What are GPs actually doing right how?

[Darkchocolateandcoffee]

I've just been talking to my 84 yr old mum who can't get a GP appt for love nor money and is worried what she does next as she has a serious condition that she needs to talk to the doc about.

I love 100 miles away from her but I haven't been able to get a doc appointment for my children for months either.

One had such severe hayfever all through the summer and the only appt I could get was with my GP surgery's pharmacist over the phone, who sounded very unengaged and said the only remedies were OTC ones despite me saying we had tried all of them.

I eventually gave up and did a one-off private GP appt and got him prescription meds which worked straightaway. But I wasted weeks beforehand in which he was suffering trying to get the same thing via our usual GP.

Everyone I talk to says the same. The rest of the NHS seems to be firing on all cylinders.

What on EARTH are the GPs doing instead?

@ivykaty44

confidentiality issue. I don’t want to discuss my menopausal symptoms in front of other people thanks

That’s not a confidentiality issue but a problem with discussing the issue with the receptionist

The receptionist is also bound by GDPR and is asked to ask you the reason you’re calling

It’s not discussing it with the receptionist that’s the problem. You don’t get given a time when a GP will call so could be any time between 9-6. I might be on a teams call, out walking the dog or have my teenage son and his friends round! Not great.

There are literally no other jobs with equivalent pay, status and seniority to GP's where the right to work a couple of days a week is treated as a sacrosanct human right.

I have a family member who is a mum and consequently a part time GP. ‘Part time’ doesn’t mean a ‘couple of days a week’. She works approximately 50-60 a week which is substantially more than the average FULL TIME working week of 40 hours. I do wish people wouldn’t throw shit without knowing the facts.

It’s not discussing it with the receptionist that’s the problem. You don’t get given a time when a GP will call so could be any time between 9-6. I might be on a teams call, out walking the dog or have my teenage son and his friends round! Not great

I agree. We try to give patients a one hour slot when we will call (barring emergencies) because of this.

@Iheartmysmart I've had this issue with callbacks too. They give you absolutely no idea what time the call will be. I had run out to the shop once and when they called I had to go into the toilets to discuss my issue - which even then that information was shared with the half a dozen people coming in and out. The car park would've been just as bad.

As for GPs being frontline staff, I'm sure some are, but mine have openly admitted they're mostly still working from home. I'm all for keeping people safe, but this is literally the job they signed up for. Countless other people have had to carry on with their public facing role - retail workers, packing, industry - and they most certainly didn't sign up for working through a pandemic.

Actually, you've all convinced me. GPs closed doors, went home, sit around and having tea and Hobnobs brought to them in bed. Biscuit bashing CFs the lot of them. If the Daily Mail start a campaign that agrees with my experience and prejudices then even better. They have a great track record. Don't mention DM and Hitler and Mussolini in the 1930s though. Apart from that, great track record.

PT - Don't try and argue their PT hours are more than almost everyone's FT hours by a significant proportion. That's not the point. Don't try and tell me how long you work. You've obviously got a guilty conscience.

And if you're paid more than minimum wage (and I know MW is rubbish and zero hours contracts are worse) then there's someone else who'd love to do that job and who currently do more for less even though they have no idea what you do nor how long it takes. They still know they work harder and longer for less and could do what you do. Four Yorkshiremen indeed.

Don't mention anyone is and has been free to apply to train to be a GP and spend the best part of a decade to train. There's a Daily Mail campaign. And a Youtube video.

Don't get me started on -

Dentists;
All teachers;
Universities - why aren't they offering refunds for teaching fees even though their cost base hasn't reduced;
Local Authority;
Every private sector business;
Every charity; and
Everything else - would hate to leave anyone out.

All sat at home, closed doors. Biscuit-eating CFs.

To be fair, we had GPs work from home. But only when they had to because they has a confirmed COVID infection or for isolation from family member infection. We then juggle so they do remote consults and colleagues in the practice take their F2F..

