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?

What are GPs doing? 6,000,000 appointments a week at surgeries, 50% with GPs, 60% face to face. Data on NHS Digital.

@Musicaltheatremum

Great post. Most people know GPs are working very hard under a broken system. The comparison up thread to the response to HGV drivers is also interesting. But I'm curious about the children who 'shouldn't have been near a health professional'. I wouldn't take my children to the doctor for a cold but that's because I know to wait it out, that anti-biotics are often no use, that I could call any number of doctor relatives and friends for advice if needed - privilege, in short. Surely every country has over anxious parents who want their children to be checked out? The UK isn't known for being a nation of hypochondriacs. So shouldn't the system be built to deal with these parents too?

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.

Well I'm just off to work, my clinic is rammed full of face to face appointments as it has been for months. Even during Covid we saw possible Covid patients in a hot hub with a plastic apron and paper mask. Hundreds of them.
Alongside that we now have telephone appointments, all preplanned and precooked. I tried four people three times each yesterday and got no answer.
Add in seeing hospital out patients they won't see, podiatry patients they won't see etc, in thirty years of nursing I've never been as busy. Covering flu clinics now too on my day off.
Hand on heart our GP's are exactly the same. In our surgery at least. Doesn't help when three senior staff with over 100 years experience have all left this month alone.
Not all surgeries are the same, but very many are busier dealing with unprecedented demand. I can't understand the disparity.

often with GPs replying with the statistics of huge INCREASE in appointments since 2 years ago.

It is just very difficult to believe that when most of us have effectively not had access to primary care for 18 months.

My GP surgery has had a compulsory increase of over 5000 patients because another surgery closed we are in a city, the patients were thankfully spread across a couple of practices they literally cannot see/speak to everyone who needs to be seen/spoken to.

I've used econsult a few times and more than once they've issued medication without even speaking to me based on my written ramblings.

I honestly think GP care as we know it is on the brink of collapse...precisely what the Tories want so they can justify a move to private practice being the norm.

My GP friends are on the verge of quitting. The hours they work and the abuse they endure is no longer worth the money they earn. Everyone has a breaking point, being well paid doesn't alleviate that these are people in their own right being asked to do the impossible.

GPs are working bloody hard, as are their support teams but supply is far smaller than demand for NHS practices.

My gp is doing in person appointments as normal

And I think it’s very dangerous when people’s lives are at stake to accept it because ‘GPs are working really hard.’ Maybe they are.

But if potentially serious child safeguarding issues are missed or early signs of cancer, that’s not much comfort to know the doctor worked really hard, is it?

The UK's GP system is collapsing because of a disparity between demand and supply, that is what is happening. GP bashing is only going to make that situation worse.

Tbf GPs run their own practices generally and are responsible for managing their own workloads and caring for their patients. So it’s generally not comparable to lorry drivers.

What irks me about the whole thing is the constant negging and dismissal. Go see your pharmacist, optician, anyone else but your GP. We are expected to be grateful to receive any care at all even if it’s awful.

Im not saying that it’s all GPs fault. But they are running their own business and getting paid handsomely by the taxpayer to do so. Many are paid more than the prime minister. If the workload is too much (and it may well be) that’s because we need to train more doctors. But many GPs may have to accept lower pay.

@Musicaltheatremum

Well I'm working harder than I ever have. I'm speaking to and seeing more patients than ever. The reason you can't get an appointment is because demand has soared exponentially and there aren't enough GPs in the system. I am about to go in for a duty doctor session and I'm already having feelings of panic about it because quite simply the system is not safe.

I feel really sorry for patients...you are getting a really bad deal but to be honest we cannot see an indefinite number of patients in a day.

But what is really getting to every single GP in this country is the lies and misinformation that is being spread about us.

Yes there may be some GPs who are doing nothing but the rest of us are at breaking point.

I can deal with 30 patients a day quite safely but now we are dealing with about 30% more and that's not good for you.

One colleague said most of her surgery the other day was dealing with chasing hospital appointments so that is a really bad use of our time.

I was at a meeting last night ....290 GPs on it listening to our colleagues in the hospitals say there is no extra capacity there either so we have to try not to send patients there. It was really really depressing.

The children's hospital were saying there was a 30% increase in A&E attendances mostly minor coughs and colds which should not have been near a health professional...let alone hospital.

Mental health consultations have soared but there is a shortage of places to refer on to and patients are waiting over a year for psychology. Our favourite psychiatrist is retiring in December and they can't get a replacement.

So that's what's happening.

Thank you @Musicaltheatremum that is really interesting. So is the problem poor management in the NHS which means doctors like you waste time chasing things up rather than seeing extra patients?

Plus a lack of GPs to serve a huge and ever growing population. If this is the case, why, and how can it be fixed?

I just want to understand it as obviously they aren't all sitting at home watching telly.

Thank you for your hard work @Musicaltheatremum and all of your colleagues.

There was already a GP shortage before Covid (amp.theguardian.com/society/2019/dec/23/uk-has-second-lowest-number-of-doctors-per-capita-in-europe - read the last bit especially). The horrendous GP bashing in the press is only going to make that worse ☹️

I think they have moved to a different way of working which has its pros and cons.
My surgery is using econsult and telephone appointments mostly, which works well for me.
Last year I had a phone consultation about a suspicious lump, and was referred straight away for a hospital consultation.
A few months ago I had a phone appointment for something else, and was called in for a face to face contact as an examination was required.
This week I have sent in an econsult form describing my symptoms, then had a phone call with appointment arranged to have blood taken, and a phone appointment follow up with GP when results are back.
So for me, I am receiving an efficient service, but I appreciate other people are struggling.

