Just been bollocked for not using out of hours GP

[SunlightThroughTrees]

I’ve just called up to get a GP appointment, the usual 8am scramble to get one. Opening question was “what’s the emergency?”, which is new. I explained that I’d had swollen tonsils for several days, which are getting increasingly painful and I now have white gunk on them.

She interrupted me whilst I was saying what was wrong (very concisely) and then twice told me I should have used the out of hours GP service. The reason I didn’t go to the GP on the first few days of symptoms was I was waiting to see if it was viral tonsillitis that would get better on its own after a few days ie following the guidance on the NHS website.

She has given me an appointment begrudgingly but ended the call by again telling me that I should have used out of hours and sounded very pissed off at me. I get that appointments are scarce but I can’t see what I’ve done wrong here. The out of hours appointments are presumably scarce too and to be honest I think of that as more of an ‘emergency’ service to use sparingly than my GP surgery on a weekday.

slightly different situation, but to further highlight the farce that is the NHS, I once had my front door kicked in by Police due to NHS 111 getting me mixed up with someone else!
I'd called earlier that evening with severe palpitations (something ongoing for me) & after 4 hours of waiting for a call back, they'd all but disappeared. So I called back, explained I was waiting for a call but no longer needed it & was going to bed. I was told that's fine, thanks for letting them know, he'll update my records & if anything further occurs, to ring them straight back or call 999 etc etc. So I went to bed.

Woke up in the middle of the night to heavy banging on the front door. Now, as someone who'd years previously fled severe domestic violence & a lone parent (widow), this was an incredibly scary experience.
Turns out they'd sent an ambulance as I'd not responded to their call back(!?!) and the paramedics had been knocking but I obviously hadn't heard as I was ASLEEP! (My child somehow hadn't heard either) So they sent for the police who arrived with one of those door rammers.

Suffice to say they didn't believe me when I explained that I'd called 111 back & said I no longer needed them. The poor Paramedic crew had been sent from 40 miles away as local crews were busy.... They insisted on doing an ECG and commented on how high my heart rate was! 🤣 Well no shit! I thought my child & I were about to be bludgeoned ffs.

Door was completely destroyed and the Landlord evicted me, after years & years of being a perfect tenant. Unsurprisingly all the neighbours complained. I suppose it doesn't look good having police ramming your front door in.....

Since when have GP appointments been for emergencies only? The NHS is a fucking shambles

GP’s are private contractors to the NHS. They receive a budget but it’s up to them how they spend it- on partners salaries, lower level staff, premises etc.

it’s likely they prefer you to go to OOH because then it doesn’t come out of their budget.

It's all a shambles OP. Not individual surgeries' fault, but the government. The one GP I know socially is working ridiculous hours

how is it the government’s fault and not the surgeries, when as above the surgery is the one with responsibility for employing, staff Rota etc. if your GP friend is working all hours it’s because their surgery hasn’t employed enough staff.

@Reallyreallyborednow - because the government dictate the funding per patient the GP surgeries receive? There is a reason GP surgeries are closing down left right and centre and there are not enough GPs to fill the vacancies, there is not enough money.

@SunlightThroughTrees I feel for you.

A relative has suffered badly with tonsillitis for years. When he was much younger (he's in his early 20s now this was when he was about 14) he was hospitalised with them and referred for a tonsillectomy (non urgent, just routine)

It was a long wait and then and when covid hit he suffered very badly. He couldn't get an appt and was prescribed antibiotics and antibiotics over the phone without a dr even looking at him.

He ended up hospitalised twice more and getting IV drugs for the pain and antibiotics that way as his infection levels were high.

Finally his father called their own Dr (who initially wouldn't speak to the dad as the son is in his 20s) and got told it was now a four year wait for the operation.

He is going private at a cost of almost £6000. They're not rich, he is taking out a loan as he can't see his son suffer for another four years.

