GP didn’t call me because their “workday has ended”

Because since 1948 Needspaceforlego, and up until 2020, they all seemed to manage fine working the sort of hours they should work, to enable them to see a normal day's worth of patients. They get remunerated very well for the longer hours and greater responsibility that they should be undertaking.

You also seem to be missing one, maybe two, important facts about the poor doctors who have to pick up their small children by 5.30pm every day. The main fact is that they can afford to have a 'nanny' pick up their children, and give them their tea.

The second fact is that most of them chose to be doctors, and chose to have children, so they already knew that most of the casualties in their lives would be any children they chose to have, and potentially their life partner as well. I have had 3 family GP's in my lifetime, which was due to me moving to different areas in England. I loved and appreciated all three of them, they were fantastic! Now that I have had to move area for a fourth time, I despise, and even feel afraid and humiliated by the few GP's I have been able to see since 2020. Most of the hospital doctors and consultants I have seen in hospital settings have still been brilliant.

I don’t want to get into a lot of back and fro-ing as I think most people have fairly fixed opinions.

But do you really think that we turn off the computers and go and watch TV when our clinics aren’t running?

I’d also be interested to know if you think A&E queues are because the doctors there don’t work hard enough; or if you think 15 month waits for outpatient appointments are because the consultants aren’t working hard enough.

It’s entirely equivalent - demand/supply mismatch all over the NHS, but my point of the narrative being held very differently is probably proven in your reply.

Private GPs charge a ridiculous amount. But you pay £20-30 for an eye test, so I would have thought £10-20 for a face to face appointment would be reasonable. A lot of people still wouldn't need to see the GP in person and could be dealt with in other ways eg sending a prescription, referring, a nurse sees you etc.

If you paid for a GP appointment they would magically become available.

I think some have retired and I think a lot must be doing private work on the side and only doing their NHS work one day a week or something.

It wasn't that easy to get an appointment before COVID, but it was much easier than it is now.

How does that help? They go through their checklist and then tell you they can't help and to go to A&E.

But why were there enough GPs in 2018, but by 2021 there weren't. I would be very sad to hear that the Covid 19 virus killed thousands or even hundreds of GPs - well, it would, of course be very sad if it even killed one GP - but it really didn't take the lives of many GPs at all probably because they refused to see patients at all unless really, really, necessary, they just sent all their patients to see the nurses who still had to turn up and do all their normal jobs, plus extra that the GPs sent their way - so what hsppened to them all, where did they go to once they could no longer use lockdown as an excuse? Yes, some inner city GP practices did have trouble recruiting new GPs before the Pandemic, but in most places, their huge salaries or shares, and much better working hours than junior doctors in hospital had, still drew GPs to the nicer GP practices.

I could keep on about all my complaints with our once great NHS, but there is absolutely no point.

Be lucky you can actually book an appointment in advance. My practice is the 8am hanging on the phone, hitting re-dial.

I certainly don't believe GPs are sitting twiddling their thumbs.

They will also need to fit in some house calls.
Possibly go deal with some shit, sign a death cert confirm nothing suspicious to police. My limited experience, that had to wait until after morning surgery.

So yes I do get why having a break in the middle of the day makes sense.

I'll think and reflect.

1. Yes, hospital delays aren't helping, and I'm sure they add significantly to GP workload
2. However. I'm just not seeing this 'hard-working GP' thing in practice.

You can't blame people for seeing, noticing, and being angry about, what they experience day after day. And it's like there isn't even a wish or a will to see more patients - just an immediate passive aggressive defensive insistence that they can't and won't, and in fact we should actually 'appreciate them more'. What, actually, for?

Totally agree the issue is there just isn't enough GPs.

If they need to leave, they need to leave. Do you want the childcare providers to be calling Social Work because the parent didn't rock up on time?

Its Mumsnet how can people not get that GPs are also Mums and Dads who have children who need collecting ?
Clocking of at 5.30 isn't exactly early.

I’ve not read the full thread. But this just makes me so sad. I’m a GP.

Yes, it’s poor that a planned appointment didn’t take place - this should be rescheduled ASAP without any further input/effort needed from the OP.

But this thread demonstrates beautifully a couple of things.

