No wonder you can't get a GP appointment

[Intherightplace]

Currently all first GP appointments at our surgery are telephone. Which is OK for most things, even good, more efficient for both GP and patient. However, for some things a telephone appointment is never going to be any use. For example, if I'd been able to explain to "someone" that I needed an appointment for a dodgy looking mole, surely they could have seen that a face to face appointment was necessary?

Anyway, I waited 3 weeks for my telephone appointment. GP said she couldn't do anything by phone and she'd need to see me (like it was my fault, I hadn't seen her!). So that's one completely wasted appointment.

10 days later I had the f2f appointment. Buzzed the door, not allowed in before they've checked you out. Receptionist said she'd tell doctor I was there. 10 mins later the doctor herself came to collect me from the door. Now this is a large medical practice, it's a fairly long walk, involving 2 flights of stairs and she was wearing heels she could barely walk in

I was with her literally seconds before she said she'd refer to a dermatologist. So, at least 20 mins of her time, for a few seconds with the GP to do something she probably could have done at the telephone appointment, if that was going to be the level of the examination.

Either way, she could have dealt with other patients in that time. Why on earth are the admin staff still working at home? There are usually loads behind the large reception desk, but only the one answering the buzzer currently.

And why not just refer the first time and save everyone so much wasted time?

I was bitten by some evil insect thing last summer. Could only get a phone appointment and had to send photos. They said doesn't look too bad and I tried to explain it looked worse in person. Just said use insect cream. Got so infected ended up in a and e on intravenous antibiotics and I have a scar. Don't think that would have happened face to face.

Just to give you an idea of the impact of obesity.... over 10% of prescribing costs are spent on treating patients with diabetes. Basically it’s doubled in the last decade due to the obesity crisis. GPs are seeing many more people with long term conditions than ever before and they require a lot of care.

The single biggest area of spend for the NHS is mental health.

Both of these conditions can be averted or improved through healthy diet, exercise, tackling the root causes of disadvantage. I’m simplifying, but in order to manage these huge care bills which are rising faster than GPs can cope with, we’re going to need to invest more in health promotion and supporting people to help themselves. This is the only way to tackle the rising costs as we won’t be able to fund the care with an ageing population.

Ps Reading that back... I’m not saying we can avert mental health illness or type 2 diabetes through greater self care/ tackling social issues alone... certainly clinical intervention will be needed for many. But it will help bring incidence rates down to a more manageable level.

You are absolutely right. It is bonkers. The level of inefficiency is just incredible now. It was always fairly bad at our GP (thankfully only been for vaccinations and routine things). But you’ll get shot for ever criticising the nhs.

It’s ridiculous. It’s frustrating for me as a sonographer who has just got on with seeing patients throughout. We’ve also had more unnecessary referrals as GPs haven’t clinically examined patients because it wasn’t “safe”. Apparently it was safe for me to be in close contact with them though. They need to go back to normal now like everyone else is doing.

@Carycy I’m not sure all practices will go back to the way it was before Covid, seeing patients f2f as the default. Our practice said demand has gone up 30% compared to pre Covid. It’s basically unmanageable to care for all patients f2f as default.

I received a phone call this evening, saying my child has an infection after dropping a swab off last week (I have a stash), to discuss treatment. Usually that would have warranted a f2f appt, time of work, an uncomfortable child being swabbed intimately by unknown adult. So I actually preferred this process of just being able to drop in a swab when my child complained of soreness and a quick call ONLY if there is a concern. If there’s no problem, you don’t get a call. Feels like a much more efficient process in this scenario.

I appreciate that many patients will need to be seen f2f and I’m happy to use digital or phone to help free up f2f appts for patients who need them.

The signage on our local GP surgery couldn’t be more unwelcoming.
I feel, if you attempted to enter the building, you would be treated as a Biological Weapon and a major incident declared.
Apparently Public Health England, ( who provides these protocols to Doctor’s Surgeries) is full of retired GPs who are over cautious and inflexible)
We can all go to a nightclub now, a cinema or exercise class, but can’t walk into a GP’s Surgery.
This is a shocking shirking as your duty as a Doctor.
I have close family members working on ICU, dealing with Covid patients.
Hospital Doctors and Nurses stepped up in this pandemic and put their patients first.
GPs ( not all) ran like cowards to save their own skin.It feels as if they locked their doors and hid.
GP’s tend to be Doctors who initially chose a less demanding career.
Hospital Doctors have a 24/7 commitment normally.

I get that some phone appointments are handy.

However I think it will lead to people being unessesarily medicated or having unnecessary examinations.

Eg I showed photos of my sons wound on a phone appointment. I was prescribed antibiotics. But the time I got them it looked a bit better so left it. And it healed up nicely. Had I gone I think the dr might have held off too. Will definitely see more overuse of antibiotics which is concerning.

The only time you can be seen quickly at my G.Ps is when they need someone to wheel in front of the medical students. Appointments available immediately.

Kteeb

I hope you "fed back" that you ended up on intravenous drip etc.

I've been hours on the phone today trying to get sorted, bounced from pillar to post and a photo would have done and two types of treatment which is what I've ended up with.
So much time and man power has been wasted instead, such a shame.

Carcy and also the under use.
You can get the anti botocics script and hold off until it becomes necessary, which is what we have done many times.

@mibbelucieachwell

Even before covid I've often thought that some processes seem inefficient. Eg blood tests ordered by the GP. Why don't gps just do the blood tests there and then instead of requiring the patient to have to bother the receptionist to make another appointment with a nurse who has to come out of her room to find you in the waiting area and walk you back to her room. GP could do it in seconds.