For the remote consults we offered, to be fair, we had some calls, a few %, outside the window we gave patients. Usually because of an emergency. Waiting for an ambulance with a poorly patient or having to spend more time than the allotted slot because someone needs an urgent referral or treatment.

@Bagamoyo1

OK, for those who are actually interested and aren’t just wanting a moan, here is a day in the life of a GP.

8am - arrive at work, deal with the inevitable problems - absent receptionist, staff isolation, locums needed, quick chat with practice manager about the latest dramas (there is always something)
8.30am - at computer, look at the blood/urine test results that have come through in the night, code all the positive PCR tests on patients records, read work emails.
9am - start calling patients. Call 15 patients during the morning. Some can be sorted over the phone, some need face to face review, which is arranged for the end of surgery. Type up notes after each patient.
12ish - start seeing patients face to face, which involves cleaning the room afterward each patient.
2ish - by this time there will be multiple hospital letters and test results that have arrived, as well as numerous medication requests for meds that aren’t on “repeat prescription”. Make a start on these. Many of these will require calls to patients to advise them about results, or letters to patients or hospital consultants. Also try to type any hospital referral letters that have arisen from morning surgery, if there wasn’t time to do it during the morning.
3pm - start afternoon surgery - as with the morning, this involves phone calls followed by face to face appointments.
6pm - return to letters and blood results - there will be more by this time, plus the ones from earlier.
6.30-7.30pm - extended access phone calls - 4 slots have to be allocated for patient calls in this hour, it’s a CCG requirement.
7.30pm - back to letters, results, requests, tasks, emails about staffing issues, medication requests. Hospitals are overwhelmed so they are passing lots more work to GPs now, so most letters require us to contact the patient, arrange further tests, meds etc.
8.30ish - realise that I’m too tired to work effectively and the cleaners have already left, so I go home.
No lunch break obviously.
On Mondays we have a meeting, so that's another 2 hours to fit in during the day.
The work is too great to fit into the working day, so other admin tasks - routine medication reviews, medical reports, policies and protocols, partnership issues etc are all done at the weekend, probably adding about another 6-10 hours outside of the working day, each week.

Please believe we ARE working.

Why are GPs doing these admin tasks? Why are they not being delegated to more junior staff members. Why is the practice manager not dealing with sickness and staff issues. It seems they are doing too many tasks outside of their roles.

To any drs: how much is cleaning slowing things down? I was really surprised the other day when I went for my 6 week check that they opened on a Saturday to do this, and I arrived early. I was seen right away, but rather than having a waiting room full of patients ready to capitalise on this, they'd left time for cleaning and he wasn't seeing anyone for the next hour!

Is this annoying, or really good admin time?

Also, with my midwife, I was told that if I used the loos for the urine sample, they'd have to go and wipe round! This seems such a silly use of their time?

I'm frustrated for medical professionals, not with them.

@2blackandwhitecats

I am a teacher and I don’t consider it teacher bashing to say some aspects to the education system are disorganised, nonsensical and difficult to negotiate.

It isn’t a criticism of individual doctors. It is a criticism of the system and how stupid it is.

Thats a really good point. DH has had 2 major conditions during Covid, one he needed surgery for, the other a chronic condition. He's been lucky he has health insurance through work so isn't clogging up the system but not everyone has that luxury.

What I do see on these threads is a lot of resentment bordering on contempt for patients from GPs and surgery staff which I'm sure adds to an already crumbling system.

I'm considering getting health insurance myself so I'm less of a burden on overworked GPs.

We still clean but don't take an hour. We're doing what we can to manage infections given the current infection rates out in the wild seem really high and we're going to be hitting the dark and damp times soon so anticipate infections might get worse if we don't, as a society, get on top of it.

There are unknowns about the clinical effects on an individual of simultaneous 'flu and COVID infections hence why we've vaccinated so many in the last fortnight.