1. How hospital delays are directly increasing GP workload, leading to harder access for patients - if she is seen more promptly by the specialist team she’s waiting on, this appointment may not even be needed as she’s not waiting in pain for ages needing prescribed pain relief.
2. How things have been spun so cleverly to paint GPs as lazy/inadequate. Whenever the topic of busy A&Es comes up, the narrative seems to be “poor A&E, they are so overwhelmed, the staff are heroes, social care and GPs let them down”. However if the topic of busy GPs comes up the same understanding and consideration is never applied. I don’t know a single GP who doesn’t work absolutely flat out for longer than their shift each day. But if we struggle to meet demand nobody ever says “poor GPs. Hospital waiting times, the increasingly frail/demanding population and hospital teams pushing more and more jobs for the GP to do is making their job harder.”

I would love it if this comment provoked some thought/reflection.

Meanwhile here GPs are sitting there googling your symptoms with you

Google is sometimes embedded into specialist or academic databases which are not accessible to the general public. Your gp is not looking up your symptoms on wikipedia.

Which presumably means more older people. Older people with more complex health needs. Requiring more GP time and appointments.

This demographic existed in 2019. Since lock down the practice I'm registered with makes it as difficult as possible to get an appointment with a GP.

I'm so bored of the "but I'm a woman, I've got family" excuses

Which presumably means more older people. Older people with more complex health needs. Requiring more GP time and appointments.

We also know more GPs are women, women with children, women who work part-time because of the children, women who need to collect children.
Women are drawn to GP work because it avoids the antisocial hours of hospital work. And can fit in with family life better.

I can't believe how many people on here expect GPs to just work on. We have no idea what else that person had on, or what else they needed to do.

It's not what you should sign up for though. A healthcare professional burning out, risking, exhausted is also not providing adequate care.

We can't expect individual workers to prop up a broken system. And if people did stop doing all the extra time they are doing the system would break and it would be forced to change.

I was in healthcare and I left for this very reason. It wasn't my job to to do the work of people who weren't there - and they weren't there because they hadn't been employed because it was expected we'd all just do extra.

You have a disabled son and are therefore presumably very knowledgeable about his condition. You had already spoken to his consultant who had advised that a referral to Orthotics was required, but those referrals need to come via the GP.

What else other than a referral were you expecting from the GP?

Presumably you had put in the online form that you had already spoken to consultant? The GP isnt going to override that - the call would have just been to confirm your convo with the orthotics centre, dot the i's and cross the t's to enable them to submit the referral. Its actually a much more efficient way of working.

Ethics and morals don't collect children!

People forget that GPs have lives. Back in the day they possibly didn't also have a working spouse.

I have to give the GP the benefit of the doubt that they needed to be somewhere. Most nurseries and afterschools close at 6pm.

The question is why are they booking more people in than they have time for and why not automatically rebook for the morning

Open my mind a bit? What do you mean?

Because I don't think a GP should have to "work till they are finished" every day? Yes, lots of jobs require unpaid overtime, but it's generally not every day and/ or you can manage your deadlines etc to some extent OR you are very well paid. I am not naive to that. I just don't think that that means that all GP's should have working hours that essentially are entirely fluid, and with no certainty as to finish time ever, in case there is a medical emergency or other delay. These are people too, and while well paid they aren't being paid millions to be at their patients beck and call 24/7 for non-emergencies. They have the right to make out of work commitments too.

I do however think that the call should have been automatically rescheduled with priority for the next day.

What a daft reply. Are you just throwing out unfounded nonsense?

Population of Edinburgh 2019 approx 531,000. Population of Edinburgh 2024 approx 530,680.

So you’re saying with absolute certainty that every single person who has died in the last 5-6 years has been replaced by exactly 1 baby leading the population to be exactly the same or less in 2026? What’s your evidence of this rare phenomenon as it’s not statistically likely?

and what’s your evidence there’s no other pressures on GP practices ie more reliance on healthcare than there was 5 years ago? Conditions that have deteriorated, new onset old age conditions, more baby care for the children? Why are you making the assumption that the demand has stayed the same or not increased? It goes without saying that some appointments take longer than others and require more consideration.

or are you just throwing out unfounded nonsense statements?

The population of my city hasn't increased since pre-Covid. The number of doctors at the practice hasn't decreased.

