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 I asked, amongst other things, was, why couldn’t GP practices use apps to modernise bookings when small gyms manage it?

I don’t know anything about IT procurement for GP practices but there are definitely some that have online booking. With ours I can choose either a phone or f2f appointment. As to why some have that and others don’t, I’m not sure.

One of the main differences to gym booking systems is that gym bookings are fully online/app based. GP surgeries do still take bookings over the phone so it’s probably a more complex system required.

@Iamthewombat one of the reasons a GP surgery might choose to not have all of its appointments directly bookable online (they could choose to do that, yes) is so that DGM who doesn't use the internet or have a smartphone can still ring up and speak to someone to book an appointment.

It’s also more likely that an older person has the time to be spending on hold to the surgery. I can never call at 8am when the phone lines open as I’m either trying to get kids to school or on my commute. It’s actually working people and parents who are most disadvantaged by this, on the whole.

If there are no appointments left for the frail elderly patient when s/he does get through it us because they have already been booked by other patients. Appointments are a finite commodity. The GP only has so much time in his/her day.

What is the answer to this?

Shall we reserve some appointments especially for frail elderly? Who is going to judge who can have one of those appointments? Probably not the receptionist, that might be a clinical judgement s/he cannot make. So perhaps the GP will have to phone and triage.

Any better solutions anyone?

@Iamthewombat

Firstly, I'm not trying to "win support", I'm not quitesure what you think this is. All I did was calmly and reasonably politely pointed out that you had posted something that was simply untrue, and explained why.

I'm sorry if you felt ridiculed but that's sometimes what happens when you post bold but incorrect statements about something and are then corrected by someone who knows more than you in that field.

I wouldn't boldly comment about NHS Senior Finance because that's not my area. I know that I'd look like an idiot. And if someone did coming along that knew about this, I would stop digging a hole.

What you are doing, of course, is trying to avoid the real question - which is the OP asking why the service being offered at the moment is so poor - by seizing on an opportunity to say “you know nothing, you’re ignorant, you’re an idiot, you’re making all of us GPs laugh”.

What I asked, amongst other things, was, why couldn’t GP practices use apps to modernise bookings when small gyms manage it?

The answer, it appears, is “because the PCTs do all the procurement locally and they won’t let us”.

(Who usually chairs PCTs and which group has significant influence over them? Oh yes, GPs. Let’s not mention that, eh?)

But don’t let that stop you from claiming that because I don’t know all the nuances of your particular practice and PCT’s IT systems, I therefore know nothing and should step away, because I’m providing amusement for you and the other GPs.

It’s the oldest trick in the book: try to shut down your opponent with ridicule or the ‘you don’t know anything so shut up’ defence. It doesn’t do you much credit, I’m afraid, and demonstrates that you have reasons for trying to close the argument down. Thanks for your concern, but I don’t feel ridiculed because I can see straight through your attempts to dissemble.

This isn’t a debate about your specific IT systems. It’s about why it’s impossible for many people, including some vulnerable people, to get an appointment of any kind and why those people are forced into a ridiculous and fruitless game of fastest finger first each morning, simply to chess the healthcare they need.

I look forward to hearing what you are doing about that.

Well I've give you the best answer that I have time for. You are beginning to sound increasingly angry (something that you're accusing the GPs of) even though people are trying to engage with you (which I'm now less inclined to do).

As an aside, and I'm sure you'll see this as another attack, PCTs were disbanded years ago (nearly a decade) - that's why I said "previously" PCTs (or something similar) in my initial post. You're referring to them in current terms. This would really imply that your knowledge really isn't current.

That's fine, it doesn't need to be since you don't work in this area. But again, you should maybe stop presenting it as such (Again, entirely up to you and crack on if you want. We can re-hash the discussion PCT-GP involvement - or at least the one everyone else was having a decade ago).

Shall we reserve some appointments especially for frail elderly? Who is going to judge who can have one of those appointments? Probably not the receptionist, that might be a clinical judgement s/he cannot make. So perhaps the GP will have to phone and triage.

Pretty sure there are appointments prioritised for babies. I’ve never failed to get a same day appointment for a baby, even if calling later in the morning I’ve usually managed to get something. Not sure about elderly.

Here you get a phone call initially but can be called in for face to face, if needed. And although it can take up to half an hour when ringing in the morning (which is because lots of people are calling so can't blame GPS) I have always had a call back by 12:30 the same day

**The thread is full of posts from GPs telling us how hard their lives are and why it’s the government’s fault. Or, on occasion, the patients’ fault.

The GPs are explaining what their day is like. Which is directly relevant to the OP's original question. Yes, they are working very hard. Which is why, when the media reports that they are 'hiding under their desks' or whatever, it hurts.

Also, I don't think anyone has blamed the patients.

Thankfully our GPs have been great all through the pandemic but if they need to refer you to a service, the waiting list could be up to 2 years (depending on what you need).

I needed surgery a few months ago and I had to have it privately as the waiting list was years. We'd just got a second mortgage to do work on the house but had to put a chunk of it aside for the procedure.

