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.

[quote ohfourfoxache]@Dhcfisssifjrsnxfjds I suspect it is your exposure to the realities of the NHS that are sadly lacking. It shows.[/quote]
Pretty poor argument.

@Cbtb

“All these stories about how hard GPs are working is no different to other professionals who work even longer hours in high pressure high stakes roles, where the work never ends and the demands never let up. That is the reality of professional life. Why do GPs think they are exempt? Clinics should provide a minimum number of appointments monthly with a fixed maximum percentage of virtual appointments, and answer calls within a fixed period of time, or public funding should be withdrawn.”

All the data shows that more GP consults than ever are happening. I think many GPs would be happy to have a contracted max amount of clinic apts like the above because the current issue is that there is unlimited demand. People just seem not to get that there are no appointments because they are all taken up by other people not because they are not being offered. It’s exactly like the petrol - the same amount of service being offered but demand going up causes a shortage.

I think the answering phone calls within a set amount of time is a bit hard because if you want all calls answered within 1min for example and most calls take 3min and the average GP surgery has 1-2 incoming calls per min then back of a napkin says you need 6 people just for answering the phones and there’s no way enough staff for that (there is also a crisis in reception staff supply)

It’s not hard 4hrs session at 10 min apts is 24 patients and then an hr of admin. So one dr can see 24 patients per half day or 48per full day (that’s a 10hr working day with no break btw). Home vists are done on top. If 60 patients call wanting an appointment what can be done? Usually some amount of phone triage and then the truly urgent 5 or so are squeezed in and a home visit meaning a 12hr day BUT there are still 5 or so upset patients that haven’t been seen.

The only fix is more doctors because asking the current ones to work more hours will result in even more of them quitting. Cutting appointment time is not going to be tolerated. The only fix is to hire more doctors. The catch 22 is that people don’t want to be GPs because it’s shit right now. Yes pay is ok but conditions are so poor that no one wants to do it.

This

And of course that number of appts is only possible if each is actually 10 mins! By the time that elderly lady has got her zimmer to the clinic room, sat down, taken her coat off and exchanged pleasantries, the slot is half over. Then she might have an issue which will need referrals to several agencies plus a blood test to organise and a prescription. And perhaps she's caring for her husband at home with dementia, and could do with a bit of a moan and some sympathy. When she's out of the door, GP has to complete the journal entry, as well as wipe clean the door handles and chair and any equipment used. Take a breath and see next patient.

Phone/video consults have been a revelation in that all of the appointment time is spent in actually talking to the patient. People complain that it's impersonal but most of our GPs report higher patient satisfaction, mostly because it's done from their own home, meaning their often more relaxed and honest about their symptoms/lifestyles/other factors.

@Koph

What taxpayer payments to their training? It costs over £230k to train a doctor. Only part of it is paid by the student. It's a fact that many GPs are contracted LTFT. I do understand why this is and I'm not knocking GPs for it. My friend went part time at 55 and still works as many hours as many in a 9 to 5 job. I still don't think that a newly qualified doctor should be allowed to work outside the NHS or part time. There are other professions who work long hours. People think teachers only work 9 to 3.30 but in fact there are very few teachers who don't spend every evening, much of the weekend and a large proportion of holidays working. For a lot less money.

Missed appts should have a penalty fee like the dentist although I've read previously that this would cost more in admin. There needs to be some accountability for repeat offenders though
A modest fixed fee for consultation (free for low incomes) would be a disincentive to waste time but is politically unthinkable.

The vast majority of newly qualified doctors work full time as to be a part time trainee you need to be eligible for health or caring reasons. There are some other reasons but much harder to be accepted on a programme with them. If you introduced a day 5 year full time return service you would penalise graduate entry medical trainees and women as let’s face it they are the ones who tend to take on more when it comes to raising children. A 5 year full time return to service would get you to a GP finishing training if they went straight through with no time out of programme. That won’t give you anymore full time GPs. So if you make it 10 years to get passed their training and some return service the person would be at a minimum of 33, if they went to medical school at 18 and did a standard 5 year course, many would be older. It would put some women off the profession and we could miss out on having some great doctors as a result. Medical school places have been increased but we are still struggling to recruit people into GP training. Making the speciality less attractive by bringing in a part time working ban isn’t going to help.