I walk past the surgery morning and evening. It has ridiculous glass walls so you can see who's waiting. Pre Covid might have been full. Now 2 people at most.

They now don't allow appointments to be booked other than the brief period in the morning and only by phone, which is engaged.

You sound dumb and uneducated

You are asking doctors to work to the point of burnout, to not leave work on time, and potentially not even get paid for this extra work. Not all GPs are salaried. They may be paid on a hourly basis with only X hours permitted ie they can’t charge infinitely.

You do realise that when doctors are overworked and not able to take a break, the quality decreases? So how do you expect mistakes to not be made due to stress, if they are expected to stay daily 2-3 hours late? You do realise, humans perform worse under work related stress? You want to put your life in the hands of someone tired, stressed, distracted, overworked and expect perfection?

Why hasn’t your mind gone to, they need to hire more staff? Or they need to book LESS patients in with the current amount of staff? Why is your solution to do more, with less staff? Your opinion is illogical. There is obviously a resourcing issue.

I do expect them too! I work in a patient facing role and we work until the job is done and the people we need to see have been seen and sorted. That does mean multiple late nights every single week where appointments overrun or we are delayed for one reason or another. It’s simply not ok to not provide adequate care. It’s part of the job and part of what those of us who work in the health care sector sign up to.

Sorry @angelinlothian, but I have only read your OP.

My MiL was - by her own choice - living in a (hospital) bed in her lounge, rather than in a nursing home. She had carers coming in 4 times a day, for both domestic and health care reasons, plus her amazing niece, my DH's cousin, checking up on her almost daily.

Unfortunately we, husband and I, lived 5 to 6 hours away by car, and had our own heath problems, so we couldn't visit all that often, but would stay for about a week in a hotel each time we came to see her. The carers were in daily contact with her niece as she lived locally, and is one of the few people in life who truly cares for others. We owe her so much, but will sadly, and probably, never be able to repay her, in any meaningful way, which we feel very guilty about.

Anyway, the carers told her that MiL was deteriorating quite rapidly, so we rang her Dr - this was earlier in 2019, several months before we became aware of Covid 19 - and I asked the doctor to visit my MiL urgently, that day. This was at about 11.00am, but the doctor, who knew all about my MiL's illnesses, and that she was so disabled and ill that she was bedbound, said he couldn't fit in a visit to her that day, even though she was in terrible pain. So I asked him to go in his lunch hour as it was so urgent, but he replied "what about my lunch?", which is when I lost it, although I managed not to swear or shout, but I did tell him that my MiL was a very old - which he already knew - and very ill lady, who was in a lot of pain, so he could either go without his lunch for once, or eat a sandwich in his car on the way to see her! He went. As well as upping her morphine, he realised that we, her family, had also been right that she needed to go onto end of life care, which meant she also had a night nurse at last.

I was the one who talked to the doctors etc, as I had some kind of medical background, and I could be - normally - quietly insistant. Also, my husband asked me to do it, I wouldn't have just taken over from him! Again, as a family, we were very glad for MiL's sake, that she died before Covid 19 was much more than just a rumour.

I am in my late 60s now OP, and can remember that as recently as 2018 I still had the same family doctor that I had seen in our multi doctor practice for the last 30+ years. He knew, and had been the doctor for, all my children as well. How has so much changed in under 10 years, and so much for the worse? I'm very sorry that you are now also a victim of this awful crumbling national health service, that was once envied by so much of the world. So I don't think you are being at all unreasonable @angelinlothian.

Hopefully, without sounding condescending, I can say here that younger women might not realise that once upon a time, and not actually that long ago in reality, GPs had ethics and morals, and they would have never put such an early home time before their patients who needed them! They were, and presumably still are, given a salary that reflected their now, apparently gone, work ethic, and their genuine care for their patients. I do hope that you get the help you need very soon now, OP. 💐

What difference is paying to see a GP going to make?
Its not going to create more appointments
Its only going to mean people who are financially sensitive will put of seeing a GP.
Those on benefits will get it free. Those just over the threshold won't.

Hospital once said - we think we have her in time - I was so close to cancelling the GP appointment that lead to me going to hospital in first place. A week before I re-emerged out of hospital