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?

Direct your anger at the government and not the already oversubscribed GP surgeries.

There is a nationwide shortage of GP’s and the constant bashing and hatred of them isn’t going to help.

Contact your local MP and complain about funding, complain about la j of GP’s just don’t complain about the GP’s you already have, they are there until really late most nights.

You want an NHS then fight for it in stead of moaning. Stop voting Tory who just want to run in it into the ground and force you all into private healthcare.

My GP uses e-consult, it's great. Usually get a reply with reassurance/prescription the same day.

If you need to be seen and it's not urgent the situation isn't ideal, but health demand and compexity has soared and it's just another demand on an already depleted and demoralised workforce.

I have nothing but absolute praise for my surgery. My son has been very unwell this last week - got 2 telephone appointments the same day I rang up, both times was told to head straight to the surgery to be examined, resulting in an emergency hospital admission for a couple of nights. I cannot fault my surgery at all but appreciate I may be lucky.

In the last 3 weeks I have had 3 same day appointments with my GP over the phone. I’ve been really impressed with the service, and I could hear her little children in the background, so some are clearly working from home and others are seeing patients face to face

@POSITIVETHOUGHTSS

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.

I'm sorry that sounds awful 🌻 I hope you get a bit more sleep tonight and things improve.

the OP mentions that her mum has difficulty at 84 years old and lives alone. That is the nub of the problem - it is all very well MN talking about videos, e-consults and phone calls - many many people of all ages struggle with those things and often live alone with no-one to help.

Just because your GP sees you and you can handle the new normal does not mean THAT EVERYONE CAN.

My great aunt is nearly 100. Has been quite with it and active until about a month ago when she had a mini stroke, followed by another a fortnight later. She's not in a good way after the 2nd, but was OK after the first and made it clear that she wants to stay at home and just go, rather than go into hospital for interventions and medication,. With limited visiting etc. GP knows this, hasn't seen her once. She's obviously bed bound. No one has been out to see her. Because covid.

Same here. I had a new lump in my leg diagnosed as ‘nothing to worry about’ over the phone with the use of a photo.
No physical examination. I didn’t see anyone in person.

It’s a bit shit really.

@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.

That's not entirely true

My GP joined a consortium of 6 others. Moved the telephone to a call centre which clearly doesn't have enough lines or staff - they refuse to turn back on online booking for appointments as we had pre covid. The telephone lines have a maximum of 50 callers who can queue at anyone time - the wait time IF you can get in the queue is regularly 90 minutes but 90% of the time you get a message saying the queue is at capacity and call again later. If you do get through they won't book further than 2 weeks in advance and tell you to call back when the diary next opens.

NONE of that is government policy or caused by government that is purely greedy GP surgery owners

Before Covid it was a nightmare even getting through to the receptionist then a battle to get an appointment.
Since Covid you ring up and dr calls you back that day . If the Dr thinks they need to see you face to face they book you an appointment that day.
The couple of times I’ve had to speak to a dr has been hrt related so I didn’t need to see someone face to face but I have family members that they have had a call then seen the same day .
Personally I hope they never go back to the system they used before as this is much more efficient.

There is a shortage of GPs. More leaving due to government and public bashing. Huge increase in work load due to online service due to government insistence. It's all very political.

@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.

Agree with this - it is a narrative being pushed by the Conservative Government so they can push ahead with privatising NHS (even further) with money being made hand over fist by big business mates of theirs.

@bunnybuggs

the OP mentions that her mum has difficulty at 84 years old and lives alone. That is the nub of the problem - it is all very well MN talking about videos, e-consults and phone calls - many many people of all ages struggle with those things and often live alone with no-one to help. Just because your GP sees you and you can handle the new normal does not mean THAT EVERYONE CAN.

The OP has asked generally what GPs are doing. People have answered from their own experience.

E-consult will help 84 year olds, as it will reduce the waiting times phoning reception and booked appointments in the practice.

In my area the GP surgery staff are doing the 12-15 Covid vaccinations.

@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.

But you have time to post on a forum at 7am?

Surely this proves the OP's point?

In the last year my GP has treated me for one serious and one not so serious illness, both of which have involved consultant appointments and hospital admission, which was arranged quickly and efficiently. I’ve had both telephone and face to face consultations, and my two first Covid jabs. I consider this excellent service and realise I’ve to some extent been lucky. Yes, it takes longer in the phone and yes, attendance at the surgery involves stringent protocols, but that’s not surprising. I suspect there are many more GP surgeries like mine than otherwise, and wish they were all like mine (I live in a semi-rural area with pockets of both wealth and considerable poverty, so it’s not just the area or demographic).

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.

I had a request for a hospital ordered face to face appointment. Receptionist refused. I received a phone appointment and I was happy with it. What annoys me is the receptionist insists on knowing what is wrong and then someone else decides if you'll get a call. Though this seemed to happen before covid but it was whether you'd get an actual appointment or not of course and someone non medically qualified would decide. Other times straight to appointment time. .

I’m on annual leave today.

My local surgery is brilliant and I am very grateful to the practice nurses and the GPs.
BUT what I don't understand is the seeming lack of planning for the future. If we have such a shortage of GP's, why are Med students still having to pay £9,000 per year in university tuition fees? Are there any bursaries/support grants for students from lower income families ?

I’ve had several GP appointments, both by phone and face to face. It’s actually easier to get an appointment now than pre-pandemic. If the dr needs to see you, that now happens the same day or within a few days. I’ve also had hospital appointments very quickly.

@Bagamoyo1

I’m on annual leave today.

Even if you weren't, god forbid you have time to post on a forum BEFORE you start your paid day. sometimes you have to laugh at the things people come out with.

I always get an app the same day I ring. It's a telephone app then they'll see me the same day if they need to which they normally do. Really really lucky

Interestingly on my local Facebook page, there has been a load of ranting about the fact that the local GP surgery is not doing the Covid boosters. They did all the categories of vaccines in the first round, but have opted out of the boosters as they need to catch up on normal services (or appts for illnesses and chronic disease management). Patients have to travel 7 miles to a vaccine centre.
There’s an outcry! People are furious that the doctors and nurses aren’t spending all their time vaccinating! Honestly, we really can’t win.

I don't dispute GPs work work hard etc it's the "gatekeepers" to the GPs that are the problem - usually the practice owners to be honest who restrict access via call centres etc

Why not turn back on online booking? I was even told to take a photo of my breast lump and text it?!

There is outrage in my area over what's going on - the consortium of my GPs out right lied that call centre wait times were 9 minutes when thousands of their patients don't get through in less than 90