Dulwich Medical Centre

[jimbo1964]

Do the NHS have the power to take over the running of a surgery if that surgery in incapable of managing itself? It sounds like the medical staff are fine. But the administration is pathetic.

[James Barber]

Hi jimbo1964,

Yes, I believe they do. As with just about all GP practices they are and have always been private businesses. So the NHS will have termination clauses in the contract. The contract presumably is prettyy standard and agreed with the BMA - http://www.england.nhs.uk/wp-content/uploads/2014/05/gms-contract-04-14.pdf

I've only briefly scanned clause 26.

Anyone game to read al 126 pages and share their views?

[DMC Healthcare]

From talking to patients we know there is some confusion and irritation about the triage process. Where patients phone in the morning, they will be called back by a doctor and either be given a same-day appointment, which we do in appropriate cases, or directed to one of our nurses or prescribing pharmacists. We are facing the same systemic pressures as other London and Dulwich GPs, as described by Dr Rosemary Leonard speaking on TV this week. There will be new information going up on the practice website. We find that patients accept the clinical triage and the need to red flag certain symptoms early in the morning, once we explain it to them. Please be assured we are working very hard to deal with the current situation.

[Cora]

But why is there still a 45min wait despite pressing repeated re-dial to get through? Can you tell us what immediate plans are being put in place to get more phone-lines, terminals and staff so your ill clients are not wasting their time and depleted energy to get through to you. I would have thought a couple of week's grace to sort this out should be sufficient. Temp staff booked initially if necessary, technology ordered and installed and three days training.

[katgod]

Agree with SPorthuntor, on MOnday there were no appointments available despite numerous calla sand a long wait on hold between 8 and 8.30.

I did manage to get an appointment today. I do not think the triage system works. My child has not been to the Gp since 2008. I know she is unwell. A doctor would need to see her to determine how ill- Seldoc had already done the phone triage.

One thing that might help DMC is to set their clocks to the right time. Another patient tried to point out that all the clocks there are set 5 minutes slow, and the receptionist really argued about it. Someone else with a phone and a watch set to the right time agreed. No wonder they they think the system is running on time ( per the check in screen at the back) when in fact it is always late.

More doctors, better phone system and more reception staff in at 8. Not that hard.

[MrBen]

Question - can anyone confirm the subsidy model (even roughly) for a privately run surgery like DMC?

I'm keen to understand whether they're on borderline margins /break even and struggling with service because of the funding model....or whether the owners are driving around in a Bentley whilst skimming the operating costs right back.

[brain_opera]

Oh do shut up DMC, you're making yourself look even worse. I've moved twice now. Nunhead surgery were easy to get appointments with, and to get prescriptions from. Streatham High is great, and a huge surgery too. Appointments are easy to get, doctors ring you back and they do prescriptions within 24 hours. Your problems are caused by your greed and shit management. Countless other surrgeries even a few miles Way manage.

[Fuschia]

Primarily funded for the no of patients registered with the practice

http://blogs.bmj.com/bmj/2014/12/23/samir-dawlatly-how-gp-practices-are-funded-between-a-rock-and-a-hard-place/

[Fuschia]

Primarily funded for the no of patients registered with the practice

http://blogs.bmj.com/bmj/2014/12/23/samir-dawlatly-how-gp-practices-are-funded-between-a-rock-and-a-hard-place/

I wonder how many patients there are to each DMC gp

http://www.gponline.com/exclusive-huge-variation-gp-patient-ratio-across-england-revealed/article/1327390

[kristen]

Fuschia Wrote: I wonder how many patients there are to each DMC gp

There are 10,564 patients registered at the Crystal Palace Road practice according to this website - http://www.nhs.uk/Service-Search/GP/SE220EQ/Results/4/-0.0704028904438019/51.4513816833496/4/0?distance=25

Although I'm not sure if this figure was before or after people started to be removed from their list.

At a guess I'd say there are usually 3 or 4 GPs working when I go in for an appointment - although this is just based on a vague memory of how many room colours come up when patients are called and might be completely wrong.

Interesting info here on DMC survey results but only 100+ surveys returned it's not a very good sample size for 10,000+ patients - https://gp-patient.co.uk/practices/G85651

[kristen]

Also @DMC it's not just a current situation - it might be slightly worse now but for the past few years I've been regaling friends with tales from DMC - it's comedy gold (or pure farce). For eg waiting over a year to get referred to have a lump investigated - despite requesting it every time I saw a dr - and the hospital saying it needed looking at.

My favourite one at the moment is your claim to have none of my hospital notes since 2013 so are unable to discuss my condition properly after I've queued up outside & taken the day off work to get a Drs appointment and then telling me you can't prescribe my pain relief medication without direction from my consultant (who incidentally is happy for me to be treated symptomatically for pain). Then when I say fine I'll give up the pain relief but can I get support from a pain clinic you change your mind and are happy to prescribe it - presumably because it's less costly.

The amount of frustration I've had with your practice over the past few years has made living with a long term chronic condition a nightmare. GPs might be underfunded but you have wasted loads of money on my care along just from general incompetency. I've had wonderful care from one GP - Dr Prabhakaran - who I worry will burn out as she works so hard within an otherwise broken system. But it's impossible to see her and trying to manage a long term condition when you're only able to see locum after locum is hopeless.

[bawdy-nan]

My favourite DMC story, admittedly from a few years ago was being told off by a French accented GP for still breastfeeding my baby at 6 months ...

