MUS, PPS services and IAPT integration into NHS primary care - what's happening across the UK?

[Countrygirl]

Excellent idea, @Countrygirl .

I suggest you put your request for this referral and their response in writing, and lodge a copy with your lawyer, and tell the doctor you are doing so. And take a witness with you to the appointment...

It must surely be unethical for a GP to refuse to refer you for tests recommended by a hospital doctor. .

@trishrhymes Unfortunately, as stated from the MUS article above, that is just what a GP can do.

The GP would under-take to review the most severely affected patients 6 monthly (or yearly) with a senior mental health professional. The GP would be the named doctor for the patient. The GP would keep track of any attendances at A&E departments, walk-in centres etc. The GP would watch for any new referrals from these points of contact in to secondary care and if they were for known conditions that the patient had been investigated for, they would halt the onward referrals. The GP would liaise with the local hospitals, ensuring consultants did not refer to secondary care colleagues unless appropriate.

GPs are not obliged to act on the advice of a hospital doctor or a consultant. They can disregard the recommendations if they wish.

 

[trishrhymes]

'The GP would watch for any new referrals from these points of contact in to secondary care and if they were for known conditions that the patient had been investigated for, they would halt the onward referrals'

I can see that if an A&E doctor doesn't know, for example, that a patient with stomach pains had had a gastroscopy last month, and has recommended one, then the GP would be right to stop the patient having another one so soon.

But surely in your case, the point is that you have not had the relevant hospital investigation and resulting treatment.

 

[Countrygirl]

'

But surely in your case, the point is that you have not had the relevant hospital investigation and resulting treatment.

Yes, that's right, @trishrhymes

I find it bizarre, but not surprising. Once one has a diagnosis of ME then common sense flies out the window it seems.

 

[Countrygirl]

 

[Countrygirl]

What on earth is .GP valency for a special nest of patients.................'????

 

[Molly98]

we really need the ME charities to act on this and oppose it, its so wrong on so many levels

 

[MeSci]

What on earth is .GP valency for a special nest of patients.................'????

God knows - ditto a lot of the rest. It seems to have been carefully constructed to discredit all/most of the things that we might seek help with. Oh well, as long as we know not to bother...

 

[TiredSam]

Adhesive? Special nest of patients? Well if we're inventing new collective nouns it sounds like an arrogance of bullshit to me.

 

[AndyPR]

What on earth is .GP valency for a special nest of patients.................'????

From https://en.oxforddictionaries.com/definition/valency

Which still doesn't explain anything to me. Looks like the MUSers are assigning new meaning to words as they see fit.

 

[Esther12]

Where was that from?

Looks like an attempt to blam patients for not accepting quackery.

 

[A.B.]

Translation service:

Adhesive, distorted, or perverse attachment to GP and or practice.

A patient tormented by illness seeking help.

Seeks concrete explanation. Hard to talk about complexity

Doesn't buy into psychosocial bullshit explanations.

Trauma history

They really have emotional trauma.

GP valency for a special nest of patients

Being considerate with these patients is a personal weakness.

Complex bio-psycho-social experience & trauma are hard to articulate & easily mistaken for bodily symptoms or signs of disease needing cure

You should not investigate further when the diagnosis isn't easily made. Patients can't tell the difference between their repressed trauma and serious illness.

Anxieties often hidden behind manifest aggression, emotional instability and pressure for cure

Patients never angry because they're being mistreated. They're only hiding their emotional trauma. Longstanding undiagnosed and untreated disease never results in emotional instability or pressure for cure, so when you see these, it again confirms the presence of emotional trauma.

GP experience of emotional or intellectual dissonance relative to patient presentation.

If the case baffles you, it confirms that the problem is emotional trauma.

 

[TiredSam]

It seems that the only diagnostic criteria for unconscious emotional trauma is whether the GP decides you've got one or not. If you are unaware of having one, that counts for nothing, or is even proof that it's so bad you can't remember it. Even witches stood a better chance of a fair hearing, and when they were tied up and thrown in the village pond they still had better prospects of getting out alive than an ME sufferer in the UK in 2017.

 

[duncan]

It is hard not to speculate that this transcends dogma, and rises to deliberate obsfucation.

 

[A.B.]

Even witches stood a better chance of a fair hearing, and when they were tied up and thrown in the village pond they still had better prospects of getting out alive than an ME sufferer in the UK in 2017.

If they floated, they were a witch.

If patients deny that the problem is emotional trauma, then they have emotional trauma.

 

[trishrhymes]

And if we didn't have emotional trauma to start with, burying us in this pile of horseshit will surely cause emotional trauma.

If I write any more it will be a string of swear words, so I'd better stop.

 

[Countrygirl]

.

If I write any more it will be a string of swear words, so I'd better stop.

Shame!

 

[Countrygirl]

The blighters are at it again!


https://www.ncbi.nlm.nih.gov/pubmed/28183406

Long-term economic evaluation of cognitive-behavioural group treatment versus enhanced usual care for functional somatic syndromes.
Schröder A1, Ørnbøl E2, Jensen JS2, Sharpe M3, Fink P2.
Author information

Abstract
OBJECTIVE:
Patients with functional somatic syndromes (FSS) such as fibromyalgia and chronic fatigue syndrome have a poor outcome and can incur high healthcare and societal costs. We aimed to compare the medium-term (16months) cost-effectiveness and the long-term (40months) economic outcomes of a bespoke cognitive-behavioural group treatment (STreSS) with that of enhanced usual care (EUC).

METHODS:
We obtained complete data on healthcare and indirect costs (i.e. labour marked-related and health-related benefits) from public registries for 120 participants from a randomised controlled trial. Costs were calculated as per capita public expenses in 2010 €. QALYs gained were estimated from the SF-6D. We conducted a medium-term cost-effectiveness analysis and a long-term cost-minimization analysis from both a healthcare (i.e. direct cost) and a societal (i.e. total cost) perspective.

RESULTS:
In the medium term, the probability that STreSS was cost-effective at thresholds of 25,000 to 35,000 € per QALY was 93-95% from a healthcare perspective, but only 50-55% from a societal perspective. In the long term, however, STreSS was associated with increasing savings in indirect costs, mainly due to a greater number of patients self-supporting. When combined with stable long-term reductions in healthcare expenditures, there were total cost savings of 7184 € (95% CI 2271 to 12,096, p=0.004) during the third year after treatment.

CONCLUSION:
STreSS treatment costs an average of 1545 €. This cost was more than offset by subsequent savings in direct and indirect costs. Implementation could both improve patient outcomes and reduce costs.

Copyright © 2017 Elsevier Inc. All rights reserved.

 

[slysaint]

valency for a special nest of patients

something to do with bed sheets?

"It is undeniably true that the best bedding will offer you the chance of having a good night sleep. Thus, you need to buy the best bedding set that will leave you at your most relaxed and calm sleep.Remember that sleep is one thing that you should not be deprived of."
bedding with matching valances - Esters Chaefer

 

[Countrygirl]

More good news! The NHS will now not only cure all out diseases with CBT or Behavioural Activation ( a special Devon-based therapy......don't be jealous ) , but they are going to give us spiritual guidance too. (cast an eye on the bottom line..........oh joy!......what lucky bunnies we are! )

 

[Valentijn]

More good news! The NHS will now not only cure all out diseases with CBT or Behavioural Activation ( a special Devon-based therapy......don't be jealous ) , but they are going to give us spiritual guidance too.

It's long been apparent that their treatment model bears more in common with religion than science