To be so disappointed with my GP's service - bit long sorry

[Filimou]

Basically I have two separate health problems, firstly I have had a cough since January, at first I just put it down to winter coughs/colds etc. However, it is getting worse, particularly at night, some nights I wheeze so much I get really out of breath.
After I had had it for a while, I tried to make an appointment at my GP to see a doctor, but now you have to go through a triage nurse. The nurse, called me in, listened to my chest and said “well your chest is clear so its not an infection, just rest and drink fluids”. This has been going back and forth with the same outcome/response for months. It is now getting worse, especially at night.

I also have a crap knee, was diagnosed with osteoarthritis a few years ago and a little damage to my cruxiate. This can occasionally flare up, and have been trying to manage it over the last few years mainly by getting my weight down but the past month or so I can barely walk on it, I can’t put any weight on it and it gets so stiff and sore.

The regular nurse was off sick last week when I called and the nurse I saw agreed that the cough isnt normal and so sent me for a chest xray and also a set of blood tests to check for infection and arthritis. I called the doctors, and spoke to the nurse (again), and she told me that they had come back normal so no action required. I asked what we do next and she said nothing. So, I am just supposed to live with a knee so painful that I can’t really walk up and downstairs without discomfort, I cannot bend without pain, walking or sitting for a long period can be extremely painful and kneeling is out of the question, and on top of that, a cough/wheezing that is so bad I can just about get my breath.

Tbh, the doctors at my surgery are really good and they have been great with the various ailments DS has had, but I just cant ever bloody get to see one.

I am currently waiting for the practice manager to call me back (maybe today, maybe tomorrow), would I be within my rights to demand to see a doctor and bypass the nurse completely? I am just so tired and fucked off, so don't know if my disappointment/anger is just an overreaction.

Just ask to see the doctor.

There's no requirement to tell anyone else your health problems.

Our docs operate a triage service weegie, so we have to speak with the practice nurse before we get anywhere near an appointment with the doctor.
I am currently waiting for the call because I want to go straight to the doctor and bypass the nurse completely.

Could you go get an appointment for DS and then go in and get yourself treated (I know it's a bit cheeky but maybe worth a shot?)

I'd be leaving that surgery and finding a new one if your complaint isn't taken seriously. Triage of unselected patients is incredibly complex and an experienced GP, never mind a practice nurse, finds it hard work. To be honest, any GPs that put up with such nonsense can't be that great!

Ask for their complaints procedure when you speak to the practice manager. Tell them you are not happy with the current set up. You can't be the only one getting pissed off with it!

I would go to a different surgery - nurses, whatever they may like to think these days, are not Drs. They are trained to follow a fairly narrow protocol, and do not have the same diagnostic skills.

I'm glad you're speaking to the practise manager, I would insist on seeing a GP, and if they refuse then I would complain to PALS.

Could you ask for a telephone appt with a doctor.

Blimey, at my surgery we only need triage for emergency appointments

Not an uncommon scenario. GP surgeries are closing left right and centre around here, and it's set to get worse. There's no money, they've had to lay off staff. GPs are asked to do more and more on less and less money, a lot of them can't make their business work anymore. A know a number who are leaving to work abroad permanently. Patients are fobbed off with seeing nurses when they should see a doctor (of course seeing a nurse is appropriate in certain situations, but increasingly I'm seeing it being used as a delaying tactic as there are no doctors appointments). Every government gets primary care panning wrong, GP incomes fall, no one wants to go into GP, then they have a recruitment crisis, and have to pay them loads more to come back to general practice. It's like a 10 year perpetually repeating cycle FFS.

It's not ideal, but the NHS is set to implode and we are going to suffer for it. I fear a fully privatised health service in the UK is looming.

I hope you can see a doctor soon!

If you can afford it, go and see a private physio about your knee. Even if you did see a doctor fir that, there isn't much they will do, and whatever they do do will take months and be the bare minimum you need.

Try to see a private doctor if you can op. How can they say nothing is wrong and nothing can be done when you are in such pain.
It's so sad to see this happening, I fortunately have private healthcare and the difference is huge. Every single time I was the only patient and the doctor had ample time to see to me.

Thanks everyone.
I am not really sure I can afford to go private, have been looking into a discounted scheme that I can get through work today though.

You are absolutely within your rights to expect to be seen. Chest x-ray and blood tests would not diagnose asthma or COPD which are the most common breathing problems as far as I know. You need to be seen, have a proper history taken and your chest listened to.

Triage is a way to see that patients are seen in a timely, clinically appropriate fashion and that resources are used correctly; it is not a way to fob people off

I'm a practice manager and that doesn't sound great tbh. There is a triage system which is used by quite a few practices, but the triaging is done by the doctors themselves. It seems unethical to me to expect the nurse to triage patients for her more highly qualified GP colleagues.

My dh has suspected COPD. Three paramedics have told him this is likely He smoked for 48 years. He has had breathing problems for 8 years.

Chest x ray and blood tests are what he has had and its still not been officially diagnosed.

OP that sounds awful. Breathing problems and a painful knee. Ive just rang our surgery and they have abandoned the sit and wait clinic in favour of returning to the old system of booking on the day or in advance.

The nurse shouldn't be doing triage, except in the very basic sense of deciding the timing of appointments in order of need. She should absolutely not be refusing to allocate an appointment at all; even the dr. shouldn't decide via a phone call that no treatment is necessary.
Change surgeries if they refuse to budge.

I also think it's grounds for a complaint.

I'd change surgeries ASAP- and complain. If that's not possible, I'd just lie to the triage nurse and then when I saw the doctor, I'd explain what I'd done and why - suggested lies - coughing up blood, fainting, pain down left arm- any or all! What a shower!

Your symptoms sound like classic asthma/copd - I'm pretty appalled the practice nurse hasn't picked up on it (I'm an ex practice nurse myself).

I'd suggest a phone call to the practice manager.

Sorry I didnt update last night, spoke to the practice manager who arranged for a doctor to call me back this morning.
After explaining my symptoms again and him looking through my notes, he said, in his opinion it sounds like asthma, so wants me to have a spirometry test, so that is now booked for 3 weeks time, he also advised I go in and have my knee examined again and so looking at that next week. I can now finally see some light in this tunnel!

Oh, and I am definitely going to put in a written formal complaint.

Good for you Filimon - sounds horrible, Hope you get it sorted soon.