[slarti b]

@Mr Ben See http://www.dailymail.co.uk/news/article-2063458/Family-doctors-firm-raking-1-8m-YEAR--patients-say-surgery-appalling.html

According to the accounts for the year to March 2014, DMC Healthcare made post-tax profits of ?470k and paid dividends of ?600k. It still had ?1.8m left in cash at year-end though.

How much does a Bentley cost nowadays?

[Becola]

Might be of interest to those on this thread that the CQC started a new inspection programme of GP practices last year. As someone earlier noted they haven't inspected DMC yet, though their latest monitoring report makes for fairly depressing reading http://www.cqc.org.uk/sites/default/files/1-565650623%20GP%20IM%20V101.pdf

James is absolutely right to encourage people to complain to NHS England if the practice hasn't responded to complaints themselves adequately. I'd also suggest (I say this as someone who works in healthcare) that you might also want to share concerns with the CQC directly via their website and see if that bumps DMC up the list to be inspected next..... http://www.cqc.org.uk/share-your-experience-finder

Hope that's helpful. Awful to hear such terrible experiences. The NHS is a wonderful thing, but this sort of thing lets everyone down.

Best of luck to james and those of you taking this up with the commissioners.

[MrBen]

I've just checked the accounts for DMC Healthcare at Companies House. They are turning over about ?6M, have ?2m cash/assets in the bank and had net profits of ?469K last FY and ?838k the year before. That means they are trading at between 7% to 14% EBITDA which isn't too obscene.

However, it's run by just two directors (the Guptas) and they would have paid lower tax on the ?600k dividends drawn last FY when compared with a PAYE income (as per normal salary) so they probably netted ?220 to ?230k each after tax depending on several other variables. Gross that back up and the equivalent PAYE salary is about ?430k per year. That's a salary many FTSE 250 execs would be happy about. You then have to take a view on whether that drawing is morally or socially appropriate for what is an essential basic public service impacting the wellbeing of over 10,000 men, women and children locally who need it.

Next - think what cutting ?100k off those annual divvies or investing ?100k from their reserves could pay for operationally:

- Another 4-5 operational or clerical staff to answer the phone and manage daily workloads, medical records and patient admin.

- Another full time GP to handle the high workload.

- improved IT systems / phone systems for handling triage and optimising appointments.

If they offered an acceptable service you could almost forgive the profits and drawings but as they clearly do not it is reprehensible and socially, morally and ethically unacceptable.

The funding system needs to be linked to reasonable patient satisfaction metrics- that would encourage improvements all round and prevent these guys thieving from the tax payer/NHS to pay for the ?2-3M+ house in Dulwich village.

The current system is broken and lets this happen. There is enough on here and out there in the ether to keep the producers of Panorama happy - who's going to get in touch?

[Bic Basher]

The figure quoted on the NHS Choices site for DMC are for both surgeries in Crystal Palace Road and Chadwick Road.

[Monkey]

bawdy-nan Wrote:

-------------------------------------------------------

> My favourite DMC story, admittedly from a few

> years ago was being told off by a French accented

> GP for still breastfeeding my baby at 6 months ...

My favourite DMC story: being told off for using a private French GP when DMC could not give me an appointment.

[kristen]

I didn't notice that they're both the same figures - does it state anywhere that it's a joint figure?

Sorry I should have checked first (post in haste = repent in leisure!)

Bic Basher Wrote:

-------------------------------------------------------

> The figure quoted on the NHS Choices site for DMC

> are for both surgeries in Crystal Palace Road and

> Chadwick Road.

[MrBen]

Two more points:

1. Where is the corporate governance for a private enterprise that serves the public interest? No truly independent non-exec directors....just two shareholders who happen to also be family. It needs a balance and check mechanism beyond current BMA guidelines.

2. Massive conflict of interests exist with the privately run model - shareholders want to make as much profit as possible for personal gain. To do so they have to cut down operational expenditure to a bare minimum - delivering a woeful public service as a result. Their interests and commercial objectives do not align with those of their 10,000 patients all if whom rely on their service for their basic wellbeing.

This is really basic stuff. Who ever allowed this to happen in the first place?

[MrBen]

Answer: New Labour circa 1999

[lilolil]

Remember this too. Great community practice????

http://www.eastdulwichforum.co.uk/forum/read.php?30,1376505,1376505#msg-1376505

[Sue]

lilolil Wrote:

-------------------------------------------------------

> Remember this too. Great community practice????

>

> http://www.eastdulwichforum.co.uk/forum/read.php?3

> 0,1376505,1376505#msg-1376505

If everybody went to DMC expecting minor ailments to be dealt with immediately, the whole system would collapse completely in a millisecond.

The nearby pharmacy was surely the place to go, for tweezers and anti-histamines?

[lilolil]

We were next door to DMC. The child in question had other medical issues,one of which was a mild allergy to bee stings. His lips and tongue were tingling slightly. If we had thought it to be an absolute emergency, then of course we would have rang for an ambulance.

Amazing how some people can be so callous

[sleepy-li]

Amazingly I got through to DMC this morning on my fourth ring at 8.01 - I was 7th in the queue. I finally spoke to the receptionist at 8.40! guess what, no appointments left - unbelievable.

[ednewmy]

Just tried to call through (at 2PM) to make an asthma check up. Was on hold for 40 minutes after which time my call got cut off.

DMC is a complete and utter shambolic joke.