The NHS is being run into the ground 😞

@cptartapp why should we need re-educating? A few weeks ago, there was a thread telling us that we should not waste a doctor’s time with minor ailments that could be treated at home. The vast majority of us try to do just that. We are not doctors ourselves and often have to pluck up courage to make an appointment as we do not want to be “that patient,” which the doctor makes clear that we are wasting their time.
I am old enough to remember when we had a family doctor. If you went to see him, you took a number which told you where you were in the queue and went to the waiting room upstairs. You went downstairs when you were two away from your turn and waited outside the surgery. The only downside was that the wall between the waiting area and the surgery was quite thin and the doctor had a loud, booming voice so patient confidentiality was somewhat compromised. I had bad asthma and medication was primitive at that time and, although it was a last resort for my mother to call the surgery, he came out to see me in the night. He actually told my mother never to be afraid to call him as he was always available.
The rot really started to set in around twenty years ago, when doctors signed a contract that meant that they did not need to work at nights or weekends. Perfectly understandable, of course, but illnesses tend to strike at the most inconvenient times. This is why the out of hours services were set up. We do not want our doctors to be overworked and the days of our village doctor are long gone but the present service is not working for anyone.

Re educating on how to contact out of hours services, individual to locality. And guidance on when to use it.
Many patients admit they sit on a problem over a weekend simply because they like the familiarity of their own GP. Which is understandable, but frustrating for staff when faced with the Monday morning tsunami of patients that should have been seen earlier.
As people live longer with a multitude of complex co-morbidities, hospitals discharge sooner and caseloads grow by the thousand for a dwindling number of GP's and nurses to manage, there is no comparison with the days of old.
Agree, the system isn't working.

She has no right to speak to you like this and in the long term I would make a complaint, note what time and what day it was and write down what you can recall being said for later use. As you are not a doctor yourself, nor even a medical receptionist, I presume, how would you know whether it was an OOH job or not? (Are your practice trying to bump as many people into the OOH service or walk-in centre as they can, by any chance? And what does the OOH service do then with all these extra patients?)

For now, put it out of your mind, don't waste energy or time with the GP fretting about it, and hopefully get treated or referred on today.

I can't quote, but this is in response to passport's post above about how we should know when to go to the doctor and when to treat at home.

That's the whole bloody point of GPs, or at least it should be. I'm not one to run to a doctor, couldn't tell you the last time I rang for me for something outside of regular pregnancy stuff. But I have zero medical training. I don't know when tonsillitis or a chest infection or a UTI turns from "this is miserable but fine" to "this needs a bit of help to see it off". Sure, there are broad criteria but when it's been dragging on and not getting any better and I feel like death, I'm not qualified to assess me.

We shouldn't be villainised for wanting to see a doctor (or nurse practitioner, or similar) when ill. It's perfectly normal in other countries.

Why not use Pharmacy Direct or something like that? It’s all automated and you don’t even have to collect the prescription! :)

often have to pluck up courage to make an appointment as we do not want to be “that patient,”

There is something very very very wrong with both the system and individual surgeries and doctors when patients with genuine concerns feel like this.

I find the best course of action is to use my knowledge, such as it is, and gumption, to assess a situation, work out whether on balance professional advice might be needed, and then seek it out firmly, while having developed the hide of a rhino. I deal with complicated medical stuff for a relative as well as myself and see the good, bad and ugly in terms of the way patients and carers are treated on a very regular basis. You have to fight for your own and your family's health, as the mess the NHS is in is not your individual responsibility. This is not at all easy and is very hard to do if your personality isn't naturally like that and more so when you are ill, so I am not criticising anyone who hasn't developed techniques and a rhino hide, far from it, it isn't right that it is necessary.

Obviously don't go with obviously trivial things and do use pharmacies and a first aid kit and 111, but once you have analysed whether you think you need a professional in good faith, who cares if you are accidentally "that patient"?

I genuinely have to build myself up to phone and ask for a GP appointment.

They are basically resource guarding and creating more and more barriers to keep patients away.

If I had the money I'd go private for as much as I could.

This

Trying to get medical help should be a Catch 22

No. A free at the point of use service does not have the capacity to see everyone who has a sore throat or a cold. You go to a pharmacist and use a bit of common sense. Most colds/sore throats etc get better within a couple of weeks and unless you're really ill, or have a reason that it might be more serious for you (COPD/asthma/immunocompromised etc) then generally viral respiratory tract infections don't need a doctor.

