Why are GP surgery’s still locked down?

[Itwasoverwhen]

I work in an acute hospital which is fully open (in and out patient). A&E is open. Minor injuries is open. Urgent treatment centre is open.

Tried to get a very rare GP appointment only to be told they are doing face to face, I need to wait for the next block of telephone appointments to be released on Monday (for the following week) and then ring and try to get one of them. They’ve suspended the online appointment booking facility and you have to sit in a queue on the phone hoping you get a phone appointment for the NEXT week?!

Are they ever just going to open up again?

@dementedpixie

Ours has a new AskmyGP system which is online. You submit your issue online and then they get back to you with the next steps e.g. with dd it was erratic periods and hiccuping and she had to go for blood tests and then got prescribed folic acid for low folate after the results. She's also been given the option of getting the pill to make her periods more predictable. All done without a face to face GP appointment.

We have an online e-consult service which has just been restricted to use ONLY between 9am-11am monday to Friday. And no face to face visits. I have health issues for my three kids that need support and I'm completely clueless now as to how best to help them.

It's awful. And my own health issues are completely at the bottom of the pile because it's taking so much longer to navigate support for my kids I simply don't have the available time to sort my issues as well.

It's really demoralising.

‘I don’t believe that GPs should throw open their doors and allow everyone in. However, I also don’t see why ‘some’ GPs are still refusing to even answer the phone/ emails/ web enquiries.’

If you call my surgery on a morning at the moment, it will feel as though no one’s answering as it’s taking hours for patients to get through. In reality, we took 14,000 incoming calls in March alone, not counting the deluge of e-consults. We’ve diverted as many staff to this as possible, everyone is knackered from non-stop calls 8am-6pm, and then our staff are taking horrendous verbal abuse when people do get through.

We’ve had to turn off the e-consult facility, as there are just to many to deal with, and no way of triaging them. Also, they meant that (in general) relatively young, fit people were ‘jumping the queue’ compared to the elderly/ vulnerable patients.

It’s so very demoralising, we’re working so hard, yet we’re getting criticised on all sides.
We have a legal imperative to socially distance in the surgery, which has massively reduced our capacity to see F2F. We’re seeing as many as we possibly can.

All the people who’ve stayed away to protect the NHS and are now more unwell than they would have been otherwise. All the people who were appropriately referred a year ago and then just didn’t get seen and are now struggling. All the hospital outpatient telephone consultations, followed by ‘can the GP just....’ followed by a request for something that seems innocuous (blood test, clinical examination) but we have no funding for this work, not enough staff, and everyone is doing it. All the mental health problems caused by lockdown, and the local IAPT has a 100 day wait just for assessment. All the people being discharged as soon as possible from hospital, to protect them from COVID, who are still unwell and need community care.

I know it’s frustrating OP, my husband has just waited 3 months for what should have been a 2 week wait scan, but walk a mile in my shoes and you’d think better of slagging off your NHS colleagues. God knows the hospitals are no better. We’ve all worked hard in the pandemic, we’re all doing our best do deal with the tsunami of demand, and stuff like this thread is a real kick in the teeth.

I'm sorry you have to deal with that @fluffysocksgoodbookwine

My GP (in Wales) is now doing face to face appointments as standard. Started about 3 or 4 weeks ago.

As is clear from this thread, it varies wildly from practice to practice. Our practice always operated a triage system where you'd be called by the duty GP to assess whether you needed to come in. The call would usually be same day, the appointment often also same day and it works well. Surgery has just continued doing this throughout the pandemic and it has worked extremely well.

OP's surgery is clearly not doing so well. It looks as if some major CQC inspections are needed to make sure all surgeries follow best practice and act in the interests of their patient - but that does not necessarily mean guaranteeing a face to face appointment.

Not to hijack the thread, genuine question, why are GP practices 'busier than ever'?

You can't go anywhere near a surgery with Covid symptoms, you just book a test, so it's not that.

Presumably with distancing and sanitising and lockdowns other infectious illnesses have reduced too.

So why have we apparently all got sicker in general?

