My GP has told me that 80% of their appointments don't need a GP appointment.

It's the scolding and lecturing when you have followed advice that is particularly appalling.

Why have you done this? Because you told me to.
Why didn't you do this? Because you told me to

It's the lack of responsibility and it's everyone else's fault stench that emanates from NHS establishments. It's never their fault, always the stupid idiot public. It's the arrogance.

Genuinely it's utterly crap and the number of times I've had it I refuse to attend an appointment without DH due to the poor attitude. Women are very much more on the recieving end of it and I get completely different treatment when DH is present.

I sincerely hope you made a complaint because it's the only way they will start to take notice.

I do find it irksome that the GP's preference for patients to just piss off somewhere else is so transparent from the get-go. The phone message that says "if you want health advice, visit [website] or "if you're ringing for test results, please HANG UP and dial [other number] BUT ONLY AFTER 2PM". No private company would operate in this way (and if they did, it would be insolvent in weeks). I think there is a strong case for payment by results.

I've also remembered a particularly ridiculous exchange with our surgery during Covid. DS had a nasty ear infection, so after a week on Calpol I contacted the GP to be told after examination that it was viral and to wait it out.

Another week of poorly, miserable DS and I tried again - tsk, no need to come back, it's viral, can't help and didn't I know that demanding antibiotics for every little thing was causing bacterial resistance?

Week 3 of ear pain - I call again and point out that the smell of rotting death has started to waft from DS' ear, and even DDog is swerving him. I got a call back from a very cross GP, who sounded aghast, and told me I must take him to OOH immediately and didn't I know that severe ear infections caused hearing loss. I was convinced I was going to get a visit from SS after that call, and I am as middle class (and grumpy) as they come!

There is absolutely no continuity or ownership, even from the most senior and highly paid GP partners. The obvious thing is to tell parents "if x happens bring him straight back, or go to A&E". Instead they focus on getting the patient out the door, then expect the same patient to complete another set of Krypton Factor-esque contortions to get another appointment with someone else who will start again. No wonder people are confused - sadly I don't think patients are solely to blame for the fact that so many GP's are obviously unsatisfied - their ways of working are often preposterous.

To cap it all, OOH sent me to Children's A&E because there were no appointments, then a few months later I received a "guidance" letter suggesting that DS' A&E visit was inappropriate!

The opticians I go to (various branches of Specsavers usually) have all sorts of fancy machines that check your eyes.
My husband has yearly eye checks due to diabetes done at the opticians.
So I don't understand your point?

What is bonkers, is that you access a lot of prescriptions via on-line pharmacies, that you can't in an actual pharmacy, as they are processed via a doctor. The cost is often less than a prescription too.

I know. You'd think they had the brains to work out that we go to the GP to get expert advice because we dont have the knowledge ourselves and are worried. But apparently not. I've literally had a GP speak to me as if I already knew all the ins and outs of the thing I was worried about and therefore why was I worried. Um duh!!!!!

Just as a PSA - if a close relative has glaucoma, you get eye tests for free. My mother has it so all my eye tests are free, I just had to tell the optician.

95% of prescriptions are dispensed free though so I expect a high percentage of people get free eye checks. Added to this the people who are entitled to a free eye check through their employer I bet very few people are paying out of their own pocket to see an optometrist.

Goodness knows how they manage that. My GP gatekeeps himself more securely than the criwn jewels. If my friend hadnt caught a gimpse of him last May, I'd strongly suspect he was the receptionist's imaginary friend.

Pharmacies can’t sell thrush treatments to older women, because the symptoms are the same as cancer. A pharmacist can’t do an internal to check, whereas a GP can.

Pharmacy staff don’t like to tell customers

“It could be cancer at your age, and we can’t tell!”

It would cause women to worry, maybe unnecessarily!

Some drugs are only licensed for certain conditions or people. So, eye drops are not licensed for use on children under 2. Parents have to see a GP, who can make the decision to prescribe it, despite it not being licensed.

Likewise, pharmacies are supposed to tell customers, who have tried all the otc remedies, with a cough going on more than 3 weeks to go see a GP, in case its something like lung cancer. Again, pharmacy staff don’t want to worry customers, by talking about worst case scenarios.

Pharmacy staff don’t make up drug licensing rules or pharmacy guidelines for the fun of it - there are good reasons for them and customers need to accept this.

No doubt, families would be looking to sue the pharmacy for negligence, if their relative died from cancer, because the pharmacy preferred to keep selling them otc treatments, without question?

