The NHS is making me ill

 I received a text the day before yesterday.

‘This is your NHS GP Surgery. Please log on to our website and submit a current blood pressure reading.

If you do not have a blood pressure monitor please contact the surgery.’

Around five years ago I discussed my blood pressure with a GP: we agreed that I would monitor it at home, and, if it was significantly over 140/90 - say, in the 160s - I would get back to them, but otherwise I did not need to do anything about my blood pressure.

All of a sudden, and without my agreement, the NHS is hassling me for blood pressure readings. WHY?

Of course, receiving this text has had an effect on me, and my blood pressure is through the roof - 166 / 114 yesterday. There’s no better way of inducing stress in someone than a medical authority saying to them ‘excuse me, I think we need to keep more of an eye on you than we had previously agreed, and you MUST submit some information to us.’ 

***

Viv had a similar one yesterday. At the very bottom of the list of medical issues she has, she’s non-diabetic hypoglycemic: basically, she has to keep an eye on her blood sugar. (Don’t we all, once we’re past sixty?) The text says that the surgery is able to refer her to a diabetes specialist, she should contact them to arrange this.

***

The problem is, our GP surgery is so remote from our lives that they don’t understand how ridiculous these messages are. Barely a week goes by without one of us - usually Viv - having a medical appointment for one thing or another; last week it was a NHS neuro outpatient appointment, the week before dental appointments for us both. Next week I’ve got to have a crown fitted and Viv is seeing the hygienist, the week after that we have to see a consultant in Norwich about Viv’s case, and she has to see the eye surgeon at Moorfields.

We don’t have time for any more medical appointments. 

Jeremy Hunt, our utterly useless chancellor of the exchequer, recently said that the non-working over 55’s should ‘get off the golf course and go back to work’. 

I haven’t time for golf (and can’t stand the sort of people that play it either, for that matter), but I have got a garage full of junk that I have wanted to tidy for over a year. I have a model railway I started building in 2019; most builders of such grown up toys take a year or so about it. Four years later mine is still far from finished. We had a Velux window and light tunnel fitted over our stairs in 2016; straight away I started making custom mirrors for it.  Two are yet to be made and a further two only half finished, languishing in the summer house until I get the garage tidied enough to be able to finish them.

I don’t have time to relax. I don’t have time to do the things that will help me to relax and thus keep my blood pressure down.

Sending me texts about it is only going to make matters worse!

***

Once upon a time staff at GP surgeries knew patients; now, they openly display their ignorance of your medical conditions. Viv, who surely they should know (her records have a flag on them to say they are copied to a solicitor), hasn’t had a face to face appointment since 2019. We don’t even know the names of the doctors, yet the receptionists (or whoever) feel they are entitled to send us texts about trivial conditions or on matters we thought we had agreed with a doctor.

The fact is that this sort of approach is not going to solve the problems of the NHS. It may in fact be too late to save it - many people now go partly private, so the NHS GP doesn’t even know the full facts about a patient (and, we’ve found, they often don’t seem on top of your NHS treatment either.)

Sending out texts to keep in touch with customers is what businesses who are worried about their future sales pipeline do, and may seem appropriate to youngsters brought up in the impersonal world of computer games and the ‘metaverse’, but they need to remember that there are real people at the end of that text message, and their contacting them by such means will cause them stress. Indeed, the surgery should not be contacting them on any matters without checking their records and confirming that such contact is appropriate and proportionate, for inappropriate contact is only going to cause stress to patients and their carers, with consequent negative health impacts. 

GP surgeries need to remember that patients are individuals, and that they are people, who deserve to be treated with more respect than being sent generic text messages.

***

If you enter our GP surgery, not that patients are welcome to do such a thing uninvited these days, another sign of their lack of interest in an individual’s problems is a sign, among many seemingly posted using a wind machine and sticky glue, ‘reminding’ patients that the surgery has a ‘zero tolerance’ policy and will not tolerate ‘abuse’ of its staff. 

I’ve been warned about their zero tolerance policy in the past - and walked out to avoid a confrontation - after querying why I hadn’t been given the correct information about getting a login to their online system. 