My GP surgery is great. The practice is run efficiently and I’ve rarely come across a challenging receptionist and the medical care is very good. Well, I assume the medical care is still good because I cannot get an appointment. Clearly this isn’t the fault of my surgery nor the actual GPs. While it is always unacceptable to lay the blame at the door of individual GPs, I imagine some people fee very worried and scared. I know doctors work very hard but it’s important not to forget empathy for unwell, anxious and frightened patients. You’re a doctor and you see these things day in and day out but, for some people, it’s legitimately just awful.

digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/august-2021# I know I keep coming back to this. It doesn’t explain why some practices aren’t as accessible as others but it gives an overview of workload. I hope the document opens for you. I saw it on my desktop but it won’t do on my old mobile.

Our gps are only doing phone appointment. If you need to be seen face to face they wi contact you

@JinglingHellsBells
Yes, many surgeries open at that time (but not all). Many also have late appointments up until 8 p.m. That doesn’t mean all the GPs are there for 12 hours a day (although some are at least some of the time).

I don’t think it’s particularly helpful comparing teachers to GPs (it takes 10 years to train as a GP) and I can’t speak for all teachers, but my nephew is a primary school teacher. I know for a fact (because I’ve asked him) that he doesn’t work 12 hour days, doesn’t work weekends, and works for a couple of days at the beginning of the Christmas and Easter holidays, and week at the beginning of the summer holidays. He is, by all accounts, a very good teacher and has been teaching for nearly 20 years. It is, though a very stressful job, as he has to be ‘on’ the whole time he’s teaching.

In any event, I think it is very unreasonable to expect anyone to work for 12 hours a day, whether a GP, a teacher, or anyone else.

@Rizzoli123

Our gps are only doing phone appointment. If you need to be seen face to face they wi contact you

Then they aren’t only doing phone appointments, are they? They are seeing people f2f when needed.

God I am so sick of all this GP bashing and I’m not even a GP!

I do, however, work at a GP surgery. I have worked right through the pandemic and can promise you our GPs NEVER stopped seeing patients. We switched to initial phone triage because we were told to by the Government. Damn right the doors were closed to casual walk-ins who didn’t have appointments. Reception is usually full of vulnerable patients - it would have been just great if someone with Covid came in and gave them all Covid. Ditto if the GPs had just gone ahead with seeing everyone as usual and they caught Covid and all went off sick for weeks (as well as possibly infecting the 30 or so patients they each saw every day) - who’d look after the patients then?

We’ve also had to vaccinate all our patients twice. I really don’t want to spend my Saturdays and Sundays in a freezing cold community centre inputting vaccination details on the computer, but I do it because, well someone has to. We’re now starting the flu and third Covid jabs. Our local Covid vaccination centre won’t be opening up this time, so we’ve got to do the lot.

Yes, the NHS is broken, but it’s not because of the GPs. It’s throughout the service. Just try getting one of the consultant’s secretaries to ring you back when you’re chasing up a referral if you aren’t lucky enough
to catch them when they’re in. I’m not knocking them, they’re under the same pressure as everyone else. About 10% of the calls to NHS 111 seem to be about dental problems - GPs cannot deal with dental stuff. They’re not trained nor insured to do so.

One of our GPs is leaving soon. They can’t find a replacement. I wonder why?

Luminousnose. well said and thank you. I don't work in a gp surgery or for the NHS but can't understand the gp bashing both here and else where in the media. there aren't enough gps as they are retiring and they aren't being replaced - so there will be a shortage of gps

this government reduced the numbers of training places, just remember that when you can't get to se a gp or get an appointment

Well said Luminousnose. And then people whinge that we got paid for the Covid vaccination programme How the fuck do they expect us to pay the staff for the 10 months of vaccine clinics (so far), running 7 days a week on top of usual duties, plus pay for premises etc and all the admin without any money?

@Egghead68

I have no problems getting e-consults, which work well for me.

I understand people’s frustration but I wish they would stop GP-bashing. GPs are doing their best in very difficult circumstances.

E-consults and phone calls are just not appropriate for many problems. A doctor needs to see you close up, touch you and sometimes even smell you. People pay taxes and have a right to a proper appointment with their GP. And by difficult circumstances, do you mean Covid? Covid is worldwide, but doctors aren't refusing to see patients in other countries.

"But if 75% of the calls can be sorted with a triage call"

Do you mean that 75% of patients are not being seen or even getting a phone appointment??

@Milkbottlelegs

used to go to the Pharmacy in the first instance instead, even for my son - which was esp helpful when I had a uti and was given 3 days of antibiotics

If the pharmacist was able to help you why do you think you needed to see a GP? A GP shouldn’t be the first port of call for absolutely everything. Pharmacists are great and should be used a lot more when appropriate so do.

People keep saying this but it's not true. Pharmacists can't give anything more than the most basic advice. I've tried several times and whenever a question is even slightly complicated it's 'ask your GP'.

"Many also have late appointments up until 8 p.m. "

Many? Really??? What percentage?

"Then they aren’t only doing phone appointments, are they? They are seeing people f2f when needed."

What if they decide that you don't deserve a face to face appointment when you want one? Not right is it.

Compla

Complaining about how bust that are and blocking their phone lines.

Most GP work for 4 days a week 3 hrs in the morning, afternoon for home visits then 2 and a half in the evening. I worked with GPS for years so know exactly what they do obviously you get exceptions but they are few and far between. Their interest is mainly focused on things that bring in money, so please don’t feel sorry for them.