To think it's no surprise people rock up to A&E

[Usernumber46463637262]

Obviously I'm not encouraging people to go A&E unless they really have to but you can never get through to me surgery. So it's no surprise people give up and just go to A&E??

I have been trying all day, it's either engaged or I get through and there's 10 callers in front. Last time I had 10 callers in front it took 45 minutes to an hour to speak to someone. My problem is not urgent but what if it was? you expect it in the morning but at this time of day?

my problem cannot resolved with an E consult. Last time I did an E consult I didn't get a reply for 2 weeks. They limit how many E consults they take each day too.

is it just my surgery who is pants at answering the phone?

but weirdly I was in the surgery for a while the other day - queueing for a prescription and the phone didn't ring once!!

Can you mum afford an online doctor? They’re £30/40 and you can get a same day consult.

Thanks @Mummyoflittledragon , I didn't know that. Her phone appointment is today, if it doesn't get her anywhere (and I'm not holding out much hope, she's ended up hospitalised twice in the last 18 months with symptoms her GP dismissed) I will pay for that myself.

My Gp practice is pretty good. The phone wait is long. I did an online E consult, which I hoped would be taken seriously due to the nature of the issue and I had to override an ‘are you sure you want this service as it won’t get looked at until tomorrow’. I was probably the first or second call the Gp made the following day and had a face to face within hours and referrals. The pharmacy otoh didn’t do my prescription until I got there half an hour before closing. Busy. Busy.

I hope she gets on ok @MadameSzyszkoBohusz. Some ailments are taken mega seriously. Others outright dismissed. Mine have mainly been dismissed over the years despite my post above, which led to me needing far more disabling, invasive surgery than if I’d been taken seriously.

Don't know how i'm in accurate, i'm guessing you just want to spread your socialist agenda. Yes people pay more for healthcare in Europe which is exactly what I stated and that I personally would be happy with doing myself for decent, no wait healthcare. Do you hear of Europeans complaining of their dire healthcare system, and how life is truly unmanageable? - no you don't. Do you hear terrible complaints from UK residents about the NHS? - constantly.

No ones denying the NHS was an amazing institution for decades, however nothing can remain fit for purpose forever without change, we have to evolve just like our country is. The population in the 1980's was a lot less than it is now for starters...

The majority of people that like to complain about any sort of semi privatisation generally have never spent much time in hospitals or actually experienced the benefits of it. My brother has Cystic Fibrosis, so has been in out and hospital all his life and all the elements of his care that have been "privatised" have been so much better for his health and life expectancy. My tonsillectomy was done in a "private hospital" and it was amazing. FYI, the privatised bits are still funded by the government for the user. Also Labour were the first party to start privatising parts of the NHS in case you didn't realise...

Its all well and good to keep saying its all the Tories fault for under funding, cause that's the easy thing to say, and was partly true in the beginning. Do you not think, considering the NHS is the main bone of contention for so many people, and that its in the news constantly, the Tories might have starting funding more to overcompensate, if it were that easy. They know their popularity and party depends on it.

I'd really like to hear your ideas on funding, and where all this future money will come from to fund the NHS to an excellent service level, even with Labour in power. You cant just say "tax the rich more" - doesn't really cut it.

Ours is the same. I feel quite ill but don't feel like there's anywhere to turn. Refuses to see me or dh at all. GP sent dh to hospital based on a WhatsApp pic and hospital was quite pissed off as was a simple issue that dh didn't actually need 'sortin' and a GP could have told him that but chose to send him to hospital in very worrying circumstances instead.
I feel GP should have to report their % of face to face appointments because it must be costing the NHS more to be doing things like this overall.

@drivingskiving www.pulsetoday.co.uk/news/breaking-news/gp-practices-deliver-highest-proportion-of-face-to-face-appointments-since-start-of-pandemic/

Here’s a relatively recent report. Individual practices may report their own stats, but F2F don’t really reflect demand or the nature of appointment requirements.

@Sidge thank you it's good to have a benchmark, but I meant individual practise should publish their figures so you can check which ones are working well. People are going to die if either GP miss things due to refusing to see patients or hospitals are being overwhelmed with patients who shouldn't be there but are as a result of their GP not bothering to see you f2f.

You say they don't reflect the demand but quite a lot of people would rather see a gp. I think it should be acceptable to be able to insist on seeing one if that's what makes you feel better. It's our health after all.

The problem is due to a lack of availability it should be up to the clinician to dictate who is seen, based on clinical need and not just because the patient would prefer it.

Obviously in an ideal world (fully staffed, full availability, unlimited resources) we could all have F2F appointments whenever we liked. But unfortunately demand massively outstrips supply and it’s just not possible.

I take issue with some of your wording - “refusing” and “not bothering” to see patients. That makes it sound like we’re all just trying to do the bare minimum and it’s just not the case. It’s more about prioritising and appropriate resource allocation.

Primary care is in crisis.

