So sorry for NHS staff

[6demandingchildren]

Tried calling my GP practice this morning to get a telephone appointment, Mondays is the worst time to call as you can never get through but I was lucky only this time I was met with a different welcome message, it basically said that its not the receptionists fault if their are no available appointments and please do not take your frustrations out on the staff.
Anyway once the receptionist answered (this was around 10am) all the appointments for the day had gone and she asked what was wrong, I have only got pins and needles in my face so nothing major and she advised me to call back tomorrow morning or phone 111.
No wonder these poor people are so stressed out.

[Cbtb]

And some more
18. Still having to covid clean - say one min wipe down and change ppe between patients - after 10 patients that’s a whole apt gone for cleaning
19. The army outsourceing its Medical’s to a private company whose brilliant plan is to ask the GPs to do most of it……
20. DWP outsourcing its benefits Medical’s to a private company and wait for it their brilliant plan is to ask the Gp to do most of it….(for free)

[Dhcfisssifjrsnxfjds]

It seems to me very odd that GP surgeries administer the flu vaccine in anything other than the most remote locations. Why is this not being completely handled in pharmacies? There seems to be a persistent view in this country that a GP is a panacea for all medical/quasi-medical and social issues, rather than a medical professional you see for very specific reasons after self care, pharmacy has been tried. Absolutely a massive part of the problem is appointment blocking by people who really should not be seen by a GP. This also applies to A&E which is beyond a joke. There is something seriously wrong in the public mentality, and getting a handle on this could go some way to relieving the acute pressure on the system

[Cbtb]

21. Medication supply issues due to covid/brexit/pandemic/transport crisis/fuel crisis/worldwide glass shortage meaning multiple contacts from pharmacists to GPs asking for prescriptions to be changed (prescribing generic would help with some of this but for some meds that’s not clinical appropriate OR to save money the PCT/CCG have mandated a certain brand be prescribed)

[Dhcfisssifjrsnxfjds]

Agree that fines or pay to play is not really feasible given the administrative burden. But how else to incentivise people not to abuse this resource? In the places I have lived in the UK I have never seen weekend appointments but maybe if they are offered in the places of greatest pressure, employers will quite fairly expect employees to book appointments on weekend and there will be much less abuse of the system

[Cbtb]

“ It seems to me very odd that GP surgeries administer the flu vaccine in anything other than the most remote locations. Why is this not being completely handled in pharmacies?”

I am not an expert in this but I would guess:

1. Many pharmacies don’t have space to give vaccines
   
2. Many pharmacies don’t have enough trained staff to give vaccines (yes there is a pharmacist on site but if they are giving vaccines who is checking the meds)
   
3. Pharmacies give the vaccine but rely on the GPs telling the patients they need to go get it so GP still doing admin of checking record for who is eligible or suitable
   
4. Pharmacies give vaccine only to those that come in and request it - GP spend time chasing those that wouldn’t ask for it but really should have it
   
5. Pharmacies won’t give vaccine to children/people with allergies/housebound/people who are on off medications
   
6. Pharmacies give the vaccine but don’t have acsess to health record so send Gp a Paper!!!! Slip with the details of what is given and GP still has to do the admin of adding to the health record
   
7. There is a payment for flu vaccines given. It more than covers the cost of the switched on otherwise health adult with asthma who remembers to book it every year and turns up for their appointment. It doesn’t cover the cost of the vulnerable learning disabled adult who is scared of needles and thinks vaccines have microchips and needs transport to come for the vaccine and monitoring after. Pharmacies cream off the easy ones and make money. GPs are left with the difficult ones and operate at a loss. This would only work if pharmacies were responsible for ensuring all of their population receive vaccine not just those that ask for it.
   
8. I know you mentioned rural areas anyway but a lot of GPs are still dispensing (patient five miles from nearest pharmacy so GP gives out medications themselves) so this wouldn’t help them anyway

[Cbtb]

There seems to be a persistent view in this country that a GP is a panacea for all medical/quasi-medical and social issues, rather than a medical professional you see for very specific reasons after self care, pharmacy has been tried.

Totally agree. (And I think most health care professionals would as well)

[PattiPritell]

19. The army outsourceing its Medical’s to a private company whose brilliant plan is to ask the GPs to do most of it……
20. DWP outsourcing its benefits Medical’s to a private company and wait for it their brilliant plan is to ask the Gp to do most of it….(for free)

Maybe the GPs could say no I'm not doing that thanks.

