Meet the Other Phone. A phone that grows with your child.

Meet the Other Phone.
A phone that grows with your child.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To think a 6 week wait for a GP appointment is totally ridiculous

282 replies

fussychica · 23/11/2018 17:22

Just tried to book an appointment at our local surgery to get something checked out. Not been for ages and I was expecting a 2 - 3 week wait but apparently there are no face to face appointments before the 4th Jan and they are not releasing any appointments beyond that date until the end of next week. There are also no 5 minute telephone consultations available until after 21 Dec. Apparently there is no doctor shortage at the surgery.
I am really shocked and not quite sure what to do apart from go private. It's not an emergency at the moment but at the same time I'm not happy to wait 6 weeks to sort it.
Have written to my MP advising him of the situation, for all the good it's likely to do.

So is this the norm now or are the people of this town alone in receiving such a sub standard service?

OP posts:
PookieDo · 24/11/2018 15:50

Because it’s usually cheaper to run a nurse led service or mostly employ nurses and pharmacists. Nurses are also very highly trained and can prescribe, these nurses take a lot of the burden.

Money is not really diverted it is just utilised in a different way. What is the point in having 3wte GP vacancies you can’t fill when you can use it in another way.

Extended hours is only privatised when the NHS GP’s do not want to be involved in running it. I am closely involved in this aspect of GP practice and I can find a lot of nurses but very few GP’s. So it may be more worthwhile investing in nurse training. Also extended hours is mandatory and GP’s did not get a ‘say’ in whether they wanted it or not. CCG decision

Weetabixandshreddies · 24/11/2018 15:53

Brimstonenotfire

You know what though? People that are ill have enough of a fight on their hands already. I can't blame people who are ill for complaining that they are let down by their GP surgery or who don't feel entirely sympathetic for their GP.

MPs and policy makers and drs unions etc are the ones that should be fighting for that. It isn't fair to ask patients to fight on behalf of their GPs.

And as for asking me to get my MP to increase benefits to cover childcare for dual income families? Is that a joke? I'm trying to fund my treatment - train fares, prescriptions, private physio, equipment - on a part time check out operator's wage. Seriously you want me to campaign for GPs on £60,000+ × 2 to get extra nursery fee help?

Weetabixandshreddies · 24/11/2018 15:58

Also extended hours is mandatory and GP’s did not get a ‘say’ in whether they wanted it or not. CCG decision

But they aren't covered by my GP surgery. They are situated in 2 areas of the borough with no access to medical records to what is their purpose? I can't see them to get a referral, to arrange tests, to give me results, to change medication. All they do is prescribe antibiotics.

Same with the nurses at the walk in centre. Why aren't patients signposted to them for urgent acute illnesses instead of being given a same day GP appointment and keep the GP appointment to do things that no one else can do?

Want2bSupermum · 24/11/2018 16:03

weetabix Its subsidize childcare or an increase in wages. It costs a lot to work 60+ hours a week which is why so many GPs go PT. You asked what you could do.

For a GP making £60k FT, really it's about £25k if you consider a regular 35-40 hour work week. The rest in overtime. It's not as well paid as you think it is once you have DC.

PookieDo · 24/11/2018 16:04

Whoever is running that is clearly doing a shit job. We have full access to medical records there is only a few things we can’t offer and even that is close to being resolved (systems operational issue)

Weetabixandshreddies · 24/11/2018 16:05

It's not as well paid as you think it is once you have DC.

Same as plenty of other jobs. Like someone working full time in a supermarket for 37 hours a week on £8.50 an hour. Still need to pay for child care.

PookieDo · 24/11/2018 16:06

but to add the work and cost involved of setting up and running such a service is mind boggling

Weetabixandshreddies · 24/11/2018 16:07

PookieDo

Agreed. It wasn't the patients that selected the provider though. God knows who set up the contracts. My GP is Chair of the CCG though so I'm guessing he had some say in the matter.

PookieDo · 24/11/2018 16:08

Does anyone here realise the cost of medical indemnity?

Weetabixandshreddies · 24/11/2018 16:12

Does anyone here realise the cost of medical indemnity?
Yes. I was a staff nurse for may years. I get it.

It still isn't the fault of the patients. What are drs unions doing to fight for better funding?

PookieDo · 24/11/2018 16:12

Who is running it is it a GP board or an urgent care service?
We can’t afford to compete with the hourly rates of nearby private providers. Won’t post what they pay but it’s so competitive. Our local board refuse to contract it out because that is a slippery slope

PookieDo · 24/11/2018 16:13

GP’s have to pay £xK indemnity for the extra sessions they do unless the practice or provider pays it. Think it can be £40k for one year for one GP?

Weetabixandshreddies · 24/11/2018 16:16

Who is running it is it a GP board or an urgent care service?
I don't know. The walk in centres are definitely a private company.