I know infection control is an emotive issue and many members of the public have ver strong opinions about letting infection fly and stopping wearing masks and stopping infection control. My DC's schools infection rates and absences seem really high. No infection control and no investment in HEPA filters or other measures beyond vaccination.

We can't control what anyone does outside our setting but we do what we can, especially given many of the patients we see are vulnerable.

My sister is a GP, she has non stop 10 minute appointments, often working longer than her required hours and without a lunch break. Sometimes people come in for reasonable reasons and sometimes they come it because they stubbed their toe, bruised their thumb or one very odd reason she had recently was because a woman needed a new carpet and could they help her get one. I am sorry that your dad can't get an appointment, he should be able to, but it isn't GP's doing nothing and more that the general public don't know what the GP is for or that you don't need to go to one for a bruise, stubbed toe and definitely not for a carpet.

If reading this thread in the round give rise to a view that it is the HCPs showing contempt for patients then I need to reread it as that's not the tenor of the posts I've read.

We still get appointments no problem.

@2blackandwhitecats

I am a teacher and I don’t consider it teacher bashing to say some aspects to the education system are disorganised, nonsensical and difficult to negotiate.

It isn’t a criticism of individual doctors. It is a criticism of the system and how stupid it is.

It kind of is when the question is 'what are GP's actually doing!?' Implying.. that they aren't doing anything

@NotPersephone

I have a family member who is a mum and consequently a part time GP. ‘Part time’ doesn’t mean a ‘couple of days a week’. She works approximately 50-60 a week which is substantially more than the average FULL TIME working week of 40 hours. I do wish people wouldn’t throw shit without knowing the facts.

Oh please stop with this tired nonsense. Maybe people would be more inclined to believe GP's are working hard (in the face of incontrovertible evidence to the contrary) if they laid off the hyperbole kool-aid. 60 hours a week is 12 hours a day for 5 days. Let's be generous to your imaginary relative and suggest that PT means 4 days a week. Are you seriously suggesting that she works the equivalent of 8am to midnight every day for 4 days? If you are including keeping up to date with current know-how and practice in that time, then you're being disingenuous. Every other professional has to do the same and they do not do that within their 40 hour working hour working week either. Nor are they as generously remunerated for their trouble.

It is so disingenuous. My DH is a consultant who has seen immunocompromised patients F2F throughout the pandemic and has on numerous occasions found himself only able to offer palliative care because their GP has pissed about with red flag symptoms with months between (pointless) phone appointments "because Covid". He has also found himself calling security to deal with irate people who want to know why they/their relative have been treated remotely for something trivial when their GP hasn't even arsed herself to examine them.

A 14 hour day is totally normal in general practice, so it's not hard to work 60 hours if you do 3 days a week in practice, then clinical admin and email from home.

I could tell just as many tales of cock-ups by consultants and endless dumping of work on GPs, but how would that help anyone? The reality is that we are all struggling and making mistakes because there are not enough doctors for the population. That's what we should be focusing on. Everything else is a distraction that allows the Government to get away with continuing to underfund the health service.

I have every sympathy for people struggling to get GP appointments. There is a problem, but it's a problem of under-supply, not of lazy GPs. And it will never get fixed while the public coludes with the Government in blaming GPs.

You don’t get given a time when a GP will call so could be any time between 9-6.

You might not. I do. What happens where you are isn’t necessarily what happens everywhere.

My DH is a consultant who has seen immunocompromised patients F2F throughout the pandemic and has on numerous occasions found himself only able to offer palliative care because their GP has pissed about with red flag symptoms with months between (pointless) phone appointments "because Covid"

On the other hand, I’m now into my fourth year of trying to have something dealt with effectively by a consultant, despite me and my GP (3 of them, in fact) trying to get something done by them.

There, I’ve balanced your anecdata.

@MissLucyEyelesbarrow spot on again about hours and about incompetence thrown over the wall by some consultants though I don't recall many GPs then stating that all consultants are incompetent or lazy. I know a consultant who has been isolating. I've not presumed that every consultant is working from home on that basis.

