seen dsn back in july and im still waiting and waiting to see if im going on byetta, if i could wish for one thing it would be pack up my gear and **** off back to london i know id get care there .

 

[Northerner]

am64, I'm with you totally - the care some people receive is truly atrocious, and it seems to strike from all angles, whether it being denied strips, or given incorrect information or just plain arrogance or inefficiency. Like you, I have received excellent care, and it makes my blood boil when I hear of the hoops some people are made to jump through or things they are led to believe.

 

[SilentAssassin1642]

Most of the care ive had has been amazinf. My first team in Kings Lynn were utterly fantastic, good old Dr Barter was amazing! The team I had in bath were pretty good too, the ones that got me on MDIs. But then coming to the winchester team...whilst the care was OK the attitude of the specialist was just horrific. And now...in Soton...having scripts messed around by both doctors and DSNs, and being told i HAVE to go to the GP for my annual review...(hence why im changing drs this week on thursday and then making things exceptionally clear!!!!)

 

[Caroline]

Unless I go ask for help there is no care. To actually get my GP to agree that I am diabetic I had to attend a healthcare event at my place of work wheere I got loads of tests done and the results written on a sheet of paper (of which I kept a copy). Even then he was reluctatnt until I asked for a second opinion. I had been back and fowards to him for a long time. We had a DSN. Everyone saw her once, but I think she was put off by the lack of information given by the doctor. I think I was one of the last people she saw and she was amazed at most peoples lack of knowledge because they had just listened to the doctors advice.

 

[Steff]

Unless I go ask for help there is no care.

yup sounds familier

 

[Adrienne]

We have lived in two areas over the last 9 years (Jessica's age). Both the local hospitals are rubbish totally. This second area is worse than the first area and I personally believe one of the worst in England. I am in talks with the PCT at the moment actually and they agree the care is shite and are going to be in talks with another area to contract the work from them. The PCT woman is going to be setting up a meeting with me and two friends and the consultants and hospitals trusts and herself to try and sort this out !!

However due to Jessica's condition we are actually under Great Ormond Street Hospital for care for her real condition, Congenital Hyperinsulinism and we are under UCLH for all diabetes care. We do not go locally at all and wouldn't. The UCLH is one of the best in the UK for paediatric diabetes. They are absolutely amazing. I think it is them and Leeds who are the best. I cannot fault them, I can always get someone via email or phone. The Prof (consultant) even gave me his email address over Christmas one year in case I had a problem !!!!!

So I'm aiming to change local care to be more like London, mmmm I think I have a fight on my hands but whats new.

 

[Caroline]

Adrienne, you are right some areas are shite and some doctors are worse than that.

I am glad you have such brilliant care for your daughter, you both have a tough enough time already.

 

[Adrienne]

Adrienne, you are right some areas are shite and some doctors are worse than that.

I am glad you have such brilliant care for your daughter, you both have a tough enough time already.

Thanks so much Caroline. We had the most awful night actually last night, the sensor on the pump was playing up and kept alarming low but Jessica was at a good level albeit a bit low ish ie 5.0 which sounds good but she can just plummet. So I was having to deal with the alarms and sirons and we are both knackered. I was going to let her stay off school but she has clarinet and only just started and loves it, plus I have to work so I better get a move on and start !!! 😱

 

[AndyS]

I'm in West Yorkshire. The level of care is grim. It would be easier to make an appointment to see the Queen than it would to see one of the diabetic specialists at the local hospital. I had an appointment which was cancelled 5 times. I gave up and tried the DSN at my GP's surgery. I had the bloods taken and waited a week. I tried to make an appointment to see her "she's on holiday", "she's on triage next week" "try calling at 8am and she might be able to see you" - eventually I asked the receptionist to show me the results.

I'm type 2, on Metformin, Humalog, Lantus - oh and ramipril for "your blood pressure is high, we will look at that next time your here"

 

[SacredHeart]

All in all, my care has been pretty great since diagnosis. My care goes through York & District Hospital, who gave me the direct line to my DSN, who if she's not there, tries to get back to you the same day. If it's more important, you can ring and ask to speak to the nurse on duty. I've seen the dietician three times (including a carb counting course), and I've got an fourth appointment to see him in November. I've also had my annual retinal scan, seen my consultant twice as well.

I'm so grateful, especially hearing some of the horror stories out there 😱

 

[VBH]

I think the first thing you have to bear in mind when looking at this is that there is a difference in provision for T1 and T2. Although it can be quite variable for T1s, they do at least get to see consultants etc which T2s don't. I've seen some abysmal treatment of T1s and particularly LADAs as well, but generally they do have access to services which are denied to T2s.

Although GPs do get meters from sales reps, it can be a question of timing as to whether they have any meters at the time you are diagnosed. The reason the sales reps give them away is to get people using their strips which is where the money is made.

Strips though are a different matter. They cost the NHS around ?13 per box and are not given to GPs as freebies. They always go through the prescription process. The vast majority of strips prescribed to T2s are wasted, mostly because they are not used for any particular purpose. People get told to test once a week for no readily apparent logical reason.

There's also been a couple of dire studies regarding T2 testing which claim to have proved that T2s testing is pointless and makes them depressed. What they actually demonstrated if you take a closer look at those studies is that:
a) Testing by the particular methods they studied does not improve A1c
b) The recommended diet does absolutely nothing to lower A1c.
http://www.diabetes-support.org.uk/joomla/diabetes-blogs/The-T2-You-dont-need-to-test-Myth.html

But because of the general economies in the NHS at the moment, the PCTs have been using this as justification for removing strips from the repeat prescriptions of T2s, even those T2s who can easily demonstrate that its very effective for reducing A1c when used properly. Its all about budgets and the individual patient gets ignored.

But overall, there is a huge difference in advice given to T2s in particular and a general ignorance among GPs and nurses in general about diabetes. Its mostly because they are generalists rather than specialists and have no time to become expert on the subject.

Thats why I manage my diabetes and they are there to help out. Not the other way around.

 

[Northerner]

...But overall, there is a huge difference in advice given to T2s in particular and a general ignorance among GPs and nurses in general about diabetes. Its mostly because they are generalists rather than specialists and have no time to become expert on the subject.

Thats why I manage my diabetes and they are there to help out. Not the other way around.

I do think that, despite being generalists, they should be far more knowledgeable about diabetes - in particular Type 2. This is a disease that affects a significant, and rising, proportion of the population, so some of the antiquated advice and downright fallacial conceptions parroted by some doctors and nurses is totally inexcusable. It's not that difficult to get it right - I learned the basics within a couple of weeks of diagnosis - so why do so many of them get it wrong?

 

[AlisonM]

I've just had my last appointment with my doctor before heading home. He's given me two months worth of meds, strips and lancets to keep me going till I get settled, told me he reckons I'm doing the right thing and, since I'm getting below 10mmol regularly and below 8 at least once on most days now he's decreased the Glicklazide dose, increased the Metformin and says I only need to test twice a day unless I start to feel bad. He also gave me a printed pr?cis of my history since diagnosis so the new doc can see what's going on.

 

[Steff]

well said Northener my team need to come on this forum and learn a thing or two.