Backdated fit note from GP?

surreysaver

Undervalued wrote: »

Yes well, like a lot of things, kicking up a fuss when it isn't really justified may get you what you want but it will ultimately be at somebody else's detriment.

The GP's primary function is to treat the sick and, when appropriate, refer the patient to an appropriate specialist. Writing out sick notes, quite correctly, has a far lower priority.

Contacting PALS isn't kicking up a fuss. Making an official complaint could be construed as kicking up a fuss in this case before any other course has been pursued. It is this sort of situation that PALS is there for. The issuing of Fit Notes is a primary function of GPs - they are contracted to provide this service. And the OP is unwell, so they could see the OP about their illness at the same time and kill two birds with one stone. And the issuing of Fit Notes IS a priority, as it allows businesses to function properly, allows them to claim SSP off the DWP and allows everyone to adhere to the law.

MonkeyDr

surreysaver wrote: »

Well, I am responding to the OP's thread, so that should be taken as advice for the OP

But its something anyone can do if they want. For example they might not want their regular GP to know something; they might be on holiday somewhere; they might not be registered with a GP.

Fair enough. I did say about the holiday thing, and your other scenarios are valid too.

That said, I do think the not wanting your GP to know something can be tricky. I'm not disagreeing with it, especially in a small town, for example. But I do see cases where patients don't get the best care because they choose to use providers over a wide area. Scans (with harmful radiation) are repeated, pieces of a puzzle are put together later than they would have otherwise been, and so on. It actually affects some healthcare workers themselves quite a lot, as they don't want to be seen in the patch where they work.

I don't have a solution!

Undervalued

surreysaver wrote: »

Contacting PALS isn't kicking up a fuss. Making an official complaint could be construed as kicking up a fuss in this case before any other course has been pursued. It is this sort of situation that PALS is there for. The issuing of Fit Notes is a primary function of GPs - they are contracted to provide this service. And the OP is unwell, so they could see the OP about their illness at the same time and kill two birds with one stone. And the issuing of Fit Notes IS a priority, as it allows businesses to function properly, allows them to claim SSP off the DWP and allows everyone to adhere to the law.

The GP has to prioritise by trying to see the most urgent and / or vulnerable patients first.

So no, somebody who mainly wants / needs a sick note rather than urgent treatment or referral is a lower priority.

Finally, businesses do not "claim SSP off the DWP", that stopped years ago even for small businesses! The business is required by law to pay it to qualifying employees but they do not get the money back from the government.

surreysaver

MonkeyDr wrote: »

Fair enough. I did say about the holiday thing, and your other scenarios are valid too.

That said, I do think the not wanting your GP to know something can be tricky. I'm not disagreeing with it, especially in a small town, for example. But I do see cases where patients don't get the best care because they choose to use providers over a wide area.

I would say to anyone considering to withhold information from their GP to consider the issues it will or may cause. But if someone's choice is to withhold information or see no-one, then withholding information is the best option. I will only allow my GP to receive information if I consider it necessary. You do not know how the NHS or the Government will be using information held by GPs in the future.
Hence when I was admitted to A&E when they asked me for my GP's details I simply told them I wasn't registered. If I fell my GP needs to know about my admittance in the future, I can tell them.

surreysaver

Undervalued wrote: »

The GP has to prioritise by trying to see the most urgent and / or vulnerable patients first.

How is the GP going to do that when the patient cannot get past the receptionist?

MonkeyDr

LunaLovegood wrote: »

I cannot wait nearly another 3 weeks being the way I am.

I am enjoying the discussion, but also want to return to the OP, and I think the above line is the crux of the matter.

OP, I honestly think that maybe you aren't conveying the right message to the receptionist. For whatever reason, I suspect they are hearing "I need a fit note because of my chronic symptoms", and that is not an urgent thing.

It sounds like you are not someone who calls up every week demanding an urgent appointment for a minor sniffle. This is something new, and serious to you. I think it merits an appointment over the next day or two for assessment and treatment, let alone for a note.

Try and think about which particular symptoms are bad. Why can't you go to work? (genuine question for you to focus your thoughts around; I'm not trying to be provocative). Write it down before you call. And, I am not a GP and I do not know what the magic words are to get an urgent appointment, but I suspect being clear that it is something new, that potentially needs treatment sooner rather than later is the key.

Although you need a fit note for work, I am sure that what you really want is to start the ball rolling to try and get better. If you make it just about the paperwork you may well not be prioritised.

Undervalued

surreysaver wrote: »

How is the GP going to do that when the patient cannot get past the receptionist?

The receptionist has received some training to ask relevant questions in an attempt to ensure that the more urgent cases are seen first. I realise it is far from ideal but what is the alternative?

NHS 111 does similar, as does the emergency ambulance service and patients arriving at an A&E department are generally seen initially by a triage nurse in order to prioritise cases. None of those are perfect systems either but again, what is the alternative?

surreysaver

Undervalued wrote: »

The receptionist has received some training to ask relevant questions in an attempt to ensure that the more urgent cases are seen first. I realise it is far from ideal but what is the alternative?

So, in effect, the people who 'blag' it will get seen sooner for their sniffles, rather than the people who do not make a fuss who have more serious issues.

MonkeyDr

surreysaver wrote: »

I would say to anyone considering to withhold information from their GP to consider the issues it will or may cause. But if someone's choice is to withhold information or see no-one, then withholding information is the best option. I will only allow my GP to receive information if I consider it necessary. You do not know how the NHS or the Government will be using information held by GPs in the future.
Hence when I was admitted to A&E when they asked me for my GP's details I simply told them I wasn't registered. If I fell my GP needs to know about my admittance in the future, I can tell them.

Absolutely your right to do so, of course.

I have seen plenty of cases where people do not want their GP to know about certain conditions (e.g. HIV if they are worried about stigma), and I totally respect it. But I always remind them that in withholding the information they may be putting their health at risk as the GP may e.g. prescribe something that interferes with their HIV meds, or under/over-investigate a symptom because they didn't have the full picture. I recommend finding another GP who they trust.

I don't think I could quantify the risk of fragmented care, but I am certain that in some cases it would result in serious unnecessary harm, for example if someone suffered the 1 in 1000 serious complication from an investigation that wasn't really warranted.

Further, some diagnoses really do emerge over time from a series of seemingly unconnected symptoms. I know about the ones in my field, but wouldn't trust myself to know everything. I don't know what your background is, but I would suggest that possibly you might not be in a fully informed position to know whether your GP would benefit from knowing about the admission or not.

(I say your GP; of course actually the potential benefit is to you!)

Undervalued

surreysaver wrote: »

So, in effect, the people who 'blag' it will get seen sooner for their sniffles, rather than the people who do not make a fuss who have more serious issues.

Probably I'm afraid but once again, with limited resources, what is the alternative?