The gp hub is advertised as a venture between all gp practices but they aren't staffed by our gps so it might well be a private company paid to run it.

It's still not the service that it is purported to be ie extended GP hours because their services are so limited.

AlexanderHamilton · 24/11/2018 16:19

Not the case here. Dd needed a referral to a specialist dance physiology. She phoned on the Monday and had a telephone consultation the next day.

We wanted to get ds’s ears checked out as he felt they were a bit blocked and thought he was having problems hearing the teacher at school. He got an appointment that afternoon.

My mum wanted to get a wound checked she got an appointment that morning.

Graphista · 24/11/2018 17:04

"1 with the aim to relieve GP’s and 2 to try to improve the quality of living for the cohort of people they are targeting." See that's interesting, the order that's been put in.

"GP’s need the time to invest in their local services from a business point of view - their premises, their recruitment, increasing list sizes, CCG and public health demands (yes demands), statistics and processes they are obliged to provide." But they chose, the WANTED to operate as self employed contractors to the nhs.

"Your local surgery is dependent upon it’s surrounding infrastructure. If you have a terribly performing local acute hospital, a huge elderly population who cannot access any help from social care, high levels of poverty, massive cuts to mental health services - where do you think these patients go? They go to their GP" well they try - if they can get an appointment.

"The salary isn't as high as you think if you have a family to support. If both parents are working the childcare costs for more than 1DC don't make it worth it to work FT during the preschool years" sorry I'm really not buying this one, childcare is no more expensive for GP's than it is for care assistants on nmw. But they're on a much larger salary.

"DH outearns me by a huge margin so my income is always going to be the one considered against the cost of childcare" been on mn long? The usual response to a comment like this (rightly so) is that childcare is BOTH your responsibility and that keeping your hand in career wise is worth the short term lower disposable income.

And sorry but I think tax deductions for higher cost childcare for those doing reasonably well when we have working families needing to use foodbanks, full time workers sleeping on the streets! Is not the priority.

PinkieDo as has been repeatedly said, people do want to use other routes to primary healthcare - some GPs/surgeries are preventing this.

No the health of the country isn't entirely down to GP's but they're the first port of call to the healthcare system and as such should be run effectively and efficiently and currently they're not.

"but also hope that Brexit does mean that money will be injected into the RIGHT areas of the NHS." 😂😂😂 do you seriously think this isn't happening because we're in the EU? Brexit is going to make things so much worse.

Agree with weetabix that 111, out of hours have cost more without actually providing decent services. 9/10 111 will send you to hospital - possibly even calling out an ambulance - for the most minor reasons. It's not fit for purpose. Out of hours are staffed by hcps being paid extra yet unable to deal with patients properly as they don't know them, usually don't have access to records & increasingly because they're not Drs - instead sometimes paramedics - who are great at what they're trained for which is a&e stuff, not so much chronic conditions and complex patient histories & Med regimes.

"I am closely involved in this aspect of GP practice and I can find a lot of nurses but very few GP’s. So it may be more worthwhile investing in nurse training." That makes sense to me, as long as the nurses weren't taken advantage of. Would free up GP appointments, patients get the healthcare needed, but can I suggest nurse practitioners also be able to make specialist referrals? It seems nonsensical to make patients make a GP appointment when they and the nurse can perfectly well work out that a referral is needed.

"MPs and policy makers and drs unions etc are the ones that should be fighting for that. It isn't fair to ask patients to fight on behalf of their GPs." Completely agree.

PookieDo · 24/11/2018 17:11

@Weetabixandshreddies

Ok so this is not privatised although a consortium of GP practices, but staffing is in and out sourced through no choice, and why it is hard to get off the ground is like I said

  1. Pay rates priced out by private providers elsewhere. People will travel a little further for an extra 15% an hour
  2. Gp’s can’t afford or don’t want to pay thousands in extra indemnity insurance to do more hours
  3. Gp’s already usually run a at least 1 late clinic or Saturday morning service in house and this is expecting them to do even more work, in their own spare time and they probably have families
  4. Can’t advertise what you can’t provide. If they only managing to get 30% of their clinics staffed then pressure on normal services continues
  5. Computer systems like this are really expensive to buy (and maintain), also more problems arise where GP’s have all bought different packages over the years leading to being impossible to obtain one central record
  6. Usually also running along side 111 type out of hours clinics at the same time and same places, meaning an absolute double up of what is already going on
  7. GP’s only get the money for what hours were covered, in arrears. So only cover 50% that’s what you get in costs so unless you have £££££ to invest in it it’s being done on a shoe string.
  8. Money cannot be allocated elsewhere to any other area of general practice. So you can’t adapt what you already have as they will only fund this
  9. Have to set up and register with HMRC, CQC, develop policies etc etc etc, a lot of work involved for already stretched GP’s
PookieDo · 24/11/2018 17:16

but can I suggest nurse practitioners also be able to make specialist referrals? It seems nonsensical to make patients make a GP appointment when they and the nurse can perfectly well work out that a referral is needed.

