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?

"When I trained, we had a large number of students from Hong Kong, who emigrated to America after qualifying."

So lots of med school places that are charged at ££££ for intl students are going to people who don't end up working in this country.

Can unis reduce the number of international applicant places at med school? So many want to study medicine but can't as there aren't enough places.

Our GPs have been operating normally all through the pandemic. Plenty of phone consultations, but they'll see you if necessary. We've had routine bloods done and everything.

Some GPs are managing to provide a decent service.

I genuinely don't understand how the GPs on this thread have the time to be on a chat forum! Sure, you aren't all working full time. But the people I know who are at a similar level (educationally and responsibility) in other fields, and on £100K a year simply do not have time to browse forums even on their days off.
They tend to work 12 hour days as a norm and in their free time are catching up on chores.

One of the often trotted out bits of rubbish pre referendum was that "you couldn't get a Drs appointment due to all the immigrants" but that was a lie and funnily enough the situation is getting worse.
you do realise how many immigrants legal and otherwise are entering this country each week - the population is growing without the attendant growth in infrastructure. Nothing to do with Brexit.

The pent up demand, combined with the increasing population and part-time GPs has created a perfect storm of supply not equalling demand.

Added to which the powers that be have created a primary care system that insists on triaging by email/phone and video your problem which does not come easily to everyone who needs help.
How can a confused older person define their problem by e-consult - the Dr needs to ask the right questions to make sure the full story is known.
How can a 95 year old (even if they can send an email ) who lives alone take video/picture of a suspicious rash/lump or sore throat. Added to which - this generation does not want to bother the Dr - so continues to suffer.

My friend is a GP and it sounds like a very stressful job at the moment. She said basically that lots of people put off seeing their GP during the pandemic and are now booking appointments so they’re overwhelmed.

Put off seeing their GP???
Do you remember what it was like at the height of the pandemic? You couldn’t get near a GP, and the inference was that you were a social pariah, if you dared to take up your GPs time with other ailments when there was a global pandemic to deal with. (Despite GP practices not having anything to do with anyone with Covid or CV symptoms, if mine was anything to go by).

I’m sure that many individual GPs are
buckling under the strain, and working all hours to get through their
untenable workload, but don’t blame patients for having done what they were told in no uncertain terms to do, which was to steer clear of the NHS, so as not to overwhelm it. Remember?

GPs are useless, and should not be paid at all. Honesty if clap for carers ever comes back I'm doing it with a sign tha says "not for GPs". Really think they should all by made to work unpaid in A&E - they are the busy ones because GPs are all so selfish.
I've not had a proper appointment since the start of the pandemic - I was supposed to have a six week check up after a very difficult labour, involving stitches (surely these need to be checked no?), and it was by PHONE.
My then 7 mo DD had various symptoms. Got a tel appt (that was hard enough), and was told she needed to be seen by Dr, but they couldn't possibly do any work, and so should take her to A&E. Spent 7 hours there and SHE PICKED UP ANOTHER INFECTION. Wouldn't have happened if GP had been prepared to see her

I think it depends on your Gp surgery. I’ve had plenty of appointments recently, although mostly routine ones like baby vaccinations etc I’ve not had a problem getting through (at least not compared to pre-pandemic phone waiting times) and the receptionists are always friendly. When I go in there are always plenty of people waiting to be seen in person and the reception is clearly busier that normal. They have opened up an extra section of the building to allow for social distancing (it’s a tiny building) so really it seems they are doing all they can considering more people need the NHS than ever but I they have the same resources as before.

I appreciate that if you had a crap surgery before, and there are some crap ones, then they are likely worse than ever.

But there is also a Daily Mail led hysteria at the moment about gp appointments which I don’t think really helps the situation and has increased threatening behaviour towards staff.

Most surgeries are in small buildings and unless they all get an expensive rebuild they need to keep up social distancing which may mean having less people in the building. They can’t ignore social distancing like the rest of us as medical professionals they are aware of how serious it is and have a duty of care.

I really hope ops mother is able to get an appointment soon (ring for her yourself if necessary) but equally, if none of this was in place, would you be happy if your mother was sat next to someone who had no symptoms of Covid in the waiting room and became seriously ill?

Best of luck

@JinglingHellsBells

I genuinely don't understand how the GPs on this thread have the time to be on a chat forum! Sure, you aren't all working full time. But the people I know who are at a similar level (educationally and responsibility) in other fields, and on £100K a year simply do not have time to browse forums even on their days off. They tend to work 12 hour days as a norm and in their free time are catching up on chores.

Nah didn't you know everyone on MN earns £100k a year so that can't be true

GPs are currently providing approximately 1 million appointments per day in England (BMA data).

Please blame the system, the government - not the GPs themselves.

I’ve given up and gone private. I’ve had severe psoriasis since I was 15 and spent almost a year during covid waiting for a referral to be given a cream that I’ve used in the past and it doesn’t work.

10 minutes with a private consultant and given tablets that cleared it up in 3 weeks.

Since then I pay £40 a month for health insurance and put £100 away a month for any consults not covered by that we may need. I’m not rolling in it by any means, but I can’t deal with the NHS any longer.

If any GPs are reading, can you explain why the telephone system for appts is so non-patient-friendly?

It is totally unacceptable to have to wait within a 3 hour (or longer) window for a call. (It implies GPs don't think patients work, drive, have other things going on in their lives.)

Taking a call needs to be in a quiet and confidential setting and how are patients supposed to keep half a day free for that?

I've used private health care and calls are blocked into the dr's daily schedule. They give you a time and it is always fulfilled within a 10 minute window.

