This is why A&E is overwhelmed

[PackedintheUK]

And it's nothing to do with over anxious patients seeking "unnecessary" medical care.

I have a very sore very swollen ankle as a result of an insect bite. I've asked advice at the pharmacy and been told it looks nasty, see your GP, you probably need antibiotics.

So I've tried. I've been calling GP surgery all morning and finally got through to have receptionist incredulously say "you want to see a doctor for a gnat bite?" and then be told the next appointment is 16 Nov.

Me: but pharmacist said I need seeing urgently.
Receptionist: All the emergency appointments are gone for today. You'll have to call back tomorrow.
Me: but I've been calling all morning, won't the same thing happen tomorrow?
Receptionist: Well I can't do anything about that, if you're that worried go to A&E

So,I'm not sure that I am "that" worried, but I have been told by someone better qualified than me that I should be seen. We lost a colleague to sepis this year, a fit young woman and it happened incredibly quickly, plus I have a friend currently in hospital on intravenous antibiotics from a very similar looking bite he got at the same park.

I also don't actually feel that well.My body aches and feels heavy and I'm a bit queasy, which could be coincidence or my imagination.

Probably/hopefully it is nothing that won't heal itself in a few days but it feels irresponsible not to take the advice I've been given. Also to go to A&E

So A&E for something that could (probably) have been dealt with in a matter of seconds in a GP (telephone/video?) appointment?

There's no walk in or minor injuries here.

@Malibuismysecrethome

To the above poster, 4 years is not a lot to have worked full-time, especially after training.

The length of time someone works full time is all relative. Due to length of training (6 years at uni for me) I didn't start working until I was 25. After 4-6 years of working many female doctors are thinking about starting a family, after which full time work can become unsustainable. I don't feel that we should have to justify going less than full time (still 40+ hours per week!)

I read recently that the pension Lifetime Allowance (LTA) freeze has contributed to GPs retiring. The link seems loose but apparently the fact that GPs (or others with a good pension) can’t put any more in their pension without incurring super high tax charges encourages them to stop sooner than they might otherwise.
Little things like this all add up, the tax system shouldn’t discourage working when the country needs those workers.

'The number of GPs has fallen by a fifth since 2015. 5 years ago'

I wish people would give the whole picture. I wonder how many ANPs are now employed compared to 2015 for example. An ANP is more than able to write sick notes, order tests, refer to specialists and manage chronic conditions.

The problem with primary care began in 2004 when Tony Blair allowed GPs to 'opt out' of out of hours cover. Brilliant.

For example, just over the weekend I have worked 39 hours on night shifts - this on top of the 24 hours that I worked at the beginning of last week (plus an hour staying late each night) = 66 hour week, which is fairly average. I know many people work these hours. But "full time" is pretty much 150% time.

The receptionist had no place acting like you were overreacting. She had no way of knowing if it was infected etc and if a pharmacist has told you to see a GP, then an appointment should have been given.

I would disagree with your first comment though; as a nurse, part, not all of the problem of course, of why A&E is overrun is by people using it to seek unnecessary care. Of course there are a myriad of other reasons ie underfunding, staff leaving the NHS etc. However misuse of A&E is definitely a factor. I'm also not talking about people like yourself who have been unable to access medical care through any other channel - I'm talking about those who shrug and think 'aw it's free, so I'll go and see if they can sort me out' instead of trying the appropriate channels first.

I was mildly furious to see some doctor in the Daily Mail attribute heavy attendance at A&E being down to ‘Amazon Prime culture’ - ie expecting to be seen immediately. And I just thought ‘you smug fucker - no, it’s because we can’t get appointments at the GPS surgery’

< vent over >

You don’t have to justify it but 4 years full-time is still not long. It’s fortunate you have a career where you can choose to work part-time and spend time with your family. And you say your husband may do the same.

I’m a human being, not a machine. The whole thread we have been saying that there aren’t enough GPs, that we are stretched, that we don’t see our families and are burning out. How can this be a solution?

I'm not expecting one GP to work 24 hours !

@mumwon

I love (NOT!) the suggestion of other care units - we don't have them in our area & 111 can take hours (all night) & than be told to go to - A & E!

It was only very recently that I found out that urgent treatment centres/minor injuries units aren't everywhere.

There's no doubt in my mind that the ones in my county massively reduce the number of visits to our 3 A&E departments. And there is rarely a long wait, and the staff are excellent.

I don't understand why they're not more of a thing.

To the above poster, 4 years is not a lot to have worked full-time, especially after training

Especially after training? When that training could take 5-10 years? Medical degree, graduate at 23, two pre-reg/basic training years-25. Then if you’re lucky enough to get a training contract it’s at least 5 years. Add the 4 years full time and you’re 34 at a minimum. Not much time left to work full time if you want a family.

