My attempts to post a comment on NHS Choices

NHS Choices have a webpage to support patients who want to choose a GP practice where they do not reside. They do not have a list of practices offering this option (it is voluntary), patients have to research this themselves.

One paragraph reads as follows:

Because of the greater distance to your home, the GP you register with is under no obligation to offer you a home visit. If you are not well enough to go to the practice yourself then other arrangements will be made. NHS England (the body responsible for buying GP services) ensures that there is access to a service either near your home or at home (if required). When you register with a practice away from home you will be given information about what you should do in those circumstances.

However, if you are too ill to attend the practice in person, or the practice is unable to help you over the phone, call NHS 111. The NHS 111 service will be able to tell you about access to local services or, where necessary, arrange a home visit.

However, at the end of January 2015 I rang 3 different London NHS 111 centres (covering east London, north London, and central London) and none of them were aware of the new policy and none of them had in place a way of dealing, in hours, with patients who were not registered with a local GP. I was told that the patient would be advised to go to a walk in centre or to A+E.

[I rang NHS 111 for central London this morning, to see if things have moved on. I spoke to a first line adviser and then the supervisor. The supervisor thought a person could register with a GP in the home area, and then also register with a practice near their work or wherever else they chose. I told her this was not the case and I read her the text above. She said NHS 111 could not arrange this, and that the patient would be advised to attend a walk in centre or A+E.]

Elsewhere in the NHS Choices webpage is the following sentence:

This means that you are able to register with practices in more convenient locations, such as a practice near your work or closer to your children’s schools.

This idea of registering near your children’s schools has been a constant declared benefit of the policy since it was first broached in September 2009. But such a choice would not actually work, and would create problems for the parents and children. I have made a modest video explaining why.

I wrote a comment for this webpage; it was rejected; and an email exchange is in progress:

The proposed comment:

“I am a GP in Tower Hamlets. I think it is important that people thinking about registering with a GP practice away from where they live check carefully whether they will have in hours GP cover if they are ill at home and unable to travel to their registered practice. The cover throughout England is patchy. In London, there is no cover at all (at the time of writing this, 3/3/15).

I have written to Jeremy Hunt, the Department of Health, and NHS England so hopefully they will put this right.

Another issue: it is not a very good idea to register with a practice near your children’s school, it will actually cause problems, so beware. For details, see my video on YouTube:

http://bit.ly/1tzoP7S

*

The subsequent email exchange:

From: NHS Choices [thechoicesteam@nhschoices.nhs.uk]
Sent: 19 March 2015 10:11

To: Farrelly George (NHS TOWER HAMLETS CCG)

Subject: Your review has been rejected

Dear George Farrelly,

Thank you for contributing to the NHS Choices website. We have removed your contribution because we feel it is unsuitable for publication on this page. We do not allow comments which actively seek to dissuade other site users from following the evidence-based health advice provided. Please see the site Terms and Conditions or refer to the Moderation Rules policy. http://www.nhs.uk/Commentspolicy/Pages/Moderationrules.aspx

Please click the button or follow the link below to submit a new review of the service. etc etc….

*

From: Farrelly George (NHS TOWER HAMLETS CCG)

Sent: 27 March 2015 07:18

To: NHS Choices Service Desk

Cc: Farrelly George (NHS TOWER HAMLETS CCG)

Subject: RE: Your review has been rejected | 219186RL

Dear NHS Choices,

I do not accept the reasons you have given for rejecting my comment to the page http://www.nhs.uk/nhsengland/aboutnhsservices/doctors/pages/patient-choice-gp-practices.aspx

I will remind you of my comment:

“I am a GP in Tower Hamlets. I think it is important that people thinking about registering with a GP practice away from where they live check carefully whether they will have in hours GP cover if they are ill at home and unable to travel to their registered practice. The cover throughout England is patchy. In London, there is no cover at all (at the time of writing this, 3/3/15).

I have written to Jeremy Hunt, the Department of Health, and NHS England so hopefully they will put this right.

Another issue: it is not a very good idea to register with a practice near your children’s school, it will actually cause problems, so beware. For details, see my video on YouTube:

http://bit.ly/1tzoP7S

*

I can see why you would prefer not to include this comment, but I do not accept that your reasons are valid. You say that you do not allow ‘comments which actively seek to dissuade other site users from the following the evidence-based health advice provided’.

