GP surgery ridiculousness?

[fatgirlswims]

I rarely use the GPs. I had an appointment to review some medication I started on 4 weeks ago for a chronic pain condition. I stopped the old medication as it was ineffective and pain was increasing and started on this one. The GP gave me a four week supply. He said if it not enough it's the wrong thing so just see how you go come back and we can review it. Fine. He was good.

I had just enough to eke out. I'm in immense pain and cannot sleep. I feel better after I mobilise. I have good days and bad days.

The appointment was cancelled as the the GP was sick. Fine I get it. I got a message at 8.03. I could not get though to the surgery and I'm going away on Wednesday.

I drive to the branch surgery in the village. Lovely receptionist makes me an appointment for the nurse practitioner who can't prescribe the medication as it's not in her competencies she would need to see me f2f. There are no GP appointment but I can see the physio or the pharmacist. The physio can now prescribe with in his competency but not keen as found they just offer paracetamol and ibuprofen. I opt for the pharmacist as they can prescribe anything. I feel utterly fobbed off. And "gatekeeper". There are no GP appointments and the GP can't see me for 4 weeks.

Now here is the crazy bit.

In desperation I call 111 who make me an appointment at my GP surgery with one of the GPs. They call at 4pm. I get enough strong painkillers to tide me over over until I can have a review in 4 weeks. I'm fine either way that I get it.

How on earth does this make any sense. It took me all day to sort out and I was really upset too.

The surgery have to keep a certain number of appointments for 111. They can't give you one of those appointments when you ask for one, they can when you call 111. I'm not sure what about that is ridiculous?

So what happened with the pharmacist appointment then? Were they not able to help? I’m confused?!

I appreciate this has been difficult for you to sort out, I’d be a little frustrated too, but basically the GP who was supposed to do your review is ill, so obviously things have not gone as planned at your end or at the GP surgery’s end…

I had no idea that you can book your own GP appointments through 111.

111 is for out of hours or when your own surgery can't help. I assumed it be sent to the urgent care centre at the hospital, not to my own GP

Why on earth do they reserve appointments for 111 patients. Why can't you book them direct?

The pharmacist appointment this evening which is too late and now cancelled.

I obviously need to get better at working this awful system.

I was worried because I woke up breathless. I tried to call the GP and couldn’t even get through. I called 111 who said I needed to be seen. She couldn’t give me a GP appointment, she said I needed to keep trying to get a GP appointment. I got into the car and drove down to the surgery. The receptionist said there weren’t any GP appointments left. I told him what 111 had said and he said he would get a nurse to call me. Finally at 3.15 pm a nurse called me.

The nurse said I needed to be seen. By this point I was giving up the will to live. Anyway, the nurse decided the best place for me was A & E, so my DH took me. The receptionist took one look at me and said, aren’t the GPs working today? Bloody cheek!

I was triaged and told to sit and wait. At 8pm I was diagnosed with bilateral blood clots on both lungs. I was admitted at 1am and I was taken across town in an ambulance to another hospital. I was finally given a bed at 2am.

It’s rubbish currently @fatgirlswims , it’s not just where you are.

Generally 111 slots are embargoed so cannot be booked. This is done because it’s dictated from above it has to be an option, and to preserve availability they can’t be booked by staff.

I know it’s mad but when you’re short staffed, at capacity and demand exceeds supply there’s just nowhere to book people.

This sort of stuff is normal.

When you have a chronic condition you start to learn the system and what you need to do when.

Very little of it is sensible.

This sort of shit is why people don't like to change meds.

It’s an obligation. GP surgeries have to keep back a certain number of slots for 111 to use. They can be overruled and used, but only if they’ve not been taken by a certain time.

Doesn't sound ridiculous to me, though phoning 111 could have happened sooner and it would have been resolved sooner, and your plans to go away on Wednesday aren't within the NHS's remit to accommodate.

It seems obvious and sensible to me that some GP appointments can't be accessed by receptionists (who have no medical training and cannot be expected to effectively triage the most urgent cases). 111 is the correct way to access urgent care if it's not an obvious A&E situation. The trained nurse call handlers on 111 are much better placed to assess your needs and the urgency level and get you the appointment you need. If there wasn't a reserved portion of GP appointments ringfenced like this they would get booked up with routine appointments or hypochondriac panics and 111 wouldn't have any slots to offer.

The whole system isn’t fit for purpose, OP.

I don’t know what the answer is other than a massive overhaul of the GP system including its funding.

OP, I understand your frustrations and can only sympathise. I don’t use the GP very often but whenever I do, the system always seems to have changed and it’s never advertised in the website. It’s always confusing and everything takes so much longer than I expected.

Unfortunately it's quite common, they have to keep some emergency slots open.

Me and my friend both have the same GP, she frequently has problems trying to get appointments for herself and has to wait a week or more.

Where as, I have COPD and I always get seen the same day I ring up. Every time. They class me as an emergency because I end up in hospital if I don't get antibiotics quickly.