[Cbtb]

Maybe the GPs could say no I'm not doing that thanks.

That has been tried. Results in patients not getting PIP and getting sick due to lack of care and food and heating etc.

GPs not doing hgv Medical’s to help out the dvla whose job it is is in part being blamed for causing the fuel crisis. Imagine the headlines if there were then no people in the army to solve that one for them.

Also refusing to do something causes the patients, their mother, the requesting service and their MP to call blocking the phone line and then to make a complaint which has to be answered taking even more time.

[TroysMammy]

@Cbtb in my area pharmacies don't just give flu jabs to people who request it. They actively text them, I had a text in August about booking one. They also pounce ask and book in people who come in for their meds. Then they can't get meds ready in time and deal with patients under the common ailments scheme because they are concentrating too much on flu jabs.

[Cbtb]

@TroysMammy that is an issue as well I agree - it was my second point! Still by grabbing the opportunistic vaccines they are grabbing the low hanging fruit - imagine the anger if there were even longer delays in GP appointments and phone answering if Gp surgery’s did that! Instead they set up Saturday clinics for vaccines that people don’t want to come to. Impossible to keep everyone happy with current staffing numbers

[TroysMammy]

@Cbtb it impacts on the surgery because people phone and complain that their meds aren't ready even though we gave the pharmacy the script 4 working days before. Or someone wants to see the Doctor because their child has worms and the pharmacy are too busy with flu jabs to assist under the common ailments scheme.

[AnneElliott]

There's definitely a shortage of GPs but they are also inefficient. I used to be a gP receptionist and our practise had outdated IT and phone system that the partners didn't want to invest in.

We also need a conversation about people that go to the Drs (and A&E) for no good reason. But it's the elderly and SAHMs in my experience. Working people generally don't come if they don't need to as they will get pressure from their manager.

But can we please not say all NHS people are brilliant or hard working. Anyone who's worked in the NHS like I have knows there are amazing people, lots of average people and some downright shit and dangerous people. Just like all other professions. We need a serious conversation about the NHS and how we fund it without either saying all NHS are angels and the US system is the only other option. But you can't have this conversation on MN - let alone in real life.

[TroysMammy]

The pharmacy pester us to see if scripts are ready because patients have gone to get their meds from them but guess what? We are busy booking in our patients for flu jabs alongside all the other work we are trying to do.

[Tealightsandd]

@AnneElliott

There's definitely a shortage of GPs but they are also inefficient. I used to be a gP receptionist and our practise had outdated IT and phone system that the partners didn't want to invest in.

We also need a conversation about people that go to the Drs (and A&E) for no good reason. But it's the elderly and SAHMs in my experience. Working people generally don't come if they don't need to as they will get pressure from their manager.

But can we please not say all NHS people are brilliant or hard working. Anyone who's worked in the NHS like I have knows there are amazing people, lots of average people and some downright shit and dangerous people. Just like all other professions. We need a serious conversation about the NHS and how we fund it without either saying all NHS are angels and the US system is the only other option. But you can't have this conversation on MN - let alone in real life.

This is a good post. I agree. It's true that, whilst many fantastic people are working in the NHS, some are crap. (It's not unique to the NHS of course. It happens in pretty much every organisation and business - private, public, and third sector.)

Personally I'd like to see a model similar to Germany or Scandinavia. Higher taxes, but you get your money's worth with a very good healthcare system.

About the people attending A&E or GPs apparently unnecessarily. Very often they do have a need for help. Sometimes clinical, sometimes something else. Mental health, isolation, domestic abuse, confusion and/or dementia. We need to take a more holistic approach to health and significantly improve linked services - mental health, social care, elderly and disability support including social inclusion, domestic abuse support, etc.

[pianolessons1]

@Dreamstate

This why next yr when the window opens up at work ill be signing up for private medical care. So I can actually see a gp when I need to since I'll be paying for it

Private health insurance generally doesn't cover GP

[Dhcfisssifjrsnxfjds]

Most health insurers do cover online GP services - doctor care anywhere, Babylon etc

[Petronius16]

Simply health does 24 hours GP cover.

