GPs are small Businesses.

Due to an altercation I had with my own surgery yesterday, I have decided to put (all) my previous published posts on hold (archived) as I quote because I questioned a medication that my daughter was prescribed I was told and a quote I had a “Lack of Respect for the Highly Qualified Pharmacist and Clinician in the Surgery and there was a breakdown of patient/doctor relationship”. I was then told to find another surgery for simply speaking my mind.

I am also a carer and found their attitude to be very threatening, patronizing, and intimidating. Not once did I say anything derogatory yet they accused me of having a “lack of respect”. Respect works both ways from my understanding. I was simply querying the medication.

This has now caused me to have an anxiety attack as I depend on repeat prescriptions myself so I do not know if I will be prescribed these any longer and cannot suddenly stop taking them.

Again I am afraid to mention this surgery as they have threatened my daughter and me.

A GP Surgery is for all intents and purposes a small business and when I mentioned they had a 1.7-star rating the person I spoke to said she did not care.

I wonder what her bosses would think of her attitude.

GP surgeries do not work the same way as hospitals and are not part of the NHS in the way hospitals are. GP Surgeries receive funding from the NHS but their income comes from patient referrals and what pharmaceutical companies pay them. Most GP Surgeries are essentially small businesses. Just like any small business doctors own or rent their premises, they employ and pay their own staff and have all the usual responsibilities of running a business in addition to their work as doctors.

What many patients do not realize is how much general practices are having pressure on them at both ends. Income for general practice is falling in real terms year-on-year, while the costs of running a practice are spiraling out of control.

They rely on having a full quota of patients in order to cover their costs. So throwing a patient out is not beneficial to them unless the patient is violent or abusive.

Furthermore, 90% of all patient contacts in the NHS occur in general practice, and in 2017-18 we were predicted to receive 7.29% of the NHS budget – general practice is exceptionally good value for taxpayers’ money. The RCGP is currently campaigning for general practice to receive 11% of the NHS budget.

Just like any business, GPs also have to pay for medical indemnity and public liability insurance out of their own pocket. Due to rising litigation, the cost of this is increasing by as much as 25% per year.

All GPs are now forced to undergo annual appraisal and five-yearly relicensing (revalidation).

Surgeries are now obliged to undergo regular inspections by the Care Quality Commission and must pay thousands of pounds for the privilege. Preparation for these inspections is as stressful and time-consuming similar to a school preparing for an Ofsted visit.

However, I personally think they should have random inspections similar to secret shoppers to actually see how customer service behaves towards their patients in real-time rather than on their best behavior during an official visit and the inspectors should review phone calls that say “all calls are recorded for training purposes” Also there should be a patient complaint procedure where each complaint should be investigated thoroughly.

They should also care about every patient and not abandon them especially if they are on repeat medication or medication they cannot live without. They also need to address all complaints professionally and use marketing companies to get more business. Every patient that is on medication is money in their pocket.

Not everyone knows how to complain and too many people are falling through the gaps as they may no longer be registered with a practice and simply do not know what to do next.

The aim of these measures can only be to grind down the current model of general practice until they fail. Obviously, there is a political agenda to allow larger providers to take over as there is no other conceivable reason why any government would put so much additional strain on such a necessary and already beleaguered service. I personally think inspections should be paramount and should have unexpected visits to catch the surgeries. If one has a 1.7-star rating it says a lot of things about the surgery.

This particular GP Surgery that is on my radar is due for another inspection 24th May 2022

Patients are welcome to comment by sending me a private message:


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