At my GP you book a general appointment at 8am for two weeks later or you ring at 8am for emergency appointment that day. If they can't get you in the nurse will ring and triage you. I've never had an issue getting an appointment.

I would have thought this was a case where you ask for an emergency appointment as you were expecting the doctor to prescribe in the cancelled appointment, and have run out of medication for a condition causing chronic pain, instead of waiting weeks for another appointment.

Surely there are emergency appointments rather than some set aside for 111? I rang 111 once when I was away from home and in agony and was told to call the nearest GP surgery and tell them 111 referred me. I spoke to a doctor who then got me booked in that afternoon to see him.

I’m sorry you’ve been through all of that OP. I work for a pharmacy and could bore everyone to tears with similar stories. Everyone is now pretty much told to go to the pharmacy, by staff who know full well there are red flag symptoms we are OBVIOUSLY not equipped to treat. Sending people with COPD and struggling to breathe to a pharmacy. What does the surgery expect, we are not trained to listen to people’s lungs nor do we have the equipment to do so. The surgery I am connected to won’t even take over the phone appointments for people 80+ who struggle with technology and are so unwell/confused they couldn’t possibly work a smartphone. Sending the appointment message 48 hours AFTER the call is made. Refusing to take requests by people in desperate pain, instead telling them to pop into pharmacy. Everything is “pop into pharmacy”, we are also understaffed and overworked while trying to see everyone they’ve sent across who belong in A&E. Such a waste of everyone’s time! There are people coming in to enquire who have been triaged through 3 different systems and who just beg me to please, please tell them what it will take for them to be seen.
It makes me VERY angry on their behalf.
But also, far too many people who speak to me like trash because they’re in pain and their surgeries are messing them about.
The system has well and truly failed already.

Read the OP.

I got an emergency appointment with a nurse who couldn't prescribe . I drove there ancient get through in the phone.

But when did 111 become something other than and after hours emergency.

Why don't we just ring all through 111

Why would I call 111 during surgery opening hours as a first port of call?

It's madness.

It's a huge game and we we pawn!

To be fair the emergency GP increased the strength of all the meds and told me to have a great trip and to take a copy of my prescription and don't get arrested at the air port

He was lovely.

How rude are you? I did. Emergency appointments with a GP is what I mean.

Thanks everyone I felt a little unhinged yesterday!

Changing meds for chronic condition is bloody awful I agree!

The only problem is I can't even lay my way out of this. I am stuck in this useless system which is especially painful if you have an inflexible work schedule or a busy life!

111 is not just for out of hours, it is operating 24 hours a day for any circumstance where you need help accessing the right care in a timely manner. Why would staff be paid to answer the phones during weekday office hours if you aren't supposed to call then?

You should call NHS 111 when you need urgent medical help but it's not a life-threatening emergency. You can call 111 for:

• Symptoms or injuries - triage to assess whether something is serious enough for A&E
• Mental health
• Dental help if you can't access a dentist
• Prescriptions - information or urgent needs (eg if you lose your medications while away from home without access to your GP or run out and can't get a GP appointment in time)
• Existing medical conditions where you need help
• COVID-19 symptoms
• Health information or reassurance
• End-of-life care
• Child protection (reporting concerns)
• Vulnerable adults (reporting concerns)

You can call 111 24 hours a day. You can also use the NHS 111 online service. You should call 999 or go to A&E if you have a life or limb threatening emergency.

There is loads that 111 can do and vast amounts of NHS resource could be better used if people dialled 111 more rather than goong to a GP or A&E for something that 111 could deal with - because they deal with all the easy stuff directly and refer on to GPs or A&E if it's something (as in your case) that needs that.

I'm sure the nurse practitioner would have sorted the prescription out for you if you'd gone to the appointment with them. That'd be what happens in our surgery - she'd get one of the doctors to approve it when they had a spare moment. Did you ask if that was possible?

My medication reviews are always with the pharmacist. Your GP had an emergency which couldn’t be helped. You had several other HCPs who could have seen you and then a prescriber would have sorted the prescription if you needed a new one. This is all very routine. I think you’ve flapped around needlessly all day, but also planned poorly given you’re going away on Wednesday. 111 appointments are for emergencies, not medication reviews.

I went to the appointment with the nurse practitioners and she couldn't help me.

It was not in her competency. The only person who can prescribe diazepam and tramadol are the GPs as it is part of an existing care plan.

I didn't plan the review in 4 weeks. I'd didn't plan to go away four weeks after staring new medication .

It wasn't poorly planed it was a coincidence the GP was sick which is unavoidable and I am sympathetic towards.

It says all this in my OP though?

Medication review is probably a wrong phrase.

I have changed medication and GP wanted to see if it worked after trying it for a month and if I'd didn't want to change it too and if any further diagnostics were needed or referrals.

I had no idea

I'm not a frequent service user.