These notices about ‘zero tolerance’ policies - which seem to be all the rage in the I-don’t-want-to-see-any-ghastly-member-of-the-public-face-to-face, four-day-week, work-from-home-whenever-possible public sector - are all about making things easier for the employee. They are a convenient way for a business to avoid having to accept that they are failing to provide an adequate service, and for an employee to avoid having to apologise for having made an error. 

They have no place in a medical environment: the public have a right to expect the highest standards of staff involved in looking after their health and that failings are accepted and will be put right. (Such policies wouldn’t be publicly advertised, or even exist, in a high-grade hospitality business - watching a Gordon Ramsay TV programme or two (or Alex Polizzi if you prefer milder language) is an easy way to get a clear impression of what high-standard service is about in the private sector.)

I’d actually go as far as to say that ‘zero tolerance’ policies have no place in any customer-facing business. If a customer is shouting at you, your business has failed. You’ve fucked up (GR language) or messed up (AP version), and you need to accept that and put it right. Telling the customer you’ll prosecute them, or refuse to serve them, is merely trying to hide that you’ve fucked up - and it won’t solve their problem. (Going back to the hospitality example, a customer who is drunk should not have been admitted, or served - so him shouting at the barman is perhaps a sign that someone didn't notice how much he'd already had.) In the hospitality trade customers can just take their business elsewhere if they perceive they are getting bad service, but in a monopoly like the public sector it just means that the public are continually failed; in a GP surgery, a patient could suffer and might die (and you don’t think that’s a reason for getting a little bit angry?). 

Patients have a right to expect that anyone contacting them from their GP surgery has a good understanding of their medical conditions, their general health, and any constraints on their lifestyle (such as being a carer); staff contacting them should accept that patients might be a little unhappy if those contacting them do not understand the constraints within which they have to live their lives.

***

So, here’s what I’m going to say to my GP surgery about their text message:

‘Thank you for your recent text message regarding blood pressure and for being interested in my health. As you are no doubt aware, I have, for the last six years, been caring for my partner who has a number of medical conditions and regular appointments (about one a week), both NHS and private, many as a result of an incident of medical negligence at Bedford Hospital. 

I do suffer greatly from stress; I did recently consult a care agency to see if they could help out, but they are short of staff having lost carers due to the rules about Covid vaccination.

I also believe that my health may have been affected by the pandemic and the measures that were enforced at the time, including the Covid vaccine.

In one of my recent appointments with a GP - I believe it was Dr. Gledhill - we discussed blood pressure and agreed that I would monitor it at home, and, if it was stubbornly above 160/100 or so for no apparent reason, I would contact the surgery. 

I monitor my blood pressure, am careful about alcohol, do not drink coffee and exercise well. I am therefore happy to continue as agreed with Dr. Gledhill.

I do ask, however, that you avoid contacting me in this way by text. Such messages can be frightening and counterproductive - resulting in fear and raised blood pressure. 

If I do have any concerns about my health that I wish to discuss with you I shall contact you through one of your receptionists.’

And, for Viv, I’m going to suggest she replies as follows:

‘Thank you for your offer to arrange for me to see a diabetes specialist. 

Unfortunately, as you may know, my non-diabetic hypoglycemia is low on the list of priorities in terms of my medical conditions. 

I have appointments more or less every week in connection with my acoustic neuroma, epilepsy and the hydrocephalus that arose as a result of the delay getting a referral at Bedford Hospital in 2015. 

I am also concerned about the stress that all my medical appointments put on my partner; he needs to have some time to relax.

I therefore do not, at the moment, believe I have time for any appointments relating to diabetes.

If you believe I should take this matter more seriously can you please arrange for me to have an appointment with a doctor so my partner and I can come in and discuss it with them.’

I do know how much our doctors and staff at our NHS GP surgery care about the health of us patients. It was made clear in a letter a few weeks ago, that told all patients that the practice would be closing at the end of May. In future our NHS GP surgery will probably be many miles away, and our only contact with them by phone. That’ll make it easy for them to check my blood pressure, won’t it?