Your surgery is streets ahead of mine. Here you have to book a blood test and it’s never on the same day.

@RoughSeas

I was going through a very bad time with husband and honestly felt unable to cope (I’m usually a very coping type of person). I phoned GP but only able to get phone appt in 4 weeks….receptionist suggested I fill in an e-form, which I did and got a phone response. I tried to explain that I could not speak from home (where husband is) and didn’t feel comfortable talking about extremely personal things outdoors in public.

They wouldn’t give in…phone or nothing. Absolutely impossible for anyone to see me. I’m too worn out and worn down to fight about it so just getting through day to day with help of two good friends.

But do they not understand that not everyone can talk about personal things at home.

Go to the surgery and f....king scream at them that you need help. Make a scene and don't move until a GP sees you. Its a bloody disgrace they are getting away with such negligent treatment.

They are sitting there behind closed doors in their surgeries NOT providing the service we are all paying for. The NHS not free we are paying for it.
Recently booked an annual bloods review for my husband (which was missed by them) and the wait for a phone appointment is 5 weeks at our Warwickshire GP.

@Happymum12345

I don’t understand how trains, planes, dentists, schools, shops, offices etc are all open to the general public, yet doctors are not.

This.... OH and I have had x 2 dental checkups, multiple visits to the vet with the cats and still cant get f2f with our GP. Phone appts take 5 weeks and no feedback on a hip Xray 3 weeks after it was taken! Prior to Covid the service was ok so why has it suddenly gone to pot? We are working so why aren't our GP'S.

If its correct that some GP's are electing to work PT for good work/life balance then they are surely getting paid tooo much!
Most of us have to work FT to earn a decent wage!!!

MidsummerMimi ....My feelings exactly ( ex nurse)
GPs ( not all) ran like cowards to save their own skin.It feels as if they locked their doors and hid.
GP’s tend to be Doctors who initially chose a less demanding career.
Hospital Doctors have a 24/7 commitment normally.

I've not seen a dr for ages apart from for vaccination an for an allergy issue. but yes it's horrendous I have implanon/Nexplanon in which should have been taken out in Jan but I still have in, I called my gp surgery which is a new one as of last September and they said they cannot take it out there, I called all the sexual health clinics near me they said there is a waiting list, I am now 8 months overdue taking it out, I am 2.5 years into asking for it to be removed for health issues, a friend said if I threaten to cut it out myself they remove it immediately so I might do it to be honest

@LawfulSearch At my surgery they do not offer blood tests- you have to book at local hospital or community phlebotomy clinic - average wait 2 weeks.

@FreshPrincessOfLondon

I would have thought a better system would be you take a photo and send it to the doctor and then she assesses from the photo.

A friend's GP works like that now for rashes etc. Seems sensible although relies on patients being able to use IT. Saves a lot of time and hassle.

We had to send a photo of DS's mole to rule out anything sinister. GP examined picture, said all okay.

Takes at least 10years to train a doctor, so their more important than the likes of you. Tore a muscle (take paracetamol), gout at 91 (change your diet) most things you can sort out yourself or go to pharmacy, walk in centre, stop bothering these busy important people. Its not like your paying taxes to pay for them. OH HANG ON A MINUTE, SCUB THAT WE ARE

I have posted a positive experience of telephone/remote GP appointments...but there has been a negative experience too...

DS was diagnosed with facial cellulitis at hospital - antibiotics prescribed. Great. Then on day 4 his eye got worse , very puffy. I phoned GP practice. Receptionist spoke to a GP who passed on the message to me that to take DS to A&E to rule out occular cellulitis. When we took him in to A&E a consultant examined him and said why are you here, nothing wrong with your son. Eye is not swollen etc. GP had not contacted A&E to notify them we were on the way 🤷 miscommunication. If he had just been seen by a GP it would have saved a lot of unnecessary stress. Occular cellulitis is classed as an emergency so does need to be seen immediately.

amongst all the praise and brickbats about digital triaging - the fact remains that an elderly person living alone (no-one to take pictures even if they have a smartphone and an app) not wanting to bother the Dr if their problem is not serious, in pain and suffering from poor mental health - is not being served well by the current system.

Even if they do manage to get an appt, their chronic pain/difficulties can be put down to 'age-related' problems and the general belief that 'the old' are clogging up the NHS
For all this 'lack of care' - the GP practice is receiving an annual fee for each and every patient (young and old) even if they never see them at the surgery.

We can send our surgery photos - the receptionist passes them on to the GP. That might have worked here?

On the positive side. Rang my GP. 6th in the queue. When answered they booked me an appointment at the local drop in centre that afternoon. Fantastic service from our wonderful NHS.

It does seem that becoming a GP is the "go to" career for doctors who want part time work, flexible hours, don't want long shifts/unsocial hours, not prime household earner, etc. That's brilliant for them, but not for their patients. We need GPs who want to be GPs. From the ones I've had contact with in the past few years, they don't seem interested and see patients more of a nuisance. That's a very big change from what I consider "proper" career doctors of 20/30 years ago who would usually work full time, do their own emergency call outs at evenings and weekends, etc. I know which type I'd prefer. I thought that Blair's contract change was to keep more doctors by offering more money and allowing them to opt out of the anti social hours. It seems to have done the exact opposite by bringing in GPs who aren't actually committed and are only doing the job as it's well paid for family friendly part time working that they'd have trouble getting in other areas of the NHS such as hospital consultants/specialists, etc.

I had a wonderful GP but he retired this year. He helped me when I had my health hiccup. Not seen a doctor since lockdown, needed to but ended up on the phone sending photos explaining pain. Let's just hope things get back to some normality eventually