I kind of agree op, I can see my dentist every month without issue but trying to see my GP is a nightmare. The lengthly E-consult always ends with you needing to call. You call and listen to 10 minutes of automated reasons why you shouldn’t call, then the receptionist arranges an email or call back from any GP, never your own. The continuity is no longer there, at my surgery at least.

Thing is, this is what a decade of underfunding and increasing workload looks like. We were losing GPs at a dramatic rate before the pandemic, and we’ve been shouting about it for over 10 years, but nobody cared. Some practices have struggled more than others, due to myriad factors.
If you’re struggling to access your GP surgery, write to your local MP, ask what’s being done about the funding and staffing crisis in primary care, please don’t blame the GPs, or abuse their staff.
I reckon we’ve got months at best before the whole thing collapses and surgeries hand back their contracts en masse. The job is just no longer doable.

And thank you @CandyLeBonBon.

@ImInStealthMode. The phone doesn't stop ringing. GPS using Ask My GP are technically doing 2 consultations if a patient needs to be seen f2f. Patients are being seen by GPs, Practice Nurses, Midwives, Health Visitors, Phlebotomy and Warfarin clinic.

Cleaning has to be factored in and I'm dreading the doors being opened to all because we will have to clean the waiting room and anywhere they have touched. We have to clean the toilet if a patient has used it. I hate cleaning at the best of times and this will take a Receptionist from Reception and telephone duties.

People still don't social distance and think having 2 jabs they are immune.

@ImInStealthMode

Not to hijack the thread, genuine question, why are GP practices 'busier than ever'?

You can't go anywhere near a surgery with Covid symptoms, you just book a test, so it's not that.

Presumably with distancing and sanitising and lockdowns other infectious illnesses have reduced too.

So why have we apparently all got sicker in general?

It's not that they're not busier with people with covid symptoms.

People have put off seeing their dr about stuff for months and now feel they have to go and have an appointment. People who have huge waits for hospital appointments (due to business and change in working practices) are getting poorlier whilst they wait for their appointments. People might have long covid, they might have possible vaccine side effects. A lot of people have had mental health issues due to the pandemic such as health anxiety. MH issues are not easy to 'sort' in 10 mins whether that's on the phone or f2f.

Add in the fact that most surgeries will have staff who are off sick/self-isolating/stressed and burnt out means there are fewer staff to share work out between. So more lands on the staff who are in.

I have absolutely no problem with a phone consultation with my GP but what is really annoying is not being able to get an appointment in the first place and not being given a time for the call. My surgery only do same day appointments and you need to call at 8am, they have no telephone queuing system so you have to keep calling back when they are inevitably engaged. That’s fine if you can just sit and redial until you get through but we can’t all do that. And why could you have an hour slot when the GP would call pre-Covid but now it’s “you’ll get a call between 10am and 6pm, keep your phone handy”. I might not want to discuss health issues in public and I can’t sit in for 8 hours waiting for a call. It makes no sense.

Personally I find phone consultations more convenient. I don't have to take time off work to go, no hanging around at the surgery waiting for you appt that is usually running late.

I work in a gp surgery and the only thing we aren’t booking is face 2 face appointments with a gp you’ll be triaged by the gp over the phone and if needed to will be asked to send photos or the gp will arrange for you to come down to the surgery for a face 2 face appointment.There are telephone appointments available to book online.We release appointments every day at 8.00 and 13.00 and patients can either call to make an appointment or come down to the surgery.The only thing we have that we didn’t before covid is an intercom system and the doors only open to access the surgery when the receptionist opens them but this is to limit the amount of patients coming in as it is a small waiting room
Our phones are so busy as we also deal with prescription queries ,calls from third parties,booking covid vacs at other venues,General enquiries,hospital referrals,home visiting service
All our nurses and the midwife are seeing patients and we have also been running covid vacs clinics on Saturdays.

I filled in a form, GP called me two days later, gave me an appointment 9 days later and removed a keratosis. This was at the absolute peak of the pandemic.
DH started to fill in a form and got an alert to make a GP appointment and was seen the same day.
The on-line forms have definite advantages and I hope they stay, although I can appreciate that unpredictable phone calls of a medical nature can be a problem for people in many jobs/situations.
Obviously, GPs don’t want people just dropping in, but they are there and responding in my experience.

