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Six mistakes people make when choosing a private GP (#5 can cost you hundreds!)

In recent years there has been an explosion in the number of private GP services, both within Liverpool and nationwide. Unfortunately, not all private GP clinics are created equal, and I’ve seen some pretty shocking behaviour from some of our competitors. If you’re thinking of using a private GP in Liverpool – or if a relative or friend plans to – you should do your due diligence to make sure you end up with the best quality care.

As an experienced private GP myself, here are (in my opinion) some major red flags:

#1 The service you’re looking at isn’t CQC registered

Almost all private GP services in England need to be registered with the Care Quality Commission (CQC). The CQC is the regulator of health and social care in England. They’re not infallible, and they love red tape – they initially insisted we needed a written risk assessment for the fish tank in our waiting room, which we thought was a bit OTT – but if a service is registered with the CQC, you have the peace of mind of knowing that the service is being assessed against some key standards.

In a few very niche circumstances, private GPs don’t need to be CQC-registered. This only applies if a doctor, or a group of individual doctors, work in a clinic room which already has CQC registration for another service. GPs working under this exemption can’t employ other staff such as nurses or managers, or form a company together to handle payments. They also can’t offer home visits, or video or telephone appointments, or even offer advice by email. So in practice, if an exemption does apply, they’re probably offering a very limited service. In comparison, at Formby GP we are CQC-registered, so we offer home visits, remote consultations, and we regularly answer email queries from our regular patients.

If a private GP service is supposed to be registered with the CQC and is operating without registration, this is a crime – it’s a breach of the Health and Social Care Act and they can be prosecuted.

If you’re looking at a private GP service near you which isn’t CQC-registered, in my opinion it’s a red flag – either they’re operating illegally, or they have a lawful exemption because the service they’re offering is very limited.

#2 They’re offering appointments with “clinicians”

If a private GP service is offering appointments with “General Practice clinicians” or “members of the General Practice team”, the person you’re seeing may not be a doctor. Check carefully the credentials of whoever you are seeing, and ask yourself if it’s good value for money.

There are times when other healthcare professionals can be invaluable, including privately – if you’re having a smear, a nurse may well be the best person for the job. But my longstanding position is that GPs and other doctors are the best healthcare professionals to see patients with “undifferentiated presentations”. Seeing patients with a new problem, who haven’t seen a doctor about this problem before, is one of the hardest jobs in Medicine. It is surprisingly difficult to make a diagnosis, and to weigh up all the different factors to choose the best treatment for a problem. That’s why, in my opinion, it’s worth making sure you’re seeing a GP, especially if you’re paying for private care.

#3 They’re illegally advertising prescription-only medication

In the UK, the Human Medicines Regulations (2012) make it illegal to advertise any prescription-only medicine to members of the public. Despite this, some other private GP services merrily advertise medication – including, in some cases, CONTROLLED DRUGS – to the public.

We all know that in the United States, you can barely turn on the TV without seeing adverts for diabetes drugs or blood thinners. But in the UK we have a proud tradition of not advertising prescription-only medications directly to patients. In the UK it’s widely accepted that the decision about which medication to take is best made by patients and doctors working in partnership together, and that advertising drugs direct to consumers has risks and downsides. That’s why the MHRA and ASA set strict rules about what doctors can say when advertising their services to the public.

Some private doctors ignore these rules and aggressively market drugs directly to patients, including on Facebook and Instagram. This is a red flag, in my view – if your private GP can’t follow basic rules designed to keep you safe, what else are they skimping on?

#4 Their reviews are written by their friends, or their employees, or bots

Healthcare is a private matter, and so patients are often reluctant to leave public reviews for private GP services. We have been open for over 3 years and, at the time of writing, we only have 35 Google reviews. Many of our patients are high profile or high net worth individuals, or are well known in the local area, so it’s hardly surprising they’re careful about what they put in the public domain.

