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?

Also my BIL is a GP and is more burnt out and busy now then he's ever seen

Hospitals are overwhelmed so they are passing lots more work to GPs now

Speaking as someone who works in a hospital, this is not what we feel is happening. Or only in cases where the patient has presented via A&E with a primary care issue, because they were unable to see their GP (based on their report).

@Travelledtheworld

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 ?

It's also because a higher % of women go into to General Practice and then also choose to work part time when they have families - none of the GPs at my surgery (that's across the entire group of 7 practices) work full time

Impossible to see GP here. You are extremely lucky to even get a phone call.

I have to tell the receptionist all about my health issues (mental health which I'd rather not got into them with) and then often I've just had a 1 line text back from the doctor. I think once I got a call back.

And its like Chinese whispers between the receptionist and GP, so much miscommunication I've often had to ring up again to explain the situation yet again to yet another receptionist.

Eventually managed to get a referral to NHS psychiatrist but that's been 1 appointment in 1 year. They lost my referral and then forgot to tell me I had an appointment so I missed it.

GP has been beyond useless and clearly knows very little about medication beyond SSRIs and he has massively mis-managed and misjudged my situation even prior to covid. The psychiatrist even rolled his eyes at my GP's suggested treatment.

I don't have much sympathy for GP when he is getting to do a 3 day week in his 40's on a high salary with more or less guaranteed job security. Yes GPs are busy, but lots of overtime in professional jobs at these salaries is more often than not the norm.

@Travelledtheworld

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 agree. My dd is planning to do medicine but the significant extra debt that she'll be taking on in order to do it is very daunting. At the very least, they should make it so that medical students don't incur any more debt than the average student on a 3 year degree. It must put some people off, I'm sure.

Clearly they are sitting drinking coffee

Repeat after me: Appointments up, GP numbers down

“In September 2015, there were 28,100 fully qualified FTE GPs in England. In June 2021, there were 27,700, a 1.3% decrease. In February 2019, there were 25 million general practice appointments in England. In July 2021, there were 28 million, a 12% increase.”

To answer your question OP, GPs are working harder than they ever have before, but by all means please do start another GP bashing thread from a point of profound indignant ignorance where you have failed to consider that your own personal experience might be an example of the widespread national system failure of primary care.
As other posters have pointed out the fault of this lies in the decisions made by politicians who have a clear agenda to defund primary care to a point where is is so spectacularly unfit for purpose that the general public will joyously welcome in private healthcare.

Or are you a Tory bot paid to start these sorts of threads to fan the flames? 🤔

They are doing bugger all.

@tiggerwhocamefortea most GPS I know work 12 hours day. Who wants to go out to work before their kids are up and be home to just put them to bed 5 days a week. I know someone who is GP and her salary is less than the cost of her childcare.

My GP has been fantastic and this thread with all its GP bashing has encouraged me to write and thank them for the service they provide.

It’s beyond belief that people think GPs are having an easy time of it. That’s not to say of course that not all GP surgeries are well managed however funding is at the route of this problem.

but let’s blame the GPs for the Tories’ slow destruction and complete mismanagement of the NHS.

@Travelledtheworld

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 ?

The issue isn't getting medical students, there are plenty of people training to become doctors, it's just none are becoming GPs. As I said upthread there is now a £20k grant for any doctor who joins a GP partnership but so far I have only dealt with two new doctors who have taken this up.

I’m a GP.

Deep breath.

I see or speak to between 40 and 50 patients a day as do all my colleagues. That’s before I’ve signed all the repeat prescriptions and sick notes, answered queries and actioned letters from secondary care or liaised with other teams about complex and palliative patients in the community. The reason it’s difficult to get an appointment is that we’re overwhelmed. My life would be vastly easier if I went back to full face to face and said I was full when the appointments were filled- but that would mean there were fewer appointments. I’ve actually increased my capacity by finding different ways for people to access our service but we can only do so much.

Many parts if the nhs are still working remotely and they ask us to do the things then can’t do in clinic or for which the patient would rather not travel to the hospital. I speak to patients every day who would not be speaking to me if their outpatient appointment wasn’t so delayed or their operation cancelled. They can’t get what they really need so they speak to me instead. That’s not the hospitals’ fault either- there’s a huge backlog and no way to manage it, but direct points of contact to the NHS are GPs or A+E- so those are the services patients access.

And now we’ve got flu jabs and covid boosters to do as well as an earlier than usual virus season which kept us busy in our usual catch up time over summer.

I have never worked harder. Have you any idea how soul destroying it is to read this sort of thing every single day whether it’s newspaper headlines or social media? I have worked throughout the pandemic. I’ve seen sick people with only a paper mask and a bin bag pinny. I looked after swathes of elderly dying in care homes in the first wave. I deal with complex physical and mental health problems on a daily basis. My own mental health has suffered. So many of my decisions over the last 18 months have put my patients first and myself and my family second. But yeah, lazy.

It doesn’t matter how many times you’ve used the nhs, how much tax you’ve paid or if you only see a GP once in a blue moon. We can’t magic up capacity from nowhere (try as we might). And speaking of what is fair, do you know what I think is unfair? The fact that every single time the government ask GPs to do something, we get our heads together and we do it. Even though it often results in a pay cut for us. Even though we spend hours of our own time figuring out how to implement it (vaccination programme anyone?) And at the end of it everyone always just says we’re lazy and shit.