Why do GPs not create specific times in their day for phone appts rather than just slotting them into everything else they are doing?

We have an excellent service from our GP surgery in North Wales.

@JinglingHellsBells
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?

So you think the poster should be at the surgery working at 7 am? And what time would you allow them to finish work and go home? Midnight? Ffs.

Just to add I'm a doctor working in A&E, so we do see a lot of patients who have come in because they have struggled to get a GP appointment. I don't deny that in some practices/areas that access is an issue, but it's not the fault of the individual doctors or even practice management. It's the huge discrepancy between supply and demand.

I don’t know what is happening at other GP surgeries, but my GP is excellent. I’ve had to see them a few times for different things since the start of the pandemic. Never once have I not been able to get an appointment. Last year I started developing visual migraines for the first time in my life. Called surgery at 2pm, got a call back from GP at 3.30pm, was in his office being examined by 4.15pm and was undergoing a neurology consultant referral less than 2 weeks later.

Another time I had chest pains, called at 8.30, GP called me back at 8.50.

This week, I called at 8pm, face to face appointment at 3pm. I cannot fault them at all.

I know that most are now operating a telephone triage intially, but this is not a bad thing. I used to hate waiting in a packed doctors surgery full of people coughing and spluttering. My GP has throughout the pandemic, seen patients face to face if needed.

@ErgonomicallyUnsound

"When I trained, we had a large number of students from Hong Kong, who emigrated to America after qualifying."

So lots of med school places that are charged at ££££ for intl students are going to people who don't end up working in this country.

Can unis reduce the number of international applicant places at med school? So many want to study medicine but can't as there aren't enough places.

Ned schools need the income that international students bring - the fees are much, much higher. And the government also wants international students - because the government then doesn’t need to provide them loans via student finance. I know a few British-born doctors who qualified in the last few years. About half have gone abroad to work within a couple of years of finishing training.

My grandparent recently died due to misdiagnosis over the phone so I am furious. The illness would’ve been perfectly treatable if they had received help straight away. Instead they were left to fester until they were ambulance worthy.

@Kettletoaster

I don’t know what is happening at other GP surgeries, but my GP is excellent. I’ve had to see them a few times for different things since the start of the pandemic. Never once have I not been able to get an appointment. Last year I started developing visual migraines for the first time in my life. Called surgery at 2pm, got a call back from GP at 3.30pm, was in his office being examined by 4.15pm and was undergoing a neurology consultant referral less than 2 weeks later.

Another time I had chest pains, called at 8.30, GP called me back at 8.50.

This week, I called at 8pm, face to face appointment at 3pm. I cannot fault them at all.

I know that most are now operating a telephone triage intially, but this is not a bad thing. I used to hate waiting in a packed doctors surgery full of people coughing and spluttering. My GP has throughout the pandemic, seen patients face to face if needed.

Do you mind telling us all which practice this is? I'd like to register there!

Great service here at my practice in Cornwall, and my parents' down the road. Two in one town doing a great job. My parents are housebound and I can easily get visits for them.
I am happy with phone or online triage and on the two occasions where I've needed to be seen I've been called in.
Our hospital and caring provision is crap, mind - don't get old or acutely ill in Cornwall

@bubblepond

Just to add I'm a doctor working in A&E, so we do see a lot of patients who have come in because they have struggled to get a GP appointment. I don't deny that in some practices/areas that access is an issue, but it's not the fault of the individual doctors or even practice management. It's the huge discrepancy between supply and demand.

You are the true heroes. Shame on GPs for putting you under so much pressure.

Yeah this is awful, and you should have had your postnatal check in person. But when you say they don’t do any work, how can you be sure that didn’t already have 7 or 8 other mothers and babies who had managed to get through before you who were already booked into their face to face appointments that day. GPs need more resources but the gov doesn’t want to stump up which is why they are putting the blame back on the GPs and it’s working because now everyone hates GPs.

Sorry to hear your baby was sick

@Ostryga

I’ve given up and gone private. I’ve had severe psoriasis since I was 15 and spent almost a year during covid waiting for a referral to be given a cream that I’ve used in the past and it doesn’t work.

10 minutes with a private consultant and given tablets that cleared it up in 3 weeks.

Since then I pay £40 a month for health insurance and put £100 away a month for any consults not covered by that we may need. I’m not rolling in it by any means, but I can’t deal with the NHS any longer.

This is what we did years ago to be honest. My insurance covers 6 private GP visits a year and I pay for any extra.

I’m currently going though the same health diagnosis as one of dh colleagues. Only I’ve been diagnosed by a consultant and will be operated on in the space of 6 weeks.

She’s got another 4 month wait to even see a consultant, and had to speak to the GP several times before her symptoms were believed and she was finally referred to the hospital. That in itself took months.

I didn’t even need to see a GP for a referral, I was just fast tracked to a consultant by the insurance company.

We aren’t well off by any means. We just don’t do things that other people do like takeaways or new clothes to pay for the insurance. It’s worth it’s weight in gold these days.

@Luminousnose Most GP surgeries open at 8am and some even have appts from 7.30am for 'commuters'.

So yes, I don't see how a GP has time to be on a forum at the start of a day when most professionals are getting ready for work or preparing for the working day, if they are only here to say how hard they all all working.

Teachers who also work hard have to be at school often before 8am for breakfast club etc and they are paid £30K a year for 12 hour days if you include the time they spend on prep etc.

@TataMamma for clarity I am also a GP trainee!
I definitely don't agree with this sentiment as per my previous posts. We shouldn't be blaming the individual GPs.