[DamnUserName21]

@Cbtb

So why on earth do GP practices not tell people about them?
They should really. I know I did. Sometimes you got a load of abuse for it because people didn’t want to travel or didn’t want a weekend day and “I ain’t fing going all the way there on my day off” makes you unseen to offer again but we should as some people love them - I book at the Hub for my family’s own apts as they are nearer to my work and at better times for me.

Demand is through the roof. It’s multifactoral. Reasons I can think of:

1. Pandemic - it’s still going on and some people are still sick with acute and long covid
2. Aging population- much greater fragility and multi Mobutuy
3. Health anxiety triggered by the pandemic - everything needs “to be checked out to be safe”
4. Litigation fears - 111 etc advise people to see Dr as don’t want to be sued. Your gym advises you to see a dr before you join. Your beautician advises see a dr before a treatment.
5. Other services being cut - lack of health visitors and sure start and funding in schools for behavioural issues - backstop is a GP. Worried that little jimmy is being naughty in class - see your Gp
6. Backlog from covid. Hospitals asking GPs to go through all the referrals made since covid started and re refer in priority order
7. Blood bottle shortage - loads of tests delayed. GPs asked to go through all tests they have requested and decide which can be cancelled and then inform patient and then make a catch up plan
8. GPs having to plan how to give the flu jab while also being involved in the covid booster programme
9. Social care cuts - no respite care for carers equals increasing breakdowns in care needing hospital admissions etc and loads of GP time filling in forms for social services and trying to get a care package asap so Doris who has dementia and no family dosent starve this weekend or end up admitted to hospital where she will catch covid and die

10. Increasing poverty - need a food bank referral - see your GP (no idea why)
11. Complete breakdown in CAMHS services - two year wait for anorexia treatment - plan is for GP to see three times a week and do bloods and monitoring for teens so sick they should be in hospital
12. Still not return of spirometer testing as it’s an AGP - how to montor and diagnose copd/asthma etc
13. Healthcare staff still have to isolate if a covid contact (in most places) so continual lack of staff
14. Staffing crisis due to covid, low morale, brexit and the pensions mess (doctors pay so much into their pension pot they end up paying to go to work at a certain. Point- and before all the comments about gold plates pensions the doctors pension pot is one of the very few where the amount in the pot more than covers the pay outs)
15. Squeeze on household incomes means people can’t afford what they used to - so see Gp for prescription for kids calpol etc
16. So much beautocracy- your kid needs medication in school - needs a dr letter, your kid is off school - needs a dr letter.
17. Other departments of government being closed down - dvla shut and not processing Medical’s - solution GPs can do an energy authorisation for them to still drive (and theirs a driver shortage so they must do this now)

That’s just of the top of my head

Brilliant post @Cbtb

You must be a GP---why aren't you busy working??!!!

[mbosnz]

I've spoken to my GP a number of times as he's helped me contend with a mental health crisis.

Now I understand the apologies for phone only consults, the exhaustion in his voice, his apologies that he didn't work Tuesdays. . . poor sod.

[daffodils123]

@user2346421

???
Pins and needles in face doesn't sound great. Definitely call 111.

Important to note that GPs are basically private business funded by the NHS. The GPs decide their own pay, employ their own staff etc.

It isn't fair on the NHS to imply that GPs zero Covid policy and thus behind-doors behaviour is in any way reflective of the NHS proper, which is functioning normally. Especially shit in Emergency Departments of the proper NHS where all the patients who can't see their GPs properly end up going.
So yes, you really SHOULD feel sorry for the NHS, but not highly paid GPs.

Such BS & it's people like you who believe everything you read in the media that are part of the problem!

1. There is a massive shortage of GPs in the U.K.

1. The system is consistently abused by people getting appointments for frivolous things or getting appointments so they can get free paracetamol instead of buying it for £2.

1. People in Britain are SO entitled, are so rude to doctors and demand the best service while not recognising that there is a huge shortage and chronic lack of funding in certain areas

1. GPs are not that well paid based on their intelligence and the number of years they have had to study! Ridiculous to compare their salary to other jobs that just don't require anywhere near the same skillset.

1. Relatively rubbish pay, horrible conditions as the rude public and demanding government who throw GPs under the bus mean huge numbers are retiring early or leaving for other countries in droves!