In my comment I make 2 main points: 1. there is no cover in London for patients registering with a practice at a distance from where they live should they fall ill and not be able to get to their registered practice; this is a matter of fact, and introduces a safety risk for these patients; you are offering a service which has a very basic flaw and patients should be aware of it.

2. registering with a practice near your child’s school: this simply does not work and offering this as a benefit to patients is misleading and irresponsible. I illustrate why in this video: https://www.youtube.com/watch?v=JMllmAcg9II

Would you please explain in what way this advice to register near your child’s school (or the policy as a whole) is ‘evidence-based’?

Best wishes,

George

The Tredegar Practice
35 St Stephens Road
London
E3 5JD

*

From: NHS Choices Service Desk
Sent: 02 April 2015 09:17

To: ‘Farrelly George (NHS TOWER HAMLETS CCG)’

Subject: RE: Your review has been rejected | 219186RL

Dear George,

Thank you for contacting the NHS Choices Service Desk.

We have now assigned your query to the Subject Matter Expert (SME) within NHS Choices. A member of our service desk will be in touch as soon as we receive a response.

If you require an update at any time, please feel free to respond to this email quoting the reference 219186RL in the subject line.

Kind Regards,

Rachael

The NHS Choices Service Desk

*

From: NHS Choices Service Desk [servicedesk@nhschoices.nhs.uk]
Sent: 10 April 2015 12:21

To: Farrelly George (NHS TOWER HAMLETS CCG)

Subject: RE: Your review has been rejected | 219186RL

Dear George,

Thank you for contacting the NHS Choices Service Desk.

Please see the response below from our user generated content team.

” Dear George,

Without making any judgement on the validity of your arguments I have to tell you that NHS Choices is not the correct forum for your concerns.

Choices’ comments section was set up to offer patients the opportunity to rate and comment on their NHS care and treatment. Our comments policy does not permit campaigning of any sort.

The moderator used the correct rejection category though they should have paid more attention to the wording used in the automatic notification sent when that category is used.

Kind regards “

Please get back to us if you have any other queries.

Kind Regards,

Rachael

The NHS Choices Service Desk

*

Dear Rachael or Colleague,

Thank you for your reply.

I have three questions:

1. if a patient, non-‘campaigner’, were to point out on your page that he/she is unable to find ‘at-home’ GP cover in London, would that be acceptable? Or if a patient were to point out that registering with a practice near their child’s school did not actually work, would you accept that comment?

2. If someone like me, with specialist understanding about how a frontline service works, finds a flaw with a ‘choice’ you are promoting, what is the ‘correct forum’ for my concerns?

3. What is the governance for ensuring the ‘choices’ you are offering on the NHS Choices website are safe and workable? If it is pointed out that a ‘choice’ you are offering does not work or is unsafe, do you have any responsibility to look into this or is it ok to simply leave it unchanged?

Best wishes,

George

The Tredegar Practice
35 St Stephens Road
London
E3 5JD

*

From: NHS Choices Service Desk
Sent: 15 May 2015 09:57

To: Farrelly George (NHS TOWER HAMLETS CCG)

Subject: RE: Your review has been rejected | 219186RL

Dear George,

Thank you for contacting the NHS Choices Service Desk.

Please see the response below from our user generated content team.

” Dear Dr Farrelly,

As I explained to you a while ago when you last tried to post your comment NHS Choices comments policy prohibits all campaigning of any sort.

This is no reflection on the aims of your campaign or any judgement regarding its merit, merely that Choices is not the correct forum for your concerns. We are very strong on not supporting or endorsing any campaigns. Furthermore providing health advice is not permitted.

Choices is meant to be a platform whereby patients can comment and rate their NHS care and treatment.

Choices comments policy is explained here:

http://www.nhs.uk/aboutNHSChoices/aboutnhschoices/termsandconditions/Pages/commentspolicy.aspx

Kind regards “

Please get back to us if you have any other queries.

Kind Regards,

Rachael
The NHS Choices Service Desk

*

From: Farrelly George (NHS TOWER HAMLETS CCG)
Sent: 15 May 2015 16:09

To: NHS Choices Service Desk

Subject: RE: Your review has been rejected | 219186RL

Dear Rachael,

They have not answered my questions. They are in plain English; there are three of them.

Please ask them to answer them, one at a time, directly, without evasion or obfuscation.

Many thanks,

George

*

[I will add their reply when I receive it]

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