Have I been a twat or should the GP surgery have given me an appointment?

Suppose you had got an appointment

he looks at your toe
he knows he isn’t qualified to judge so sends you off to minor injurues unit
you have wasted your time and his

I don't think they could.
Some time ago I fell on the stairs and hurt my finger. It didn't swell and I strapped it up as it was painful to bend. It didn't really bruise, but every time (e.g. every day or so) when I unstrapped it, it hurt.
After about a fortnight I went to minor injuries, who did an X-ray to check it out, even though it wasn't swollen or bruised. I'd broken it.

It’s not a GP issue… ffs.. people complaining they can’t get appointments for serious issues and people wanting toe injuries looking at 🤦‍♀️
Also… MIU is not primary care. Totally different entities

Maybe not the whole reason, but certainly a contributing factor. When a person has been told by GP practice that they need to go to minor injuries,A&E etc but still insist they need to be seen by GP they are taking up an appointment uneccessarily.

It’s a minor injury.
The clue is in the name….
Appreciate you would be inconvenienced attending the MIU but that appointment would have been inappropriate and far better given to someone who actually needed a GP 🙄

Why is it she’s wasting time for the Gp and not the MIU, all primary care services are overstretched.

”NHS England is focused on empowering patients with more choice and control, setting standards for care to be smooth, supportive, and convenient”

You don’t have to be a martyr to the NHS. It’s there for you.

Absolutely right of the GP to say you need to go to minor injuries unless he has x-ray vision! It would be a waste of an appointment just to be told to go to minor injuries! No doubt if you’d seen the doctor and he’d told you to go to minor injuries you’d be here saying why did they not just tell you to go to minor injuries !

I don't think you've been a twat, but I think the GP was right. A swollen toe would only be treated if it was a bad break, and that can only be confirmed with an X-ray, so the GP is no good to you.

If it keeps improving you likely don't need to do anything. If it gets worse or gets no better you'll have to find a way to make time for the minor injuries unit.

Hopefully it's better soon!

Agree! Absolute rubbish @BoudiccaRuled 🙄
My dh walked, and worked, all day doing building work with a broken ankle! Big toes need to be checked.

That is outdated advice

Mine WAS broken and they didn’t do anything 😬😂 just sniffed it to make sure it wasn’t infected.

A Gp can't make that decision. They are obligated to send you for an x-ray.

I'm not overcomplicating it at all. If she was sent to MIU she would need to be assessed in the exact same way she would if she'd just taken herself there in the first place and it would be that clinician's clincial decision whether to x-ray so it's wasting time and resources. There's no facility for GPs to book directly for an urgent x-ray because they are not commisioned to do this therefore the safe and appropriate advice to somebody who's had an injury is to go to MIU/ED whether that person likes it or not. The patient wanting a more cosy appointment experience and not wanting to travel should not and does not impact that decision making.

That’s not how it works, certainly not round here. And the chances of getting an appointment today for something like that are slim to none anyway.

GP surgeries are not drop in centres, minor injury assessment centres etc. We aren’t sitting around waiting to just check if someone might need an X-ray and we don’t write letters to MIU - someone either needs routine imaging and we refer, or urgent imaging which GPs can’t request. GPs can’t even request MRIs - it has to be requested by a consultant.

You may have worked in ED a long time ago (as did I) but things are a very different landscape now.

Also at a risk of sounding brutal her childcare and work disruption are not really my problem. If she needs to go to MIU, she needs to go to MIU and she’ll need to make that work if she wants her toe injury looking at properly.

It's minor injuries not gp appointment.

You’ve massively over complicated this, she can be seen by someone at the surgery, they either offer advice (all gps should be able to assess if something needs x-rating) or go onto a MIU.

The practicalities of her looking after her own health are really not the responsibility of the GP especially in the current state of the NHS. The most appropriate place to assess and manage her care is MIU or ED. Being assessed by the GP would mean she was quite likely to be sent to MIU/ED. Even if the GP thought she needed an x-ray she'd still need to be seen by another member of staff who would ultimately make the clinical decision as to whether an x-ray is needed. That's at least one extra clinician's time taken up vs if she went straight to MIU. The clinician at MIU (who is likely much more experienced at assessing injuries) might then disagree with the GP and think it doesn't need x-ray at which point the clinician is in a really awkward position where they either have to disagree with the GP or perform an unnecessary x-ray. If they refuse the x-ray OP will still be pissed off with the GP and probably the MIU staff too. 40 minutes is hardly the outer hebredes... OP could have got there and back or strapped the toe up herself in the time it's taken to argue with the medically qualified GP staff

Minor injuries is the correct place for an injured toe after a fall.
Although if its resolving (swelling is lessening) i doubt X ray is needed.
Rest,ice compression,elevation should resolve it.
i get that a minor injury is an inconvenience but from what you describe its resolving spontaneously and you are still able to go about your day.
If it so severe it impairs your daily activities of living or isnt resolving or worsens ,id go to minor injuries,GP isn't the place for a minor injury.
Hope it resolves soon.

To strap your toes together put a piece of cotton wool between the two toes so that it’s comfortable and then use micro pore tape or sticky plaster on a roll to wrap once or twice round the bottom of the toes and once around the top. It needs to be tight enough not to move to but cutting the blood off or uncomfortable. You can check by pressing your toenail (if it’s not too sore) it’ll look white where you press and go back to normal colour in a few seconds.

and if the GP says 'needs and xray as I can't see if its ok or not'.. what then?

It's not your GP's issue if you can't take the time... you are being unreasonable.

Because she could drive 40 minutes out of her way, disrupt work & childcare drop off for them to refuse to X-ray.

Whereas if she gets it assessed by the Gp surgery two things will happen, she’ll either be reassured/sent home with advice or sent to the Minor injuries with a letter explicitly requesting an X-ray.

I worked in A&E for the first 10 years of my career we really only X-ray’d toes/fingers if they were misaligned.

no, they can't tell by looking at it.
BUT if it is any toe except your big toe, they will probably not x-ray it, but tell you to strap it to the next toe for the couple of weeks.

Only if your GP has x-ray vision 🙄

But they’re not going to do that. They don’t have X-ray vision and aren’t likely to send her home without some sort of imaging, as it’s a big toe and they do need assessment. They will - very sensibly - advise her to attend a minor injuries unit (the clue is in the name) to be assessed fully by someone who can then organise imaging if needed.

Why stop at the GP on the way as some sort of validation tool? And MIU do X-ray big toes even if not obviously misaligned.

Minor injuries units don’t usually take so long, ours is typically an hour at most thankfully. Stay away from a&e though