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?

I agree OP. What are they doing?? Three weeks for a call back regarding pain management. A form to fill in instead of an asthma review, filled in, returned by hand through their letterbox then a stroppy letter saying I'm overdue an asthma review. Phoned to book a (phone) appointment for that, again, in three weeks time then a call to say the asthma nurse is busy that day and they need to rebook my appointment...in three weeks time.

They are booked out, and seeing the people they can, in order of clinical priority, whatever you think.

Our GP practice has been fantastic since Covid. They do phone appointments and then ask those they need to see person to come in.

I had a phone ask this morning and am going in in a couple of hours time.

With ours it is definitely better to request a phone appointment online than to call and ask for one. There seems to be one nice receptionist and one awful one!

I haven’t had any issues at all. Whenever I need my gp I call in the morning and get a video consult the same day, if they want to see me they usually call me in later the same day or the following morning.

However, I’ve been waiting for an appointment to see if a lump on my head is normal at the hospital for 4 months so far.

You have completely miss understood the doctor’s comments. He said there are too many sick people for GP surgeries to see them all which is why some patients end up in A&E. If they are driven out of their profession by an angry mob then the situation will only get worse.

The rest of the NHS is not firing on all cylinders believe me, my department has exactly half the staff we had before covid because they have all left, we've had to cut services so drastically things our department has done for 40 years are no longer available even to high risk patients and it's a 6 month wait for an urgent MRI scan.

@Ostryga do you mind me asking what the tablets are called? My friend has quite bad psoriasis and has used creams, light treatment along with numerous other OTC treatments, none of which do much good. She would be willing to go private.

I waited only two days for an urgent MRI scan.

Ours is a rural surgery with over 6k patients. 4 GP's but all are part time which is why it's so hard to see anyone. The lead GP works mainly in OOH at the local hospital; the one in our village has his own medical practice doing HGV medicals and insurance injury claims. The 2 female GP's are both mothers with young families. Which leaves one locum or registrar on duty to deal with daily patients - it's simply not enough, and they've openly admitted that they can't recruit due to the shortage of GP's. It doesn't help that the villages served have had around 1000 more homes added in the last 10 years but the surgery isn't any bigger. And they also took on all the students from the local Agricultural college, so in term time it's even harder to see anyone.

I'm now 2 years on from my last diabetic medication review, and I keep getting really high blood sugar readings in the morning...... I've tried 6 times to get an appointment and failed. Private GP's won't deal with ongoing medical conditions, so until I have a crisis of some kind, I'm screwed. It's very frightening, to be honest, and I don't know how people with cancer/life limiting conditions are managing

If they are driven out of their profession by an angry mob then the situation will only get worse.

No angry mob, just a lot of scared people wondering what the implications of a broken healthcare system are for us all.

@YearsSinceISawYou

In answer to your question: GPs are doing the bare minimum while drawing £100,000 a year.

There was no problem getting an appointment before the pandemic and now there is. What has changed?

They can get away with it, so they do, Over the years, they have done less and less-less evening appointments, weekend appointments and no home visits. Many of them retire early because they are on fat pensions.

Anyone who says otherwise has a skin in the game as the rest of us know we can't get an appointment and, if you do manage to get into the surgery to see a nurse-not a GP-the barriers and one way systems are stupid.

To conclude: lazy, over paid bastards-too thick or lazy to specialise-and now see a chance for doing less.

That's it.

You’re either ill informed or deliberately ignorant, there are too many ways that this post is wrong to even know where to start. Reading around the issues and talking to people who actually have the correct information, rather than just believing what you see on your local Facebook group would be a start.

There is a co-ordinated attack on GPs at the moment. People are saying they are useless, not seeing people, wasting time. Not sure where it is coming from but the media seem to be playing a part in it.

GPs are busy because people are using them. You can’t get an appointment because there aren’t enough to go round. GPs have been chronically understaffed and underfunded for a long time. The problem has been coming for years, with more GPs retiring than training. In 2018 the BMJ reported on the issue, saying there would be a problem within 5 years, and here we are. More are retiring early because of the pressures of the job. With the number of people having a go at them on here, I can only imagine what they are facing from patients.