This is tied up in red tape NHS tariff and clinical policy isnt it. A trained emergency nurse could read your wrist X-ray and prescribe something for flu but there is a line they have to draw for certain medical conditions - only a docror is allowed to request and read a chest X-ray, aren’t allowed clinically to refer to some specialist services as rightly so, they aren’t doctors and not paid to be doctors. The specialist services also design their own policies so if they exclude self referrals, that’s not the fault of the GP either

PookieDo · 24/11/2018 17:20

They are using paramedics and highly trained nurses for minor illnesses clinics. They can’t really go above that

We need a better patient flow system. Without a doubt. No I don’t expect it will get better with Brexit at all, like I said in a decade I think we will all see a very different (and privatised) system

dontalltalkatonce · 24/11/2018 17:23

Wow, from the responses on here, I have no idea why anyone would want to be a GP! You can't do right for wrong and it's all their fault. You couldn't pay me enough money to take that kind of abuse.

Weetabixandshreddies · 24/11/2018 17:24

PookieDo

Honestly my reaction to that is "and?"

My surgery runs no Saturday morning or late night clinics. At all. Never.

After 6.30pm M - F and at weekends you go to GP hub 6.30 - 10pm weekdays and 9 - 9 at weekends, or OOH at local hospital or walk in centres which are open until 8pm.

The contractual ins and outs are of no interest to me. There are many, many back office staff employed at my surgery. Perhaps they should look at deploying resources to better support the drs or the drs should campaign for better funding. Yes I will add my support. I will urge my MP to support (though I know that he already does).

All of these are political issues but the actual formation of primary care services have been decided by someone. In my area, whoever has set it up hasn't done a good job. What is the point of paying for basically glorified 1st aid sessions?

Want2bSupermum · 24/11/2018 17:29

graphista That's my point though, to fix the big problems you need to fix the smaller ones. Supporting families with large childcare costs means the government will collect more tax in the long run which will make it easier to support those in need. For a family you are looking at 15 years of support over a career of 40 years. It will also really help address the current shortages of clinicians and reduce wait times.

I also don't agree that childcare costs are a shared expense. The lower income earner will always be comparing the cost of working vs staying home to raise their family and look after the home themselves.

weetabix Someone making £8.50/hr isn't covering their childcare costs in full. They will be receiving benefits to offset the cost if they don't have a family member watching their DC at no cost. Nothing wrong with this set up of receiving benefits but please do be aware that finding quality childcare on weekends is very tough. I've done it because we have no family close by, DH was traveling while I had to work weekends and had to get a sitter which is very expensive. No daycares or good childminders are available although our local hospital has 24/7 childcare for under 12s for staff and patients DCs. It's heavily subsidized and lots of women with young DC are working FT.

PookieDo · 24/11/2018 17:30

Whoever has set yours up is doing a shit job of it, but I am just giving the reasons as to why. I live in a different area to where I work and my own GP hub has no problem with medical record or referrals and I have been there a few times for me and DC with no issue. It is not working where you live but that is not true for all areas. Yes you should complain about the services

Do you mean just move out their secretaries and receptionists as back office staff to run extended hours? What resources should they be utilising if they don’t have the resources to see the patients they do have IN hours? I don’t get it

Weetabixandshreddies · 24/11/2018 17:32

Want2bSupermum

Yes weekend and evening child care is impossible to find. Which is why I left my job as a staff nurse when I had children. Over 20 years ago too so no benefits either.

Weetabixandshreddies · 24/11/2018 17:36

Do you mean just move out their secretaries and receptionists as back office staff to run extended hours?
No I mean take some of the money used on salaries for back office staff and employ more clinical staff. They have recently employed a pharmacist who can prescribe. I was a bit sceptical but saw her because it was the only appointment available and she was excellent so employ another 1 or 2 of her. Honestly there are a good 10 - 15 office staff plus 3 receptionists plus 2 answering the phones plus a practice manager. That must be expensive.

PookieDo · 24/11/2018 17:47

I don’t know your practice size but I am doubtful that sacking a handful of receptionists who probably only earn £10k a year will make a worthwhile dent, whilst leaving referrals that need typing and sending and chasing, answering phones, booking appointments, organising prescriptions (usually a full time job in a busy practice), dealing with patient files, letters and all of the disgruntled patients will help relieve the burden on a GP practice. At all.

Most areas are using pharmacists in this way now for medication reviews as you have stated and that is what senior GP’s spend time organising collaboration such as this. You have a very extended service from 8am-10pm? And 9-9 on weekends. It is just that whoever is running it is having issues with the patient records and referrals? Bring this up. Make a complaint.