If you’re reading a private GP clinic’s public reviews, it can be very entertaining to do a bit of snooping to work out if the person who wrote the review has any connection to the owners of the clinic. It’s surprisingly common for new clinics to have glowing reviews which turn out, after a bit of Googling or Facebook stalking, to be written by the clinic owner’s childhood friend or their employee. Sometimes there are a string of reviews written by people who bear the hallmarks of being bots. You can pay for online reviews! We don’t.

In my opinion, as an established and successful private GP, it’s a bit sad if a clinic has a string of reviews which don’t look genuine 😂

#5 You get locked into an expensive monthly membership

This is probably the BIGGEST mistake you can make, as a prospective patient, in my opinion! Private GP memberships often work out more expensive than just paying as you go. Private clinics which operate a membership model may try to make their prices sound affordable with phrases like “it’s cheaper than a daily coffee”. But it’s important to sit down and crunch the numbers to see if a private healthcare membership makes sense for you, in your specific circumstances. Many people are pretty healthy and only go to the GP a couple of times a year – in which case it often works out cheaper just to pay as you go. And if you do have complex needs and expect to visit the GP regularly, check the small print of any membership contract you sign – many have a “fair use” clause which limits the number of times you can be seen without incurring further charges.

At Formby GP, we do offer the option to pay a small fee annually for prescription charges and guaranteed GP appointment access – this is our “Priority Club” and it works out cost-effective if you need private prescriptions for more than 5 items per year, or if you need a lot of email advice. But we don’t offer an all-you-can-eat appointment offer, for good reason – it’s very difficult to find a price point which seems fair to both the GP and the patient. We have previously written about this in more detail.

#6 They’re using AI, or an external marketing agency, to pump out lots of glossy but soulless adverts

OK, I admit it – this one is just personal preference. But hear me out! Most private GP services’ social media accounts are indistinguishable from one another – lots of glossy graphics and generic content. It’s not adding much to the sum of world knowledge – you probably already knew you needed to sleep more and drink plenty of water – and it’s very hard to get a feel for who the doctors actually are. If you’re paying to see a private GP, one of the benefits is that you can get to know and trust your doctor. As a patient myself, I’d rather book in once I’ve got a sense of the doctor’s personality from their website and social media.

Also, AI is terrible for the environment! Just make your own graphics on Adobe and save the planet, guys 😘

If you’re worried about your health and would like to book an appointment with a reputable, trustworthy, established private GP, we offer direct online booking so you can secure your appointment with Dr Heather or Dr John at Formby GP:

Alternatively, give us a call on 01704 617050 and chat to our friendly team.

If you’re looking for a private GP in Liverpool, a private GP in Liverpool city centre, a private GP in Merseyside, a private GP in Crosby, or a private GP home visit in Liverpool, contact Formby GP today.

Formby GP’s chaperone policy

Formby GP is committed to providing a safe, comfortable environment where patients and staff can be confident that best practice is being followed at all times and the safety of everyone is of paramount importance.

All patients are entitled to have a chaperone present for any consultation, examination or procedure where they feel one is required.  

Regardless of the sex of the patient or clinician, you will be offered the option of having an impartial observer (chaperone) present for any intimate examination. Our trained staff routinely undertake this role and will:

  • Be sensitive and respect your dignity and confidentiality  
  • Reassure you in the event of distress or discomfort  
  • Be familiar with the procedures involved  
  • Stay for the whole examination and be able to see what the clinician is doing, if practical  
  • Be prepared to raise concerns if they are concerned about the clinician’s behaviour or actions. 

The GP you see may also require a chaperone to be present for certain consultations.

Formby GP is registered with the Care Quality Commission

The CQC is the independent regulator of health and social care in England. It is an executive non-departmental public body of the Department of Health and Social Care. The CQC monitors, inspects, and rates services, including NHS and private clinics.

Formby GP’s page on the CQC website can be found here.

You can give feedback on your experiences with us – good or bad – via the CQC’s Give Feedback on Care portal.

Travel vaccinations

It is once again the time of year when many people are starting to prepare for their travels, and we are getting many enquiries about travel vaccinations.