So are you saying doctors should sacrifice career, family, life in general because they should work full time after training? Everyone should be able to work pt if they choose to. We just need to make changes to this idea doctors should put their career and the public above everything else- make training more compatible with family or lifestyle for example.

@Malibuismysecrethome

You don’t have to justify it but 4 years full-time is still not long. It’s fortunate you have a career where you can choose to work part-time and spend time with your family. And you say your husband may do the same.

I know we are fortunate, we also work very hard (as we know many people do). This is not said without some perspective from previous childhood experiences which make us realise how lucky we are, which I won't go into on here.

OP how did you get on at A&E? What have they said about your bite?

@Derbee no need for such vitriol. I was merely asking if there is more to it than not enough GPs. Some are great. Some aren't. But it has to be everyone in the chain doing well and sometimes the receptionist is rubbish and sometimes it is the system or the capacity.

@Malibuismysecrethome

To the above poster, 4 years is not a lot to have worked full-time, especially after training.

Sorry, what is this relevant to? She's trained for around 10 years, worked for 4, so I'm assuming she is early 30s. A perfectly normal age to have a baby and this take time off/go PT for a while. She is understandably having some time out/going part time for a while to cover maternity leave, childcare etc. She has 30 years of professional life ahead of her to go full time should she choose/circumstances change etc. However many parents (particularly women) do go PT after having children. As they are entitled to. Sorry, I'm just not sure why you're saying 4 years isn't a long time to have worked after training, if you're implying something? Should she give it another 10 years and be in her 40s before trying for children? Sorry, I'm not arguing, just not sure of the context of your statement.

Bubblepond it costs a lot to train a doctor and it would seem that most, for whatever reason, now only want to work part-time.

Years ago I was seen in hospital and needed to see a different specialist. The hospital doctor wouldn't or couldn't just refer, send notes over so I had to make a GP appointment and ask him to sort it. He said what am I, a message boy? He got on the phone and sorted it there and then. I think they were taken aback but what a waste of an appointment.

@Malibuismysecrethome

Bubblepond it costs a lot to train a doctor and it would seem that most, for whatever reason, now only want to work part-time.

But as posters on here have said GP part time is actually 40 plus hours a week so not really part time!

It would seem that most GPs already work part-time so that is the point of my argument. Especially after the cost of training.

OK, so the general answer is that we have too few GPs due to them leaving the UK, going part time and retiring early. Fair enough.

BUT, considering GP practices are paid "per patient" where is the money going if it's not going on GP wages (because of the shortages). Who is pocketing the money being received by GP practices which should be paying the wages of the GPs, but who aren't being paid because they don't exist?

JaniieJones
The problem with primary care began in 2004 when Tony Blair allowed GPs to 'opt out' of out of hours cover. Brilliant.

This was the start of the slippery slope with GP services. For a few years we did have the buffer of walk in centres but many of these have since closed down.
So, where do we go now?

Doctors in my practice work 2 or 3 days a week. How is that 40 hours unless they are doing 20 hour days.

@Malibuismysecrethome

It would seem that most GPs already work part-time so that is the point of my argument. Especially after the cost of training.

Part time is often 40+ hours per week. I'd much rather be part time than work 60+ hours full time once I have my baby, and be exhausted and unsafe, I wouldn't be much use to anyone in that case and would be putting my patients at risk. We all have to know our own limits.

Re the part time working, surely past govts should have increased the number of training places 10-20 years ago, when part time working became more common. Surely it was blindingly obvious that if doctors are only going to work, say, half hours, you need twice as many of them. Considering GPs take, say, 10 years to train, it's not the fault of the current government that we didn't train enough 10-20 years ago, is it?

@Malibuismysecrethome

Doctors in my practice work 2 or 3 days a week. How is that 40 hours unless they are doing 20 hour days.

Many don't just work in the practice, they often do commissioning work or teaching GP trainees or medical students, or working in A&E or urgent care as well. Days in the practice will often be 10-12 hours plus admin from home on "days off".

@caspersmagicaljourney

*JaniieJones The problem with primary care began in 2004 when Tony Blair allowed GPs to 'opt out' of out of hours cover. Brilliant.*

This was the start of the slippery slope with GP services. For a few years we did have the buffer of walk in centres but many of these have since closed down.
So, where do we go now?

I agree. And Blair did it with the purpose of making the job of GP more attractive due to the high wage and family friendly hours (i.e. opting out of evenings and weekends). That worked well didn't it??