Also I hate this mn attitude of dismissing anyone criticising poor education or healthcare as “teacher bashing” or “doctor bashing”. Education and healthcare are hugely important and are on their knees at the moment. We should be able to discuss them freely.

@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.

This 100pc

@2blackandwhitecats Exactly this.
I’m certainly not saying there isn’t huge strain on the NHS and that they’re working incredibly hard under pressure. But I haven’t been able to see my doctor throughout and the nurses all welcome you in as normal. I’m disappointed in a failing system, not slagging off all of the doctors.

Sadly as demand for GPs has risen as restrictions ended the available workforce has reduced even further as more and more are leaving the job (I won't go into what my job is but I deal with GPs retiring basically and we are very busy at the moment!).

The problem is only going to get worse as the government have made being a GP very unappealing compared to other specialisms, they are currently offering a £20k bonus to any graduate doctor who becomes a GP partner but so far not many people have taken up this offer (I think the BMA are releasing exact figures next month). Sadly there will probably be big changes coming to primary care over the next 10 years but not sure what...

What a lot of people also don't realise is GPs work in sessions, a full week is 8 sessions and most GPs don't work the full 8 sessions. However along side this they will have other jobs e.g at out of hours. So as demand at out of hours/A&E has increased they have dropped their sessions as a GP and worked more hours in their other job, some because they feel that's where they are more needed and others because in reality it's a nicer job!

I understand the frustrations people have, and I have struggled to get appointments too, but I really don't agree that it's GPs fault. It's the government for completely shitting all over the service for the last 10 years.

There is unprecedented demand on the system, and a chronic lack of GPs with no viable way of replacing them - we simply aren't training or recruiting enough GPs to fill the gaps given the pace that they are leaving/retiring, partly because people don't want to do the job.

EConsults aren't liked by the people who just want to be able to ring up and book a face to face, but they are an effective a way make sure that people are seen by the right person, filtering out people who don't actually need to see a GP and could be just as easily treated or advised by another member of the team of professionals that works in general practice.

@Musicaltheatremum - couldn’t chasing up hospital appointments be done by an administrator rather than a GP? The practice is a business after all so no need to have a Gp doing an administrative job.

Not had a problem with our GP surgery.

It does sometimes take a while to get through but once through I've always been able to get a same day telephone appointment and called in if needed.

There is a GP shortage. GPs are working very long hours (ours do weekends too) just to get through it all.

The problem is not the GPs. It's the funding cuts etc down to this government.

If you're angry, take it up with your MP.

Side note: my kids had severe hayfever and we've also tried all the meds, none worked.

What did work was a spoonful of locally-made honey every day. Maybe you could try this if your child is old enough (sorry not sure of their age).

@Musicaltheatremum

Well I'm working harder than I ever have. I'm speaking to and seeing more patients than ever. The reason you can't get an appointment is because demand has soared exponentially and there aren't enough GPs in the system. I am about to go in for a duty doctor session and I'm already having feelings of panic about it because quite simply the system is not safe.

I feel really sorry for patients...you are getting a really bad deal but to be honest we cannot see an indefinite number of patients in a day.

But what is really getting to every single GP in this country is the lies and misinformation that is being spread about us.

Yes there may be some GPs who are doing nothing but the rest of us are at breaking point.

I can deal with 30 patients a day quite safely but now we are dealing with about 30% more and that's not good for you.

One colleague said most of her surgery the other day was dealing with chasing hospital appointments so that is a really bad use of our time.

I was at a meeting last night ....290 GPs on it listening to our colleagues in the hospitals say there is no extra capacity there either so we have to try not to send patients there. It was really really depressing.

The children's hospital were saying there was a 30% increase in A&E attendances mostly minor coughs and colds which should not have been near a health professional...let alone hospital.

Mental health consultations have soared but there is a shortage of places to refer on to and patients are waiting over a year for psychology. Our favourite psychiatrist is retiring in December and they can't get a replacement.

So that's what's happening.

Thank you for everything you are doing.

@ilanois

Not sure, but there's about 500,000 identical threads on here you could have read or joined- often with GPs replying with the statistics of huge INCREASE in appointments since 2 years ago. And where it has already been outlined in detail that this is a government and political issue and not the fault of individual GPs. But don't let me stop you. Let's bully more of them into leaving general practice so that we can complain more.

This ^ GPs are under incredible pressures, working extremely long hours, totally burnt out and now dealing with a shameful attack by the media for not doing anything. GPs do so much that the average person doesn't see; Responsible for providing a GP service for multiple care homes, managing a lot of risk, mental health, complex physical conditions, vaccinations, referrals, repeat scripts et etc. Just from looking at my online medical record I've noticed a pattern this year of repeat scripts or issues being dealt with late at night or at 5 in the morning. It's obviously fine to be angry or upset about not getting an appointment or the treatment you need, but this isn't down to GPs not working hard it's down to lack of money, staff and massively increased expectations and needs.

More people are accessing gps than every before, the demand massively increased after lockdowns.
Medical centres have a ridiculous amount of patients on their books
GPS are leaving/off sick/part time
Guidelines on how surgeries work changed.

I can’t fault my gp or my dads. I’ve happily had phone consultations and used the online portal. My dads ran something similar and has had face to face appointments this year. Sometimes the online:phone thing works better when he needs something minor.

I’ve no doubt some surgeries may be taking the piss but mostly it’s because they are overwhelmed.

I much prefer the phone appointment system, for instance I needed a review of medication which I would have had to go to surgery for before, had a phone consult, so much better when you are working etc. The NHS seems to be almost broken though and I feel afraid of its future.

I don’t know what GP’s are doing? I had an appointment call with the doctor’s yesterday and it was the Practice Paramedic that I spoke to. I’d never heard of this before.
So, where’s my GP?