Many of our patients come to us for their travel vaccinations. Our vaccination service is:

  • doctor led
  • convenient (for some)
  • discreet
  • trusted by existing patients

Set against these advantages, we can unfortunately be significantly more expensive than other providers, including pharmacies. This is due to our higher costs, including tax.

If you would like a vaccination from us, please complete and send in the form www.FormbyGP.com/travel so that we have the information we need to be able to give you a quote. If you would then like to proceed, you can book an appointment for the vaccination and pay a non-refundable booking fee (ÂŁ60 at the time of writing).

If you prefer to go elsewhere for your travel vaccination, we will certainly not be offended. Please bear us in mind should you need a GP consultation, which can be booked at www.FormbyGP.com/book.

NHS hospital outpatient waiting times

I just came across something interesting I thought would be worth sharing here. The NHS has a waiting list tracker tool called “My Planned Care”: this means you can see how long you are likely to be waiting for your first outpatient appointment, and for your treatment/surgery, if you have been referred to an NHS hospital. The waiting list figures are grouped by department, so it’s not an exact guide, and for urgent problems you are likely to be seen more quickly than these figures, while for less urgent issues you may be waiting longer.

Here is the page for the Trust which includes Southport & Ormskirk, and here is the page for the Trust which includes Aintree Hospital.

At Formby GP, we can refer into most local NHS outpatient clinics if appropriate. The entitlement to NHS care sits with the patient, not with the person referring, so hospitals can and do accept referrals from private GPs. We have something called an ODS code, which allows the local NHS health bosses to track our referral activity to make sure we’re not doing anything too eccentric!

I hope you’re having a good weekend. We have had a very hectic time recently, so we’ve spent today doing very little. Eddie wanted to play football in the back garden, using the bins as goals; he beat me 10-4!

Join the Formby GP Patient Liaison Group!

On Monday we held a meeting of Formby GP’s Patient Liaison Group. Our PLG is a small, friendly group of people who meet every 3 months to give us feedback and help to shape our service. We are looking for new members! If you’d like to get involved, please email us on clinical@formbygp.net so we can invite you to future meetings.

As an additional inducement, we provide refreshments -John thought I’d bought too much food, but most of it went pretty quickly!

Vaccinations

We are sometimes asked to prescribe and administer vaccinations privately.

Do drop us an email with your vaccine requirements and we will check them and provide a quote before booking your appointment, so that we can order in precisely what you need when you need it.

Many of our loyal patients choose to have their vaccines with us. Our premises are located opposite Freshfield Station so we are conveniently located for Formby residents. All our vaccines are prescribed by one of our doctors.

We pride ourselves on offering a convenient and obliging service. On some occasions, however, due to the vagaries of VAT rules, we are less competitive for certain vaccines than local pharmacies, so we won’t be offended if you decide to go elsewhere.

Why we don’t recommend breast self-examination at Formby GP

October is Breast Cancer Awareness Month, and many well-meaning people – including some healthcare professionals, and charities such as Breast Cancer Now – have been sharing posts about the importance of breast self-examination. Unfortunately, the reality is rather more nuanced than most people realise. Research evidence suggests that breast self-examination does NOT result in fewer women dying from breast cancer, and it can do more harm than good; women who self-examine their breasts are more likely to undergo a biopsy of their breast, but this does NOT translate into a reduction in rates of death due to breast cancer.

Dr Heather Ryan

For that reason, at Formby GP we do not recommend routine breast self-examination for healthy women with no symptoms. Instead, we would recommend keeping an eye out for any changes (such as a lump in the breast; skin changes; or nipple discharge) and consulting a GP if you notice any of these symptoms. If you have new breast symptoms and are over 30, your GP will almost always do an urgent referral to breast clinic so that breast cancer can be ruled out. (If you are under 30, you may well need referral too, but in some circumstances your doctor will watch and wait first.)

If you’d like to read more about why the evidence base does not support routine breast self-examination, the Cochrane Review is available online here.

Why “health checks” can do more harm than good

Many private GP services offer “health checks” and “MOTs”, in which you pay a fixed price and have a set panel of blood tests and other checks. Here at Formby GP, we don’t offer set “MOT” packages – why not?