My GP is wonderful including the reception team. Before I moved house, things were quite different.

I've always appreciated and felt sorry for the pressures GPs and their staff are under but the receptionists at the old place were plain nasty. The complete power trip dragon stereotype (apologies to actual real dragons).

We were always polite and friendly. In return we'd get surly scowls, coupled with a very bad attitude. We noticed they were always much ruder to the politer patients. They did experience some aggresive patients - and that is unacceptable. But equally not ok, is that they took out their frustrations on innocent parties.

Hada not any time soon? Our waiting room is heaving. Clinics are rammed. Have been for ages?

The note in our surgery says that the government has mandated that they only do face to face if they deem it medically necessary

My previous surgery would do triage and telephone before covid

There are too few GPs , bottom line.

GP is such a difficult, stressful job. They are ridiculously understaffed and under funded. For comparable professions they are underpaid which is another reason why no one wants to be a GP now, along with all the bad press they get.
Soon there will be no GPS left! I certainly don’t blame them for working part time, for starters the majority are female and have to juggle work and family commitments.
It’s pretty obvious the government want to privatise general practice and are constantly feeding negative stories to the press and social media towards this end.

@cptartapp

Hada not any time soon? Our waiting room is heaving. Clinics are rammed. Have been for ages?

Our waiting room has had all but a few chairs removed.

Talking with others around the country I have noticed wildly different levels of services available which probably explains the discourse when it’s discussed.

I had to make an appointment to use the blood pressure machine last week. Waited over a week for that and similar wait time for blood test.

My practice is a large health centre in London.

Clearly things are not the same everywhere.

Current medical issue I have had a phone call with a gp with another one due when the blood test results come in.

I have no privacy at home and have to discuss the issue quietly.

It’s not on really.

@PeachesPumpkin

GP is such a difficult, stressful job. They are ridiculously understaffed and under funded. For comparable professions they are underpaid which is another reason why no one wants to be a GP now, along with all the bad press they get. Soon there will be no GPS left! I certainly don’t blame them for working part time, for starters the majority are female and have to juggle work and family commitments. It’s pretty obvious the government want to privatise general practice and are constantly feeding negative stories to the press and social media towards this end.

Yes agree with this.

@HadaVerde

Current medical issue I have had a phone call with a gp with another one due when the blood test results come in.

I have no privacy at home and have to discuss the issue quietly.

It’s not on really.

Could you stand outside or sit in the car (if you have one)? A friend of mine wasn't able to talk due to being in an abusive relationship at beginning of covid and drs allowed her to come in. Must be really difficult. Hope you find a solution.

Who has introduced this system of ringing in the morning?

The receptionist has wasted time telling people to call back tomorrow. She'll do the same again tomorrow numerous time. Is this a good use of her time?

It's all very well GPs having answerphone messages telling people to be nice to the receptionist but when you are unwell and getting 'no appointments today' every day they people are going to start getting unreasonable.

@Dhcfisssifjrsnxfjds

@ OttilieStonelady the rest of the professional world copes.

What a silly thing to say - lots of couples end up with one person working part time, many jobs have hours not compatible with available childcare and salary needs to be at the upper end to afford a nanny. Some professionals presumably have relatives on hand to help. You cannot get paid childcare for 60 hours a week.

@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.

Hog wash.

GPs have seen a 3 fold increase in requests for appointments with no additional staff or funding.

Hiya
No car and going outside alone not feasible due to caring responsibilities.