I'm an IT person and i found it difficult, time consuming and frustrating, trying to work out how to make an appointment with my Gp surgery. They just plonk software packages with brand names in menus hidden around their webpage - but we don't know what the systems are or what they are for- and they need different registrations and log ins.

You can only log to make an appt during surgery hours!!!! and then the doctor phones back you when it's convenient for them- you could be driving, working, eating, shopping, looking after children, somewhere difficult to talk privately.

For my surgery, this new way of doing things is NOT welcoming, accessible or patient- friendly. It's hostile and obstructive.

@Mindthesheep Thanks. I’m training to be a GP and try not to let this affect how I feel but there is only so much bashing you can take. And people wonder why we are leaving the profession.
As I said I know that there some GPs that aren’t providing a good service and I’m sorry that some patients are suffering this. The same can be said about any speciality. Many of whom are still refusing to accept referrals, then GPs get the brunt of patients frustration about something we cannot control. However the vast majority of doctors, whatever their speciality are working very hard, and GPs are managing unprecedented demand.

Underfunding + covid = the system collapsing

Some GPs surgeries are still coping, but it's clear that a lot of surgeries are so stretched now that they are unable to deliver effective healthcare, and the system is collapsing. People are frustrated and angry, and feel abandoned with no way of dealing with health issues, making it even harder for surgeries as staff leave because they are just too burnt out from it all.

It is failing of our government, not individual surgeries. It really doesn't help though when GPs pop up on these threads saying it's all fine and people are exaggerating. It's plain as day that the current situation is leaving people ill with no way of accessing care. It's a massive mess, and it needs to be talked about.

I prefer telephone as I'm busy with kids and work etc. Get an appointment telephone and if needed they see you. I rang last week with gastritis got a same day appointment and then they had me in an hour later

We moved house long distance on day 1 of the first lockdown , so we and our new GP are strangers to each other. We arrived minus our medical records ( covid glitch; not the fault of previous or new GP) and DH requiring multiple specialist referrals for ongoing treatment of serious issues. Not an easy problem for newGP practice but they coped manfully and womanfully.

Throughout covid, our GP has offered phone consults, zoom consults and face to face consults/ tests/procedures with either a GP or a specialist nurse or an HCP. DH has had frequent prompt sympathetic helpful contact at all levels. I've required only routine reviews/tests/ etc , also on time and flawless. It's a different way of accessing primary (and onward) care but both our previous and new GP and specialist care have gone above and beyond to plug the holes, bridge the gaps and keep DH's treatments on track.

Since January 2021 , they have been doing all the above PLUS community covid vaccinating (that's where we got ours) . An impressively professional, expert, highly organised program involving their entire staff , which is still in full flow,. IN ADDITION TO and on TOP OF all their other workload.

They deserve a bloody medal.

They need to start working the weekends like the rest of society of the backlog is that bad.

@Rubyrecka how do you think that’ll work out if there’s not enough for 5 days, how will that stretch over 7 days? Plus the associated workforce.

@LadyWithLapdog they can extend shifts, alternate locums, or go shifted so 7 days are covered rather than just the 5. It's not hard lots of businesses manage to do it.

@Rubyrecka there’s already out of hours access. Each surgery does this, evenings and weekends. If not individually, then pooled with others. There isn’t enough staff for more shifts. You just shuffle the problems around.

[quote Rubyrecka]@LadyWithLapdog they can extend shifts, alternate locums, or go shifted so 7 days are covered rather than just the 5. It's not hard lots of businesses manage to do it. [/quote]
The practice pays for locums. What money shall they use to pay?
My DH works eight sessions a week. He is out 7.45am-9.45pm at least each day. Sometimes he has an earlier start, he once came back at 11.45pm due to the sheer amount of admin he has to do. Now tell me how to extend shifts whilst keeping in line with legal working hours and requirements and ensuring people actually sleep. Or shall they just not sleep?