The impact of Covid on NHS services, especially with referrals is a real problem. Previously a GP could refer a patient and that was that. Now that referrals are taking a long time, more are returning to the GP to manage their conditions. I have a family member with some pretty serious gynae issues which are causing her real problems. Her “urgent” referral is apparently going to take 12 weeks. She’s already had 3 appointments with the GP and a trip to A&E to deal with the symptoms.

Instead of bashing GPs, perhaps try and understand the problems. Nobody is blaming HGV drivers for shortages, why blame GPs when their circumstances are very similar.

I have had three telephone and one in person appointments with my G.P. ( you can't fit a coil by Zoom!). DH has had one face to face appointment about a poorly ear. We are in the South West and our GPs seem to be coping quite well at the moment. I don't mind a phone appointment if it helps them and will work with the condition but I wish the could give you a better approximation of time on these.

There was no problem getting an appointment before the pandemic and now there is. What has changed?

Some people have really short memories. Not being able to get a GP appointment was the kind of argument made for Brexit.

The system is so badly underfunded that anyone that can pay is. I guess this was the Tories plan all along.

My 84 yr old mum this year used a large chunk of her life savings (£15,000) on a hip replacement as she was in agony and the waiting list for NHS was so long she'd be dead by the time it was done. She got it done within a month by paying.

My GP has been brilliant however reading some of these responses wouldn't it be easier for GP's to go back to normal F2F practice?

I know video consults are good for triage and I get that, but as said by an above poster they had a triage call by a GP, then a video consult, then a F2F. How much extra time was spent taking these extra steps when one F2F appointment would have sorted the issue in the standard 10 minutes of days gone by?

Isn't it 2-3 times the workload for the same outcome or a less desirable outcome than just seeing the GP like we used to initially?

@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.

If all the people you know are on 100k surely you don’t have the time to be on Mumsnet bragging about how many people you know who are on 100k

GPs have things like: maternity leave, annual holiday etc If they want to spend it on Mumsnet defending themselves against muppets that’s their prerogative!

the one in our village has his own medical practice doing HGV medicals and insurance injury claims

Nice dig.

Someone has to provide these services.

@BoredZelda
Accept there are problems with underfunding and other matters, but: it is a fact that before Covid people could mostly get face to face appointments and now it is impossible because GPs prefer not to. That is the point, even if there are long term issues at stake, Covid has been a cop-out where they now don't see patients at all, ever.

@TaRaLa No, I’m saying I have a rash I’m worried about on my 6 month old, and I would like to see a GP to talk about it, after I’ve spoken to a health visitor and pharmacist, but instead I’m given a phone appointment in 3 weeks time. Not sure how a GP can inspect the rash over the phone…

@Bagamoyo1

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.

This is interesting. Thank you @Bagamoyo1 - it really does illustrate what is going on.

@NotPersephone

Pleasantly surprised to bump into mine yesterday! She was doing a Botox clinic in my hair salon on one of the 3 days a week she doesn't work.

It's an absolute bloody disgrace. The lack of insight or empathy from GP's is the most disturbing thing of all.

Are you allowed time off work or do the general public get to dictate what you do when you’re not at work?

In our area the problem is the receptionists. You can get a call back and send a pic if the gp permits it but there's literally no face to face.
I know someone who was going for flu jab appointment this week and because the carer couldn't wear a mask due to the patients neurological disability the receptionist would not permit them to enter the empty waiting room, yet this carer and patient were permitted for flu jab last year and they were permitted in hospital last week. It just makes no sense especially as the receptionist is in no contact with patients and is more at risk in the supermarket and visiting family.

@Eeiliethya
Agreed. Surely even a receptionist can be trained into understanding that a sick baby needs to be SEEN by the Dr and so a tel appt is just delaying matters and wasting everyones time.