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?

Teachers are lazy, GPs are selfish, police officers are perverts…. Interestingly it’s often the people who slag off public sector workers who are also anti funding the public sector the money it needs to improve.

This is also useful:
journals.rcni.com/nursing-standard/evidence-and-practice/implementing-reasonable-adjustments-for-disabled-people-in-healthcare-services-ns.2019.e11172/full

Oh wow, really useful:

digital.nhs.uk/services/reasonable-adjustment-flag

Our GP practice seems to be functioning OK i.e. you can get a phone appointment if you call them first thing in the morning, face-to-face follow up if you really need it. I think most people would welcome the return of more face-to-face consultations though.

My elderly parents' practice, however, is just not providing a reasonable level of care. In the past few months, my 75 year old father (who has multiple myeloma, a heart condition and other significant problems) was denied an appointment until he was literally at the point of collapse and they had to blue light him to hospital. My 72 year old mother was also repeatedly denied an appointment for an infection and was eventually sent by 111 to A&E. She was sent home with some antibiotics and anti-inflammatories which could easily have prescribed by a GP. So I'm not sure who is getting prioritised but it doesn't appear to be either the elderly or those with serious conditions.

Yes, my poor old dad had similar. He died.

Service from my GPs has been great. Same day phone-call, prescription over the phone with a photo a couple of times, brought in on the same day for physical examination 2or 3 times in the last couple of years. All appointments for my children mind. Not sure whether it would be different if it were me.

Telephone appointments suit A LOT of busy people

Busy people haven't got time to spend the whole day sitting inside with a phone waiting for it to ring. And if you need to discuss a personal issue with your doctor (likely, given the context), you don't necessarily want to do it in an open-plan office, on the bus or queuing up at the Tesco check out. Nor are most employers likely to give you a day off work to wait for a call about something which doesn't itself require absence.

AppleCrumbleForBreakfast

Controversial but basically, the NHS is shit. They lost my MIL for over a week when she went in without COVID, but for cancer issues. Literally couldn't find where they'd put her!!! She was eventually found in a diabetic near coma, and had caught COVID. Went on to die from COVID in a shit nursing home.
Even before COVID every contact I've ever had with the NHS was shit, from telling me to 'just relax' when we struggled for years with fertility to ignoring my baby daughter who screamed solidly for 9 months due to extreme reflux and kept losing weight until they finally noticed she was failing to thrive, and I had PND. All shit“

Really so sorry to read that. I had fantastic cancer care. I guess it varies authority to authority. Which it shouldn’t, of course.
Condolences for your mother in law 💐

My GP rings me after hours when I say work an issue and is quite specific re time. Has done all the way through the pandemic. I think the use of more phone appointments is a big improvement but patients should always have the opportunity of a face to face if needs be. Our GP has been doing face to face all the way though and there hasn’t been anything I needed a face to face for that I didn’t get.

Service from my GPs has been great. Same day phone-call, prescription over the phone with a photo a couple of times, brought in on the same day for physical examination 2or 3 times in the last couple of years.

Ours is similar, it's usually a phone call or video call but occasionally they ask for the DC to come in (like when DS1 hurt his neck and she wanted to feel it).

@SoftSheen

Telephone appointments suit A LOT of busy people

Busy people haven't got time to spend the whole day sitting inside with a phone waiting for it to ring. And if you need to discuss a personal issue with your doctor (likely, given the context), you don't necessarily want to do it in an open-plan office, on the bus or queuing up at the Tesco check out. Nor are most employers likely to give you a day off work to wait for a call about something which doesn't itself require absence.

Not all telephone appointments require a person to sit by the phone all day. It really does vary practice to practice-smaller practices struggle more it seems but they have fewer doctors. If you read through--you'll find a lot of people prefer telephone consults as it suits them whereas some do not. As a patient, I personally prefer them but my practice gives me a telephone appointment window and is pretty good for sticking with it.

They have been working exactly the same they are doing online or phone consults as well as face to face where Necessary
Can we stop bashing everyone now ...