@NotPersephone

I have a family member who is a mum and consequently a part time GP. ‘Part time’ doesn’t mean a ‘couple of days a week’. She works approximately 50-60 a week which is substantially more than the average FULL TIME working week of 40 hours. I do wish people wouldn’t throw shit without knowing the facts.

Oh please stop with this tired nonsense. Maybe people would be more inclined to believe GP's are working hard (in the face of incontrovertible evidence to the contrary) if they laid off the hyperbole kool-aid. 60 hours a week is 12 hours a day for 5 days. Let's be generous to your imaginary relative and suggest that PT means 4 days a week. Are you seriously suggesting that she works the equivalent of 8am to midnight every day for 4 days? If you are including keeping up to date with current know-how and practice in that time, then you're being disingenuous. Every other professional has to do the same and they do not do that within their 40 hour working hour working week either. Nor are they as generously remunerated for their trouble.

It is so disingenuous. My DH is a consultant who has seen immunocompromised patients F2F throughout the pandemic and has on numerous occasions found himself only able to offer palliative care because their GP has pissed about with red flag symptoms with months between (pointless) phone appointments "because Covid". He has also found himself calling security to deal with irate people who want to know why they/their relative have been treated remotely for something trivial when their GP hasn't even arsed herself to examine them.

MissLuxyEyelesbarrow explains things nicely, I'm working NHS today and my day with be 8am to 7.30pm and then probably an hour or so for blood results and electronic prescriptions from home tonight. Quite easy to work 50h over 4 days.

You seem to have a very strongly held but ignorant view of the situation on the ground, especially when your main source of information for this is "My Husband Who Is Not a GP."

Always a funny read though.

'I have every sympathy for people struggling to get GP appointments. There is a problem, but it's a problem of under-supply, not of lazy GPs'

How can you possibly know. As I've said we haven't had any problems but I'm sure there are shirking, lazy GPs as there are in many professions.

One of the issues is practice management imo. So many hopeless 'computer says no' type of staff. So much time wasted by admin cock ups and staff doing the bear minimum.

As a pp said fgs delegate! get nurses signing sick notes, practitioners signing off repeats. Just have the drs examining patients. I should be a primary care boss obviously, I'd soon have them whipped into shape.

I think we should do away with GPs altogether, just have nurses running practices. I'm sure they are just as able to refer to a specialist if a condition persists.

If you are on hold for 45 minutes trying to book an appointment; or all the appointments are gone by 8.05am; or the telephone is constantly engaged; or you have to wait three weeks for a routine appointment how on earth is that the fault of the GP? It's obviously just that appointments are scarce commodities. GPs are in high demand. There are many, many other people who are competing with you for those appointments. And yes, some of those people will be sick children or frail elderly people who need to be seen sooner.

Mines been great throughout the pandemic. From what I read on hear I feel really lucky.

@JaniieJones

'I have every sympathy for people struggling to get GP appointments. There is a problem, but it's a problem of under-supply, not of lazy GPs'

How can you possibly know. As I've said we haven't had any problems but I'm sure there are shirking, lazy GPs as there are in many professions.

One of the issues is practice management imo. So many hopeless 'computer says no' type of staff. So much time wasted by admin cock ups and staff doing the bear minimum.

As a pp said fgs delegate! get nurses signing sick notes, practitioners signing off repeats. Just have the drs examining patients. I should be a primary care boss obviously, I'd soon have them whipped into shape.

I think we should do away with GPs altogether, just have nurses running practices. I'm sure they are just as able to refer to a specialist if a condition persists.

If you were a primary care boss you'd be sacked within a week. Nurses aren't legally allowed to sign sick notes.

If you're happy to see a nurse at first call for your family, that's fine . Plenty of excellent nurses around.

For mine, they'll be seeing a registered medical practitioner (doctor) with a breadth of experience even if it means paying.

I agree with @JaniieJones. Even the GPs posting on here admit that there are some GP practices taking the piss. They are small businesses not run for patients at all.