I have to take the GP's call at work - zero privacy so have stood outside to do it, not ideal but better than no appointment.
I don't understand the phoning back thing either - dh tried to make an appt today, told to phone at lunch each day as no appointments. He'd be happy with one next week, just wants something fixed that doesn't involve waiting on hold at a set time for days.

Much like hospital referrals and operations and A&E waiting times the public are experts on the poor service in GP surgeries too. Anyone that works in a surgery or indeed the NHS seem to be lazy and paid too much. The reality is the public is clueless, I would thoroughly enjoy seeing a mandatory few weeks in each setting for people so they have a taste. You never know they might be the ones to think of something that no one before has to improve it.

@HadaVerde

Hiya No car and going outside alone not feasible due to caring responsibilities.

So if you went into the surgery what would you need to do about your caring responsibilities?

We need to start looking at co payment. Just like other countries in Europe. Otherwise things arent going to change at all. Throwing money into the money pit that is the NHS is not going to fix things if it is still 100% free to people.

A PP said that the elderly lady might want some sympathy and a bit of a moan but honestly. There is no time for this now. I dare to say we need to become more ruthless if we want to avoid charging.

I handed a couple of boxes of chocolates into my practice last week - they have been nothing but brilliant, and I’ve never had an unreasonable wait for an appointment, pre or post lockdown.

@Koph

Most GPs do 12 hour days. So their three days a week is what most people do as “full time” hours.

People such as you make me furious! I am a hospital junior doctor training to be a consultant, if Gp was so easy and well paid do you not think I’d do that instead? It’s a terrible job, that’s why it’s the least competitive of all the specialties. And people such as yourself online slating the profession is only putting more junior doctors off pursuing this as a career.

I don’t want a minimum service term. With interest my loan will be £150k plus when paid back. I got too A levels, worked hard for 6 years at uni whilst friends started earning years before me. I easily do 55 hours a week including exams, portfolio and unpaid overtime. I have patients spit at me, work all night some shifts and have to make life and death decisions. This is a job most people could not do even if they wanted to do. I move around a huge region for jobs in different hospitals with no say. We already pay our dues!

People who voted conservative, well done. But most doctors are resigned to the end of the nhs without a serious shift in government policy and the funding to train more doctors.

@ Mummyford - well if it was serious professional work you would be agreeing with me.

@eeyore228

Much like hospital referrals and operations and A&E waiting times the public are experts on the poor service in GP surgeries too. Anyone that works in a surgery or indeed the NHS seem to be lazy and paid too much. The reality is the public is clueless, I would thoroughly enjoy seeing a mandatory few weeks in each setting for people so they have a taste. You never know they might be the ones to think of something that no one before has to improve it.

This is the thing, I can sympathise with constraints placed on the NHS etc by this government but two things;

My practice is run by a private company.

I don’t need to know the ins and outs of what it’s like to work in a gp surgery/nhs to be able to recognise that as a service user i am getting a bad service.

Telling people who can’t get a drs appointment that they are clueless is ridiculous really.

What do you suggest we do?

@ Tailendofsummer you certainly can. Do you seriously think all professional couples have one person taking a back seat, or have family nearby? All of us get by meshing together various sources of children along with unpredictable hours, frequent travel and constant unexpected ‘drop everything’ demands. I think MN represents only a very limited cross section of society.

@Koph just a follow up to another of your points.

Full time as a doctor is more than full time. Most cannot drop to LTFT without a reason. The thing is doctors aren’t making it to end of consultant training or becoming a GP. Because the workload is untenable.

They’re introducing LTFT for many specialties now as trainees are leaving. We are human beings and do not deserve to be slated for not wanting to work 55 hours a week in an incredibly demanding and stressful job.

I would love love love for you to come with me on a hospital night shift and tell me you could hack it too.

I’m not going LTFT as I want to finish my training and have kids. But I have friends who can and will leave if made to continue this level of work. Get some empathy. Doctors cannot pour from an empty cup. We have lives too.