Insisting that patients can only make appointments over the phone, and undergoing telephone triage, before a face to face appointment, is not GP bashing, its a legitimate criticism by those sectors of the population, shut out by such a system - and if they can't access primary care, then they can't get referrals to secondary/tertiary care either, can they? This is an important issue for those people - possibly life or death?

In addition, GPs are IMO in breach of:

1. NHS Accessibility Standard
2. The Equality Act 2010

I can't drive home at 70 miles an hour through my town, and when I get stopped by the police, tell them I can break the law, because I'm too busy - when the consequences for other people are potentially so serious.

All, it takes IMO is to devise a paper form (also available on the website) as a reasonable adjustment for people like me, the elderly, disabled people, etc, which says

1. Name of patient
2. Date of birth (that gives a clue about children under 5 and the elderly)
3. Is there a reason, why you have difficulties, using the telephone to make appointments or for triage - please tick as appropriate

A) visual impairment
B) hearing impairment
C) speech and/or language impairment
D) learning disability
E) age
F) mental health problems
G) a full time carer
H) other - please specify

(After all, this stuff should be already there in the medical records, if anybody tried to cheat the system)

1. Please write a brief list of your symptoms

1. Signature of patient or their representative/carer

Then, this could be triaged in the same way as over the telephone - I would have thought it would take 5 minutes to read this, but it saves people, having to wait 35 - 55 minutes, while the receptionist triages 14 people before them?

I have some understanding of the law, but I am not a lawyer - surely the NHS could afford to run this past a lawyer to make sure the wording is not discriminatory?

My GP is appalling and clearly doesn’t give a damn about her patients. I pray that my family don’t get ill, as you’re treated like a massive inconvenience for daring to book an appointment.

@Intercity225

*They have been working exactly the same they are doing online or phone consults as well as face to face where Necessary Can we stop bashing everyone now ...*

Insisting that patients can only make appointments over the phone, and undergoing telephone triage, before a face to face appointment, is not GP bashing, its a legitimate criticism by those sectors of the population, shut out by such a system - and if they can't access primary care, then they can't get referrals to secondary/tertiary care either, can they? This is an important issue for those people - possibly life or death?

In addition, GPs are IMO in breach of:

1. NHS Accessibility Standard
2. The Equality Act 2010

I can't drive home at 70 miles an hour through my town, and when I get stopped by the police, tell them I can break the law, because I'm too busy - when the consequences for other people are potentially so serious.

All, it takes IMO is to devise a paper form (also available on the website) as a reasonable adjustment for people like me, the elderly, disabled people, etc, which says

1. Name of patient
2. Date of birth (that gives a clue about children under 5 and the elderly)
3. Is there a reason, why you have difficulties, using the telephone to make appointments or for triage - please tick as appropriate

A) visual impairment
B) hearing impairment
C) speech and/or language impairment
D) learning disability
E) age
F) mental health problems
G) a full time carer
H) other - please specify

(After all, this stuff should be already there in the medical records, if anybody tried to cheat the system)

1. Please write a brief list of your symptoms

1. Signature of patient or their representative/carer

Then, this could be triaged in the same way as over the telephone - I would have thought it would take 5 minutes to read this, but it saves people, having to wait 35 - 55 minutes, while the receptionist triages 14 people before them?

I have some understanding of the law, but I am not a lawyer - surely the NHS could afford to run this past a lawyer to make sure the wording is not discriminatory?

It's not about triage--it's about getting through on the phone. At my practice, you'd be flagged as requiring a F2F appointment always. The issue would be--the long phone wait. Is there an online booking system at your practice?

Mine have been great actually but the answer phone message suggests they have had to deal with a lot of abuse.

Often phone appointments but once she said can you pop down so I can see properly

Appointments are a week to 10 day's away yes but emergencies can be supported.

@Intercity225

*They have been working exactly the same they are doing online or phone consults as well as face to face where Necessary Can we stop bashing everyone now ...*

Insisting that patients can only make appointments over the phone, and undergoing telephone triage, before a face to face appointment, is not GP bashing, its a legitimate criticism by those sectors of the population, shut out by such a system - and if they can't access primary care, then they can't get referrals to secondary/tertiary care either, can they? This is an important issue for those people - possibly life or death?