I’m sorry, but the nhs is screwed. You can listen to Boris and his lot who say it’s business as usual but it’s not. 18 months of cancelled operations and outpatient appointments can’t be made up, the whole system is gridlocked. It’s kinda nice to believe it’s just because greedy, lazy GPs are doing nothing and it’s all be fine if they just pulled their fingers out but I’m afraid the reality is much scarier than that. You’ll never hear a politician tell you that this is a huge systemic issue for which GP access is simply a symptom at the end of years of underfunding with a pandemic to finish it off. No, they’ll just tell me to see more patients and cut my pay.

The usual. The Goverment has caused the problem and managed to get the public to blame the poor sods trying to work in a broken system. Not enough GPS. And the work is so hard . Having to see and treat a patient in six minutes, and then have that patient be unpleasant.

Our GP service has been great. There's an urgent same day service which I've used for the kids before. Otherwise you can either do an econsult for minor things and a pharmacist or nurse specialist will ring back within a day. If they think you need to see a GP then they book you in. You can also ring and book through receptionist but that often means being on hold for 20 mins as they're run off their feet. I've been seem for post partem issues, mental health appointment and have never had to wait. I think they're under huge pressure. Maybe some surgeries are more innovative with how they deal with the increased demand. But there's no doubt they're swamped and doctors are leaving the profession in droves.

@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.

This.

I don't think people appreciate how many people are seeing the doctor atm. The fall-out from Covid infections has been huge! 1.7% of the population have Long Covid according to the ONS. On top of the usual autumn/ winter increase in ailments.

Our GP has been excellent. DD is a heavy service user because she has many medical conditions and I can't fault our GP surgery.

I've also seen an impact on the private health sector as it can't cope with the overflow from the NHS. We see 3 private consultants for DD because the NHS doesn't treat her conditions. The waiting times for follow up appointments has increased from a couple of weeks to 3 months.

Our GP surgery are not outright refusing face to face appointments, but they've cut right down on them. We have to go through an online consultation first, which is followed up by either a phonecall or an email from the GP. So for example I did the online triage last year when I was first suffering from a frozen shoulder, and was then asked to come in to the practice so that the GP could assess me physically. However when I've done consultations recently for things like menopause advise, asthma etc, they've just been followed up with a phone call. They will see people F2F if it's truly necessary, but to be honest I prefer this system as it's so much more convenient than our previous system where you either a) phoned up for an appointment, probably at least 10 days away, or b) on 2 set days a week, queued up outside for at least an hour before opening doors, then sat and waited for up to another 2-3 hours to be seen.

My GP has been brilliant - econsults work really well and actually much more practical for me than going in to surgery to see someone f2f, although that option is always there if needed. Fully recognize that for people who can't access the internet or need a face to face appointment it's more difficult but our surgery has worked so hard to meet these needs as well. I honestly think they are doing an incredible job in really challenging situations. Thank you to any GP staff reading this.

DH has brittle asthma and high BP. He keeps himself as fit as he can by running but he needed to see his GP recently for a change to his heart rhythm. Couldn't get through for days, couldn't use the online booking system because it wasn't working, receptionist told him someone would ring him some time during the day to ask him about his symptoms and then would decide whether to refer that on to a GP who would then make a decision whether to ring DH for a phone appointment only. It took all week to get that far. The GP eventually agreed to ring DH some time after 1pm one day. The call came at 7.30pm. Clearly he had been busy all day and had only just got round to making calls but, even so, a very frustrating experience for DH and he still hasn't been able to see anyone in person. The surgery has a big sign telling people they must not enter unless they have an in person appointment. You can't even drop off repeat prescription requests to the outdoor letterbox anymore. Everything must be done online and, if you don't have access to online services then it's too bad.

The surgery I go to is small, the phones are always answered, you can speak to receptionists, and get a call back from a nurse or GP same day. I needed to see a doctor last week and was given a same day appointment.

@yearsSinceISawYou what an offensive inaccurate load of bollocks said by someone with a huge chip on their shoulder. Do you even KNOW any doctors and spoken to them about what they're dealing with??! Doubt it. The demand for appointments has gone up 30% and theyre dealing with a back log of people who left medical conditions unchecked throughout the pandemic. They're understaffed working extra hours. Unless you work in a surgery or have spoken to many doctors about what they're dealing with then you are just completely ignorant.

The GP service where I am has been brilliant, in fact better than pre pandemic. Usually you'd wait 2 weeks for a face to face appt, now you get a call back the same day which I find is fine for most stuff and if you need to see the GP/nurse face to face then you will.

It’s absolutely fine where we live. They’ve been brilliant through the pandemic and have been easy to get appointments with. I’ve never struggled to get a face to face appointment either.

@TheYearOfSmallThings

Hospitals are overwhelmed so they are passing lots more work to GPs now

Speaking as someone who works in a hospital, this is not what we feel is happening. Or only in cases where the patient has presented via A&E with a primary care issue, because they were unable to see their GP (based on their report).

A few years ago I would have had a consultant letter saying “I saw this patient etc etc, I’m going to arrange tests ABC and will see them in the clinic in 3 months with the results” Now I get “I saw this patient etc etc, please can you arrange tests ABC and follow up the patient with the results, then refer back to me if the problems persist”.

Tests ABC are often tests GPs don’t have access to, so we have to write back to explain.
Or we arrange the tests and speak to the patient, all of which takes time.
Or we get the results but they are abnormal and we have to refer the patient back etc.

Hospitals are up against it too, and are no doubt under pressure to minimise outpatient follow ups unless strictly necessary, hence passing it on to the GP.

It’s been going on for a while but has shot up since Covid hit.

Ime and that of friends and family in other areas if you need to be seen you will be. Any new bleeding, lumps, breathlessness, acute pain, signs of infection etc will get a f2f.

Some people use their GPs for general ongoing aches, pains and long winded therapy sessions which can be managed by econsults or self care and otc meds.