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.

This running down and under funding of medical services is deliberate imo so the government can say a publicly funded service doesn't work and the NHS can be sold off and privatised.
I think they've pretty much succeeded in privatising dental care already.
And It's all our own fault for letting them.

[quote SunshineCake1]@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.[/quote]
@SunshineCake1 it’s a ridiculous thing to suggest that people who are working their arses off should adopt a 24 hour service. And these GP bashing threads are so unfair and pointless.

@Kendodd

This running down and under funding of medical services is deliberate imo so the government can say a publicly funded service doesn't work and the NHS can be sold off and privatised. I think they've pretty much succeeded in privatising dental care already. And It's all our own fault for letting them.

I have wondered this myself in recent years and I think it has a ring of truth to it. However I don't agree that it's our fault as no patient would want this to happen. Also as a taxpayer I totally object to paying for public services that may no longer be available.

This running down and under funding of medical services is deliberate imo so the government can say a publicly funded service doesn't work and the NHS can be sold off and privatised

Actually the privatisation started many years ago, under Labour. The idea then was to throw money at the nhs- new it systems, management schemes etc, to prove it didn’t work even if well funded.

They introduced privatisation via “social enterprise”- encouraging staff to form business entities which then contracted their services back to their own departments. You’d be surprised how much of the nhs is technically private- GP’s are, they are one of the staff groups that left the NHS employee umbrella and provide services via contracts. GP’s aren’t employed by the NHS, even though they still benefit from their pensions and benefits, some excellent negotiating went on there..

Actually the privatisation started many years ago, under Labour.

Actually I think it started even before then but Labours terrible PFI was unforgivable.

Yes, it has been going on for decades. But it has got much worse.
Circle are providing the easier more profitable NHS day surgeries in my City. The NHS are providing more complex surgery or surgery for patients who need more support and medical care.

@HalzTangz

I don't know why people aren't signing up for online services for their doctor's surgery. You can book an appointment online without trying to ring all day.

I am sick of seeing this line trotted out

Many , many surgeries do not offer online appointments or online e consults

Our surgery is the largest surgery in a town of 89’,000 plus residents and is still using the “ phone at 830” free for all

Also in Scotland we don’t have these minor injury / ailments places

It’s the doctors or 111 or A and E

All extremely stressful

Doctor is engaged constantly
111 takes hours and hours and hours to call back
A & E I wouldn’t even contemplate unless last resort / actually in accident or emergency

My GP doesn't do anything online. I need a smear test but I can't get through to book one. Even if I do get through I need an appointment on a day off work which seems to be impossible to get
I would like to speak to someone about my back acne (tried most OTC stuff, no luck) as I've never had it before and also started spotting between periods. On the day appointments only, and you can't get one
When I say you can't get one - I rang at 5.45pm to speak to someone, they closed at 6.30pm and I hadn't managed to get through and was still number 6 in the queue

It's not improving at all, and it was never ever like this prior to covid

To add I don't blame the staff. I just don't know why prior to covid it was fine and now it's totally broken. And I wish they offered smear tests on a Saturday morning or even after 5pm
It's ok for now but I'm worried about if I get an infection and need antibiotics the same day

Serious mental health issues have also soared and GPs tend to be the first port of call. And these are rarely short appointments.

@NotMyCat there may be staff off sick at the moment. I know where I live covid is rife. Can you go to the surgery to book a nurse appointment? A nurse can do a smear and give advice about acne on your back. If spotting is an issue, a smear test would be the first thing to check.

[quote julieca]@NotMyCat there may be staff off sick at the moment. I know where I live covid is rife. Can you go to the surgery to book a nurse appointment? A nurse can do a smear and give advice about acne on your back. If spotting is an issue, a smear test would be the first thing to check.[/quote]
It's been like this since the start of covid
They're still not allowing people in without a booked appointment so you can't actually get in the door!
I'm going to try again but I only have one day off work (and no annual leave left) as I don't get more annual leave until December
And I can't ring when I'm working so I need a day off to ring them to be able to get through, and a day off for the appointment. Argh!

@JaniieJones

'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.

Only GPs can sign MED3s (sick notes) so you are incorrect there

@Spicychickentenders

I understand your frustration, but I don't understand what you expect be done, if all the appointments are gone for today? The GP surely does not operate an unlimited service? If the appointments are gone, the they are gone.

Some GPs have chosen to strictly implement a book on the day service, as otherwise the appointments are booked months in advance.

I just wonder what you think should happen, if there are no more available appointments. Surely you understand that they will run out at some point during the day?

What do you think should happen?

@lightand

I think the UK is becoming broken in general.

And I am not convinced that it is not all being done on purpose..

...to what end ?

British GPs do a lot that is managed by specialists in other countries

True. The first thing my French GP does for most things is write a referral. But he then gives that to me and I go and make my own appointment with the physio / dermo / podiatrist / ent / rheumatologist / surgeon or whatever, at my own convenience. Sometimes i have to wait a while for an appointment but not often.

Similarly very few GPS work with nurses here, but lots of nurses set up on their own. So if, for example, I need a wound dressed regularly the GP gives me a prescription for the care, I contact a local nurse and make the arrangements with her, whether it’s home visits or whatever.

For appointments there is a great system called Doctolib which lets me search online for whatever medical service I need, and make a rdv. I can also cancel / change rdv, do online consultations, send and receive documents and prescriptions through the same app.

Medical care here is not free at the point of service but most routine / urgent care is fully reimbursed, a system that keeps the paper pushers busy as well.

You want to try getting a dental appointment, it's even harder than getting a GP appointment. I've lost 3 teeth since Covid started & urgently need treatment to prevent me losing any more due to illness. When I had my last extraction the dentist said I needed a long course of treatment to prevent further loss, I asked when I could book in & was told they were only doing emergency treatment & I wasn't an emergency as I didn't have symptoms of an abcess or dental trauma & to ring after Christmas. I rang last week & asked to speak to the Practice Manager, after a lot of arguing I managed to get booked in for an assessment on 6 December, no indication for how long it will take to get any treatment, we have lost two NHS dentists in the area & mine had 4 dentists until the practice was sold, now there is 1 dentist 3 days a week & a locum for 2 days.

julieca a smear test wouldn't necessarily be the first thing to check for spotting if one isn't due. You ideally need a bi manual gynae exam which most practice nurses can't do.
I also wouldn't advise about acne in your back. I can't prescribe. Am not dermatology trained. I'd refer you to the GP.

[quote julieca]@NotMyCat there may be staff off sick at the moment. I know where I live covid is rife. Can you go to the surgery to book a nurse appointment? A nurse can do a smear and give advice about acne on your back. If spotting is an issue, a smear test would be the first thing to check.[/quote]
No, most surgeries won’t allow you through the door.

I have seen my nurse every 12 weeks for an injection throughout the pandemic but I realise that could be unusual. The door is now open to just go in and the only difference is no touch screen to say you have arrived and lots of hand sanitizer.

@alexdgr8 Privatising the NHS

For those having trouble getting through my son has found if you physically go to the surgery even if they make you stand in the queue outside you eventually do get to the desk face to face with the receptionist gate keeper and then tend to be able to get an appointment - but easy for us to say as my son i s a student so time is utterly different from full time working parents. I am very very lucky. I have needed a GP for 7 minutes in 15 years. Let us hope it stays that way.

I had an infected mosquito bite on my ankle when I was living in Italy and was sent to the local hospital, so I would say go. I was given antibiotics, it was bandaged up and I had to elevate it as much as possible for a while. Just be prepared to sit around waiting in A&E.