In addition, GPs are IMO in breach of:

1. NHS Accessibility Standard
2. The Equality Act 2010

I can't drive home at 70 miles an hour through my town, and when I get stopped by the police, tell them I can break the law, because I'm too busy - when the consequences for other people are potentially so serious.

All, it takes IMO is to devise a paper form (also available on the website) as a reasonable adjustment for people like me, the elderly, disabled people, etc, which says

1. Name of patient
2. Date of birth (that gives a clue about children under 5 and the elderly)
3. Is there a reason, why you have difficulties, using the telephone to make appointments or for triage - please tick as appropriate

A) visual impairment
B) hearing impairment
C) speech and/or language impairment
D) learning disability
E) age
F) mental health problems
G) a full time carer
H) other - please specify

(After all, this stuff should be already there in the medical records, if anybody tried to cheat the system)

1. Please write a brief list of your symptoms

1. Signature of patient or their representative/carer

Then, this could be triaged in the same way as over the telephone - I would have thought it would take 5 minutes to read this, but it saves people, having to wait 35 - 55 minutes, while the receptionist triages 14 people before them?

I have some understanding of the law, but I am not a lawyer - surely the NHS could afford to run this past a lawyer to make sure the wording is not discriminatory?

I agree with this. Many GP surgeries are in breach of the Equality Act and, I think, the Autism Act, and hopefully the new scrutiny system will crack down on those which are breaking the law.

@Gwenhwyfar

"Just because YOU think it's inferior care, doesn't mean it is!"

To diagnose somebody you need to see them, touch them and in some cases smell them so yes, if you don't get to do this, it's not proper care.

Have you thought perhaps that many many gp appointments don't involve a new diagnosis, but are about ongoing care?

peasoup8

My GP is appalling and clearly doesn’t give a damn about her patients. I pray that my family don’t get ill, as you’re treated like a massive inconvenience for daring to book an appointment.“

Why do you suppose she spent years learning and train RG? Fortune and glory?

"Have you thought perhaps that many many gp appointments don't involve a new diagnosis, but are about ongoing care?"

Yes, I have thought about that. So what? My point is that phone appointments, even video calls aren't always appropriate and it seems that the patient doesn't get a choice.

No, there isn't an online booking system for appointments at our practice. I wouldn't have complained, if there were.

The only way to get through to them is by hanging on in a telephone queue for between 35 - 55 minutes; or even worse, being told the system can't cope with any more callers and being cut off.

@Intercity225

No, there isn't an online booking system for appointments at our practice. I wouldn't have complained, if there were.

The only way to get through to them is by hanging on in a telephone queue for between 35 - 55 minutes; or even worse, being told the system can't cope with any more callers and being cut off.

Our surgery has implemented. System where you fill in a form for an appointment and then it's sent to the appropriate person.

For me this has worked well as the appointment was for my autistic son with depression. I wanted a referral for a MH assessment.

What they did was transfer it straight to a MH worker who phoned and did a MH assessment including adjusting medication.

Obviously this type of system won't work for everyone but it makes sense for patients to see the right person which might not necessarily be a GP.

I do not know why more surgeries are not offering a messaging and triage service like this as it would mean people don't don't have to hang on the telephone for silly amounts of time .

Had a very lengthy (telephone!) chat with my GP very late last night.

He explained that his practice has been putting out adverts on every media possible (true, I’ve seen them) for permanent GP’s and they simply can’t get them for love nor money. Direct quote: “We’re doing everything we can to get bums on seats”.

All GP’s want now are short 6 month contracts as apparently they earn more by going for that option. My GP said his practice won’t entertain that idea because they want their partners and staff to build relationships and get to know their patients.

I, for one, believe what he says. Can’t fault him or his place of work. I have multiple chronic illnesses and am under several clinics and hospitals over a few counties and rely on good communication.

He’s got a 9 year old child and hasn’t spent a day with her in 7 weeks due to being committed to his work.