Optometrists charge for eye tests. You only get them free if you’re young/old/on benefits/a few other categories, and then they’re paid for by the NHS.

I haven’t read the entire thread - but I’m simply sceptical of that 80% figure. I would not be surprised if confirmation bias is in play. There’s good reason to suspect that the GP is not accurately reporting numbers. How did they arrive at that figure? Was it through review of data - or gut feel?

Others have further raised the issue of what does - not needing to be there mean? If a child is suspected of having swallowed a battery but it turns out they swallowed a lolly - did they need to go to emergency? If a woman finds a lump in her breast but it’s not cancer - was that an unnecessary visit? What if a person is feeling unwell after starting new medication (but turns out they just got a cold) was that unnecessary?

I’m sure there are time wasters and hypochondriacs (but that’s a medical condition). I suspect they aren’t 80% of appointments.

I’m also sure there are beauracratic silliness that makes people attend appointments that aren’t necessary medically but are administratively. Im not in the UK, but we have a referral system for specialist. I have an incurable medical condition. The treatment cannot be prescribed by my GP. Every so often my specialist tells me I need to get my gp to refer me to my specialist so the specialist can treat me. This is a genuinely unnecessary appointment - cause the specialist is the one who determines that I can be treated and need treatment.

Why do people keep talking about opticians as if they are health professionals rather than people who sell glasses? It is not as if they examine your eyes or anything.

I thought the whole point of their funding system being capitation, i.e. £x per patient per year was for prevention and monitoring as that was the big thing back 2/3 decades ago, i.e. to move away from being reactive to proactive. That's simply never happened. Now they pocket the money and still do everything possible to avoid seeing the patients they're being paid to "monitor".

We need to go to a system where they're paid for what they do, i.e. per consultation, per treatment, etc., so that they aren't disincentivised from actually seeing patients.

Well our GP partners make profits out of the drugs they prescribe through their attached pharmacy (which happens to be owned "on paper" by the GP partner spouses!).

I agree. DH has had recurrent ear infections for as long as I've known him. When it gets bad and "wait and see" hasn't worked, it's always a matter of him needing a GP appointment for a specific antibacterial ear spray which does clear it up. What a monumental waste of a GP appointment for something a pharmacist should be able to sell him. Same happened back in the day in the 80s when he was grossly overweight and got really bad chest infections for which the GP prescribed a very strong cough medicine - why not available via the pharmacist to save a wasted GP appointment? Even more so when there's a record of past prescriptions/medications that have proved to work with no side effects.

It's paid for by taxes- we don't pay more or less dependent on how often we go. GPs don't get paid more or less dependent on how many patients they see.

It's also massively underfunded. There's only so many 10 minute appointments that can be fitted into one day and GPs do have to do other things in between appointments.

Posts like this don't help people who have had a mental health crisis and then passed around departments who don't want to know and they get misdiagnosed along the way and just generally don't get any help and support because they haven't ticked all the right boxes. It is a fight for people in this situation to get any kind of support that they legitimately need.

The lack of services means that those who really need help are tarred with the bullshit 'timewaster' brush. Honestly, I find it bizarre that anyone would 'fake it' given just how difficult it is to get any kind of support for these conditions even with a diagnosis and a long, credible medical history.

That's right. What products does your GP sell?

Our new online triage form is brilliant had a phone call with appointment 10 minutes after I submitted it.

Free at the point of service but definitely not free. We still pay albeit not on the day.

Never paid an optician - their salary comes out of the profit on the products they sell, same as any other salesperson,

Having lived abroad in a country where you call a GP in the morning to get a choice of appointments that day I am horrified by the uk system as are my GPs there. They would not believe me that GP receptionists triage when they are not even medically trained.
Similarly they would say we would rather 1000 people went to a&e who didn’t need to than we missed one person who needed help and didn’t get it.
I find the way that the people in the UK defend the terrible system and blame the patients rather than the crappy bureaucracy that needs to be fixed amazing. I can only think these people have never lived abroad and believe everything they’ve been told about how amazing the NHS is. Yes it’s better than the US system if you are not wealthy but that is an extreme. There are many many countries with better systems - the two options are not the US style or the UK.

Have you noticed that you have to pay your dentist and your optician for their services, whereas your GP is free at the point of service? If you would like to organise a private GP, they'll see you as often as you like.

I'm so sorry that happened to you too! It's terrifying isn't it! He is doing better but it's been a long old road to recovery 🫤 hope you're doing ok too 💐

Opticians sell you glasses. They are not health professionals.