[daffodils123]

@Maassi

GP's should be an ESSENTIAL 24hr service as I said previously. I didn't say an emergency service, you said that. Please read carefully

Why should GPs be a 24 hour service?

If you have w life threatening emergency then you should call 999 & go to A&E. most things that you see a GP for can wait a couple of days.

Shocking how entitled people in the U.K. - want workers especially in the public sector to be available 24/7 but to pay them peanuts relatively!

I can only be thankful I'm not a GP as I honestly don't think I would survive or like many do, I would leave the U.K.

Most the people who overuse the GP services get free prescriptions and take much more from the system than they pay in complain the MOST! People often talk about how much tax they pay but if you don't earn a high salary, chances you use a lot more than you contribute. It is often working and higher rate taxpayers who pay an arm and a leg in tax, but don't even have time to go to the GP.

[ohfourfoxache]

Re community pharmacies

The contracts would need to be amended to facilitate the provision of additional services. Not insurmountable by any means, but potentially costly

It was recently suggested that pharmacies could do routine BPs - which theoretically sounds great. Until it’s suggested that the tariff for this should be £15 per BP taken

So although it sounds hugely sensible, there are not the funds to do this when GPs provide this under an existing contract (CHD will give you the biggest number of “points” under QOF, checking BP is a key indicator - but I don’t think GPs get additional funding for non-CHD patients….suspect that this means GPs checking this “for free” - in which case, why pay pharmacies extra?)

[DamnUserName21]

@Cbtb -I had to repost your list on another GP bashing thread as I felt it was spot on.

[snazzynamechangetiming]

The thing is you are part time if you only work certain days. If you work somewhere else that doesn't make you full time at the job , it means you work multiple part time jobs. Your choice. I know my GP works Wednesday, but doesn't see patients, whether he gets paid for this or not, I don't know but the majority of people that don't clock in and out for their work will do extra stuff outside their hours. In fact I used to clock out of a job because the clocking machine was on the top floor and I had to lock up, which took 15 minutes. I couldn't clock out after as I'd have unlock everything again 😂

My GP is an arse and they get away with it because they are so important and in demand. Even worse, he's happy being an arse infront of trainees.

[Cbtb]

"The thing is you are part time if you only work certain days. If you work somewhere else that doesn't make you full time at the job, it means you work multiple part time jobs. Your choice. I know my GP works Wednesday, but dosent see patients."

Several things here.

I disagree that you are part time if you only work certain days. Or rather by this definition the vast majority of people are part time unless they work 7 days a week. If part time status depends on number of days worked would I be full time if i worked one hour per day every day? How about those Gps working nights...do they not count as there not working in the day time? For this reason full time is defined by the goverment in hours not days....its like the concept of shift work is just to hard for most people to get (yes Mr delivery driver i was not "having a nice lie in arent i lucky" when i answered the door in PJs at noon on a monday, id just got back from a 13hr shift overnight)

Your GP dosent see patients on Wednesdays but they are in work....maybe they are checking results, auditing prescriptions, writing letters and reports, attending meetings etc all this is work. Much more volume of work than seeing patients. I dont know what job you do but lets use a lawyer as a comparison, are they only at work when they are meeting clients? or maybe they are at work when they are writing reports etc also?

You say its multiple part time jobs if a person works in GP surgery on Mondays-Wednesdays, covid hot hub on Thursdays, teaching on Fridays and Saturday night in OOH co located at A and E....maybe it is maybe its not, as a trainee GP i do all of this and its all for the same employer with one payslip.....I am just not at your local surgery on all the days I am at work. Often it will be with different employers but ad GPs are independent businesses its more like they have different clients...all of these jobs are valid GP work. If your OOH service had no GPs you. would notice, same if no one was teaching the new GPs or providing care to the patients of your local nursing home or hospice.

Say you are a childminder and you care for child x on Monday and child B on tuesday and child c on wednesday and so on, you are a full time childminder but not to the same people every day. General Practitioner means that that person has a membership of the royal college of general practice and is on the "performers list" of that area. To work "full time" previously most people would have said you need to work as a GP for 10 sessions (thats 50 hours a week)but since that is over the wtd and frankly unsafe now I would say if you work 35 hours a week as a GP you are a full time GP, its quite easy to do that and work absolutley none of those hours 9-5 mon to fri.....