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?

Where I live in the past few years their have been 1000 or more new houses built with more still to come. Yet no investment has come for the GP services and so what was already stretched is now even more stretched even without adding in the extra problems that come with dealing with things post pandemic.

I think a balance between virtual and face to face is a good step forward. Not everything does need to see a GP in person and yes that should always be an option but it doesn’t need to be default. Ds had a chest infection a few weeks back, his history and notes all show this is normal for him, that we know what antibiotic works and that I am confident dealing with it from home and know when it does need hospital. Telephone appointment let me discuss the symptoms in an hour agree on a course of action and meds on their way. Much more efficient

I’m lucky in that the care provided by our practice has been fine. What annoys me however is that emergency measure brought in during the crisis appear to have become the norm due to long term structural issues. There is no attempt to think of more creative solutions, plan medium / long term etc. This is obviously not just down to individual gps and their practices (although gps are not powerless) and requires a collective approach supported by a government (and medical profession) committed to health care free at the point of consumption.

Hmm well I avoid the gp as much as possible now after constant misdiagnoses. I have reoccurring tonsilitus I know which by now what is viral and what one is bacterial and needs antibiotics. Thanks to one gp at the surgery I go to he said it was viral, it wasn't and so refused to give me antibiotics. Well that turned into laryngitis and then pharyngitis and it took 3 courses of antibiotics back to back over 6 weeks yo get better. My stomach was wrecked from the antibiotics. It scarred my tonsils now I suffer tonsil stones. All completely avoidable!

I complained of not normal pain down below when I went to toilet mostly and also sometimes back pain and bleeding for 3 weeks a time every 2 weeks. Male gp fobbing me off saying I was adjusting to the pill and nothing was wrong with me. I've taken the pill before and how my body reacts to it and I know my normal cycle and know what period my pain is and what isn't. He sat there insisting the pill was the reason and i should come off but I had to force him to send me for a scan and it turns out I have 3 fibroid one is large and at the back hence back pain and after my results come I insisted on a female gp who actually gave me correct information and said to stay on the pill cos it'll help.

So I avoid the gp now cos rarely do I meet one who actually listens and isn't dismissive.

@Longdistance

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?

This is the government's way of 'helping' the worsening situation, since 2019 all GP practices now need to be part of a Primary Care Network. Part of this is that you can be seen by other healthcare professionals employed by the network where possible to take the pressure of GPs.

I do think the triage with the GP on the phone before getting an appointment is taking up a lot of their time. Therefore reducing the time they have for face to face.

Pre-Covid if I called up the doctor and said 'I think my 2 year old has an ear infection' they'd just book an appointment because common sense says they need to look in her ear. But now they throw an extra 10 minute phone call into the mix before giving me an appointment.

Since Covid I've between me, DC, and DH we've had around 5 appointments for various things. All of them have been a 10 minutes phone call and a 10minute appointment. When previously they would have been one or the other and only taken 10 minutes rather than 20.

I can’t complain about my GP practice…

DS has had a persistent chesty cough for 3 weeks, tested negative twice but can’t shake the cough and has started wheezing

I phoned the GP at 9am yesterday, I had missed the available face to face appointments so had a telephone consult at midday
The doc had sent a prescription to our local chemist which was ready to collect by 1:30

The doc said he has never seen so many ill children as they’ve dealt with since the start of September and half the calls and appointments are for under 10s with breathing difficulties of some sort. Lower lobe pneumonia is the worst they’ve ever seen it, it sounds like they are working flat out

@Longdistance

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?

Working their arse off because there aren’t enough of them to start with and now they’re seeing more patients every day with no where to refer people on to.

So (and this has been going on far longer than the last couple of years), the government response to the long term shortage, is to come up with different roles in primary care so that the GPs can deal with people who need a GP as opposed to people who’s needs can be met with other healthcare practitioners with specific training and experience.

@CayrolBaaaskin

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.

The OP post isn't about the disorganised or nonsensical structure. It's about 'what are GPs doing'. And the answer is working f*ck hard and they're tired of being accused of otherwise. They would probably welcome a thread that was constructive and discussed ways it could be done better by those who pull the strings in how General Practice is run. But this thread is not that.

My own GP has been a bit rubbish, but it has got marginally better lately.

My parents however, a couple of hundred miles away ... Well I've no words left really.

Elderly and vulnerable people who can't navigate the fierce gatekeeping, who can't 'just go online' who struggle with the telephone. Who don't usually "bother the doctor".

Presumably they can just fuck off and die.

Well I'm working harder than I ever have.
I'm in work already, I've been up with the baby all night and had 2 hours 22 minutes sleep according to my Fitbit.
I'm exhausted but yet I'm here.
Our patients have a choice of face to face or telephone consult, no doubt we'll be fully booked with extras by 10am but we can't magic appointments out of thin air.
We're all doing our best but the demand is huge.
I'm so close to burning out I can't even put into words how bad things are.
So when that eventually happens and I go off sick there'll be one less GP and the wait for an appointment will be even worse.

Mine are working as normal, during the height of the pandemic, the surgery delivered prescriptions to my house (pill so not life threatening stuff) and I’ve been seeing them face to face since last summer not regularly but when needed. Husband has had a face to face to enquire about a vasectomy and daughter went for a rash.