It's supply and demand. If you have a workforce in a practice that can consult safely 150 patients a day but 200 patients want to have a consultation what happens to the extra 50? Practices have tried to address this by doing telephone/text/online consults so that 2 can be done in the time taken to do 1 face to face. However I agree with everyone that face to face is preferable. I can spot the very ill from the not so ill, and it's often more time efficient. There's no such thing really as a quick telephone call. So many I just wanted to review so that meant 2 appointments used up. We've gone back largely to in person consults and we still get complaints when we ask people to attend. We can't win!
As clinicians we could just up our numbers but once I get above 40 consults in a day I'm not sure how safe my decision making is. I wouldn't want to be my 40th+ patient at the end of a 10 hour day.
I don't know what the answer is but it's really rubbish and I hate what it's doing to the GP patient relationship.

It's so bad at the moment. I am currently having escalating problems with my MH and am having to wait 2 weeks for a telephone appointment. I know the NHS is bad I work as a nurse and see it first hand. It is really scary. I don't know what it will take to fix it.

I can’t see it getting better.
Another thing around our area is that more and more houses are being built , in our small town we have five developers like Wimpey etc all with developments of hundreds of houses.
But no new doctors surgery to accommodate new residents?

I am sure this is the case in many areas

I think the experience of accessing healthcare from GPs is now entirely dependent on the ability to understand and navigate or game the systems and being digitally literate.

For those who haven't got this advantage (the elderly, people with mild learning difficulties, those whose first language isn't English etc etc) they are by default excluded from prompt healthcare now.

Totally agree. You have to go having read the NICE guidance for whatever you want checking out, then use the correct trigger words. It is draining and unfair. But no way can you turn up and say 'i don't feel great' as you get generic advice and the brush off.

And I have a pretty good practice!

Yes it needs to be a partnership, and you need to “do your bit” as a patient. (Of course HCPs need to listen and ask the right questions too). A good concise history with accurate information, as specific as you can be, a time frame of the problem and if necessary a written summary is really helpful.

Saying “I don’t feel great” is all very well but doesn’t give us much to go on. Say “I am struggling with pain, fatigue, nausea, I don’t sleep well because the pain wakes me. It’s pain in my lower tummy and I also seem to be pooing differently” is much more helpful.

Also quoting NICE guidelines at us is all very well but be aware they are guidelines not policy. We are limited by local protocols, local hospital referral criteria, prescribing authority restrictions and drug availability. We’re not really an “on demand” service.

How can this be true if whenever I walk into my surgery, the waiting room is completely empty bar one or two people? From what I hear it's the same everywhere. Where are these GP's seeing a record number of patients F2F if not at the surgery?

@ichundich I can’t speak for all surgeries but we still are required to socially distance patients. So we have to stagger numbers through the surgery and limit how many can wait in the waiting room at any one time. Patients are in with a clinician then escorted out of the back door, so not through the waiting room. We aim to minimise waiting, and minimise exposure between patients and staff/other patients.

I’ve just called my GP surgery, phone answered in under a minute. Pre booked appt for just over 2 weeks time for 12yo DS. Ok so I know it’s not urgent and we can afford to wait a couple of weeks but was quite happy with that. And it’s face to face with an actual doctor.

@sorchaedwards

Don't know how i'm in accurate, i'm guessing you just want to spread your socialist agenda. Yes people pay more for healthcare in Europe which is exactly what I stated and that I personally would be happy with doing myself for decent, no wait healthcare. Do you hear of Europeans complaining of their dire healthcare system, and how life is truly unmanageable? - no you don't. Do you hear terrible complaints from UK residents about the NHS? - constantly.

I don't think you understand what I meant.

I wasn't referring to the fact that that people in European countries with privatised or semi-privatised healthcare systems make certain payments at the point of care that we don't. I was referring to the fact that when you add up the TOTAL resources put into healthcare across the country (including those taking the form of taxation) they are greater in those countries than here.

I agree with you - I would also be happy to pay more for a better health system. The problem is just that nothing you have said provides any evidence that "a better system" necessarily means a more privatised system. It could just mean the same system we have with better funding (ie, funding still coming from tax, but more of it).

You can't meaningfully compare the outputs of different types of systems while ignoring differences in inputs. If you took several countries with similar amounts of GDP being spent on healthcare, and found that the ones with privatised systems all had much better outcomes than the ones with state-run systems, then you'd have a point. But you're not doing that. You're comparing countries who spend more on healthcare with a country (the UK) that spends less (including its tax burden). There is then no evidence that the discrepancy in outcome is due to the way it's organised; it could just be due to the amount of spending.

I'd really like to hear your ideas on funding, and where all this future money will come from to fund the NHS to an excellent service level, even with Labour in power. You cant just say "tax the rich more" - doesn't really cut it.

Why not?

I certainly think discussion about income, wealth, inequality and tax needs to be more nuanced than it often is and take account of the reality of how economic privilege actually operates. But in principle: the rich have continued to get richer while living standards and public services have stagnated for everyone else. That was a political choice. We could simply make a difference choice.

Yes it needs to be a partnership, and you need to “do your bit” as a patient. (Of course HCPs need to listen and ask the right questions too). A good concise history with accurate information, as specific as you can be, a time frame of the problem and if necessary a written summary is really helpful.

It might help if the receptionists actually wrote down the right information. If I have to explain to someone other than my GP why I need to see/speak to a doctor I expect them to at least make accurate notes. 'Some kind of cyst' when I'd told them what it was and that it had been diagnosed at A&E isn't enough information for the GP