If we are saying that healthy adults can't use their common sense and need to see a dr for every viral infection then we will need an awful lot more doctors.

I used E consult when I wasn't sure about the seriousness of my complaint.
All sorted quickly with a few photos snd a prescription left at pharmacy.

Well we do need an awful lot more doctors!

The other day my MIL was telling a story about calling the GP out in the middle of the night when DH was little (so mid-1980s). Just made me realise how low the standards have sunk. It's not the doctors' fault (or even the receptionists'!), there just aren't enough of them and those who are there are far too stretched and stressed. As others have said, the system is broken. And this is BEFORE Truss and Kwarteng start cutting public spending to pay for their tax cuts!

I think you have been a model patient, OP and done exactly the right thing. Tried to get better yourself and called for help when you needed it.

If we are saying that healthy adults can't use their common sense and need to see a dr for every viral infection then we will need an awful lot more doctors.

You're so so so close to getting it.

Yes, we need more doctors. And more nurses, and physios, and SLTs and everything else. The whole NHS has been systematically underfunded and it's an absolute disgrace.

No, I wouldn't go to the doctor with a sore throat. But I've only had tonsillitis once and it was torture - that's not just a sore throat. As someone who isn't prone to tonsillitis and who has zero medical training, I don't know when I become ill enough for treatment. Because after feeling like shit and being in agony swallowing saliva for a couple of days, I would like someone who knows what they're talking about to have a look. I have a life to get on with, if it's reasonable to take antibiotics to get better quickly then I will do that thank you very much. If the doctor wants to send me on my way because there's no clinical reason to prescribe something, then that's absolutely fine.

I do have asthma, and so I'm more confident judging coughs and chest infections because they're a regular thing for me. If I do ask to be seen, I usually need antibiotics and/or steroids but again, if the doctor doesn't think that's necessary that's fine - they actually know what they're talking about. I don't.

Exactly this, you could argue I’ve been to the doctor for a cough, but actually I could tell it was turning into a chest infection by the wheeze, crackling and rattle I could hear. Doctor agreed.

You could also argue I’ve been to the doctor for a “sore throat” but my tonsils were so swollen I needed IV antibiotics.

We only know our own pain thresholds and what we’ve felt before. If you are feeling more ill than you have ever done before, I don’t think you can be blamed for wanting a medical professional to check that.

In contrast, when I had a bad pus-filled throat, I did the online triage, sent some photos and the gp had me in my 9.30 that same morning. To be fair they were a bit worried about quinsey which is why I was in so quickly but I was absolutely in the right place to be treated and got my antibiotics. It shows how much variation there is at the moment.

When my adult dn had a sore throat and couldn't swallow painkillers the 111 support told him not to be a baby.
His dw took him to A&E.
He had aml, acute myeloid leukaemia.

I know. It's a riot.

You can't get seen quickly if you are very unwell, because it's a mad rush for appointments. But at my GP practice, you also can't get routine appointments in advance.

I've tried to schedule things that are not particularly urgent, but do need to be addressed, saying "it's not an emergency, no rush, I'll take any appointment" and you can't get that either because they "only open appintments one week in advance"?? So it's a mad scramble for every to get through on the phones the quickest to get the appointments. If you don't dial the quickest, repeat again the following Monday.

It's a total joke.

Oh no! Is he ok?

there are some people on certain meds who will be advised to report any sore throat

Yup, this is me. Been on Adalimumab injections for two years so I'm immune-suppressed. I currently have a very sore and swollen throat that's getting worse. LFT negative.

I'm very loathe to 'bother' anyone about it. I can imagine the Receptionist's reaction. I don't think we'll get much past the words 'sore throat' before she triages me to the naughty corner of shame.

As it happens I received a text to ring the GP practice anyway about some medication issue. Been ringing all day. Can I get through? Can I fuck.

Who is going to man them? There is a shortage of GPs which is part of the problem.

And yet kids with 4 A stars at A level this summer have been told to FO with their med school applications. Makes me so angry. I know 3 kids who have just started other sciency degrees instead due to this fiasco. Those should have been our future doctors!