I had a bad experience 2 weeks ago but couldn't tell you if that was down to the GP or the receptionist not passing the info on. I am pregnant, when this happened I was 22 weeks. I called my surgery at 10am with symptoms of a water infection and dropped a sample off within the hour. At 3pm the symptoms had gotten worse to the point where I couldn't stand up so I called back and spoke to the receptionist who said she was waiting for a doctor to check my results. By 5pm I called again crying down the phone, pain was unbearable and I was now throwing up. I finally got a call back (not from the GP but from the same receptionist) to say I had a UTI and a prescription had been sent to the chemist. I finally took it at 6.30pm when DH had collected it for me.
I couldn't keep the antibiotics down, and was up all night in severe pain. At 8pm there was now blood in my urine, and at 4am I considered calling an ambulance. The next morning I went straight to a+e as I suspected a kidney infection and based on the farce from the day before had no confidence in my GP. I was correct, it was a kidney infection and if I had had my antibiotics earlier it likely wouldn't have spread to my kidneys. A+E also said that when I called the surgery for the second time or even the third time they should've asked me for another sample then, which would've shown the infection had spread to my kidneys and I could've had the right antibiotics to start with. Like I say though I have no idea if that was down to the GP or if the receptionist didn't actually pass the info on.
I actually ended up back at A+E 5 nights ago as the symptoms had returned and I was adamant I needed new antibiotics to nip the UTI in the bud before it again turned into a kidney infection.
A+E is not the right place for a UTI but due to the failings by my GP surgery I would have no hesitation in going there again if I had to. The system is broken.

OP, I find it difficult to believe this is the first time you've heard that the system is at fault. You've clearly done nothing except read the daily Mail headline before bashing your keyboard on here.

GPs (and dentists) warned the government a long time ago that the system couldn't cope. They have continued to warn them. The government haven't listened and instead have relied on people like you to believe their blame shifting.

Write to your MP instead of perpetuating the issue by getting your capital letters on and blaming the individual.

And id just like to add, that I am an A&E doctor and;

• yes we are seeing patients who 2 years ago would probably have been seen by their GP
• yes we are busier than normal as a result of the general practice crisis

But I would never swap with the GPs right now. They are carrying a far bigger workload and more stress on their shoulders.

Please recognise that this is a general practice crisis and not GPs not working hard enough.

@worrybutterfly

I do think the triage with the GP on the phone before getting an appointment is taking up a lot of their time. Therefore reducing the time they have for face to face.

Pre-Covid if I called up the doctor and said 'I think my 2 year old has an ear infection' they'd just book an appointment because common sense says they need to look in her ear. But now they throw an extra 10 minute phone call into the mix before giving me an appointment.

Since Covid I've between me, DC, and DH we've had around 5 appointments for various things. All of them have been a 10 minutes phone call and a 10minute appointment. When previously they would have been one or the other and only taken 10 minutes rather than 20.

But if 75% of the calls can be sorted with a triage call then overall that will be more time effective for the practise, especially when you factor in the extra cleaning etc needed between patients.

[quote Plotato]@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?[/quote]
@Plotato I agree. I have no issue with reassuring parents. It's one of our roles. The hospital was saying more likely to get unecessary investigation if goes to hospital.

@Longdistance

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?

Seeing the more complex chronic stuff

I think the shortage of gps might be to do with the fact the health service plan to train a certain number of doctors based on previous scenarios.
This is not working out because there are more women than men being accepted for training. The fact is they didn’t take into account that many women choose to work part time.
There will be a time lapse until this anomaly is rectified.
I hope they are now training more doctors as they realise this is happening.

Of course there are other issues too, but this issue is glaringly obvious and easy to sort out.

I had the paramedic too. Specifically asked for a GP second time round as the paramedic’s advice had not helped and was told no GPs available. Mine was a more complex issue and I’m now seeing a specialist. What training and experience do paramedics have compared to GPs?

My elderly mum is waiting for triple bypass surgery and can’t see a GP for 10 days. She’s so worried

@CayrolBaaaskin

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.

We are training more doctors but few are going into GP and we are sending the more minor ailments to pharmacists and opticians because opticians have more training in eyes than us and pharmacists can manage minor ailments. GPs are now dealing with much more complex conditions. This was always going to be the case. Our Scottish government wouldn't give funding for more GPs as they said there weren't any so they said they would give us physios and nurses and CPNs so we could deal with the harder stuff that wasn't now going to hospital as much. This has been coming through since before COVID.

I believe that if the GPs can't do their job, they should have a 50 percent pay cut. It's ridiculous. Everyone else is back to work, what makes them so special?

@GetDrunkWithMe

I believe that if the GPs can't do their job, they should have a 50 percent pay cut. It's ridiculous. Everyone else is back to work, what makes them so special?

Can only assume you're joking about 'not working' so have a

As a family we have needed a doctor a number of times in the last few months - all were a phone call first and then 90% resulted in a face to face appointment the same day. Do I think the phone calls for some things are a waste of time, yes. But overall I have only praises for my practice

Well my GP is working his arse off. I had a Covid related breathing issue, got a call back from him at 8pm the same night (and I know he’d had morning surgery) and fitted me in between clients first thing the next morning in the car park to check my O2 sats and chest and prescribe accordingly