The problem with one-size-fits-all “health checks” is that research evidence actually shows that they don’t work. There is actually a Cochrane Review – the highest-grade evidence there is – which shows that “health checks” do not reduce patients’ risk of death from all causes, do not reduce patients’ risk of dying from cancer, and have little to no effect on heart disease outcomes.

Furthermore, there is actually a risk that generic “health checks” can do more harm than good. Whenever we do tests, there is a risk of false positives or other “red herrings”, which can result in patients having unnecessary tests and treatment, as well as causing a lot of worry and stress. There is also the risk that a patient with symptoms may be falsely reassured by normal test results. This is why it is best practice only to do tests when they are needed – such as if a patient has symptoms of an illness, or certain risk factors, or a relevant family history.

That’s why, if you contact Formby GP requesting a health check, we will advise you to book a GP appointment first. Patients almost never request a health check for absolutely no reason – perhaps you’re feeling tired and run down, or you’ve gained some weight recently, or your brother had a heart attack last year and you’re worried it’ll be your turn next. In your GP appointment, we will discuss any symptoms you have, your family history, your risk factors for illness, and we can explore anything that is worrying you. Then we can agree together on a plan, including any tests you need.

This approach often saves our patients money, as you don’t get charged for lots of unnecessary tests. But more importantly, it means you get a better standard of care.

This is why we describe Formby GP as “ethical”; our top priority is doing the right thing for our patients, rather than doing what is easiest for us or makes us the most profit.

If you’re worried about your health and would like to talk to one of our friendly GPs, you can book an appointment online:

www.formbygp.com/book

Reference:

https://www.cochrane.org/CD009009/EPOC_general-health-checks-reducing-illness-and-mortality

Hay fever injections

Every Spring we see posts about the so-called “hayfever jab”. Unlike many of our competitors, we very deliberately DON’T offer Kenalog injections for hayfever. Why not?

Kenalog is an injection which was once approved to treat hayfever. The idea of just having one or two injections to keep hayfever at bay for months may seem appealing. However, the evidence shows that Kenalog, a long-acting steroid, is no more effective than safer treatments. For that reason, it is no longer approved for use in the UK (and most other countries) as a treatment for hayfever.

Most doctors no longer offer the treatment, and Allergy UK – a national charity supporting allergy sufferers – explicitly does not recommend its use for hayfever. International experts also warn against the use of steroid injections for hayfever. Yet despite this, many private medical clinics and aesthetic services offer the treatment. Many of those giving the treatment are beauty therapists rather than doctors or nurses.

Although steroid injections do usually help with hayfever symptoms, there is a real risk of side-effects, some of them serious – they can affect blood sugars, mental health, and bone health, and may make you more vulnerable to infections. So they are not routinely recommended because there are effective alternatives which are much safer. Alternatives include antihistamines – which can be given as a nasal spray, or as tablets – and nasal steroid sprays, which are much safer than Kenalog because much less of the steroid is absorbed into the bloodstream. Most of these options can be bought from your local chemist. If those don’t work, then your GP – either NHS or private – will be able to advise about prescription-only treatments.

If, despite those prescription-only treatments, your GP can’t get on top of your symptoms, then it may be appropriate for you to be referred to an allergy specialist. Specialists can sometimes offer options like immunotherapy treatment, though that isn’t an option for everyone.

Patients sometimes seek Kenalog because they have an important event coming up, but even then, we would not recommend it; there are other alternatives which are as effective but safer, such as a short course of oral steroid tablets.

At Formby GP, we want our patients to know that they can trust us. We will not try to sell you things which we believe would do you more harm than good. As doctors our duty is clear: to first do no harm.

References:

https://www.allergyuk.org/news/kenalog

https://www.pure.ed.ac.uk/ws/portalfiles/portal/332099603/Int_Forum_Allergy_Rhinol_2023_Wise_International_consensus_statement_on_allergy_and_rhinology_Allergic_rhinitis_.pdf