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

[fussychica]

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?

My DH is a GP in central London and is senior partner in the practice. He left working in a hospital to train as a GP when our DC’s were small as it was more family friendly hours as I work full time. Over the last 15 years things have changed so much and it’s no longer the job DH loved. Due to Brexit we are probably going to leave the UK and I can’t wait for DH to have a change before his work affects his health negatively. GP’s in the UK provide an amazing high quality service, not seen in many other countries but the system needs a major overhaul and investment of time and money, neither of which the NHS has.

My surgery is great, not sure the normal wait as my physical health is ok and I only get seen same day if my MH goes to shite. I know when DD banged her face up at school we got her seen by a nurse within 10 minutes.

My family lives a village over (roughly 2 miles) my gran is in her 80's she's housebound with dementia. I've been chasing her flu jab up for 6 weeks with no luck, they missfiled paperwork when she had a stroke she never got seen and it was just luck she never suffered another one, told my mam she would have a 5 week wait when she found a lump on her remaining breast. I could go on.

We had to upsize this I have purposely stayed put despite being able to move closer to family I care for partly down to the local GP's.

So in my case it's luck although I seem to spend half my life chasing my grans various appointments/prescriptions/tests up so I can understand the frustration.

Pharmacist not just doing medicine reviews. I went because I needed pain killers more than co codamol and she prescribed tramadol.

The extended hours are great. Just very very limited in their application.

And I have doubts that an 8 dr practice needs over 3 times as many office and reception staff. Is that normal?

My sister is at a 2 dr practice, 1 nurse and 2 receptionists.

Most areas are using pharmacists in this way now for medication reviews

Is this a new thing?

I keep getting pulled about one of mine, I'm on an older style antidepressant but have been for years and was put on it when I was an inpatient.

I'm all for pharmacy's and treating common ailments, pain etc but I don't really want to discuss my full mental history with them. We'd be on a fortnight for a start.

It’s a trained pharmacist the same as you would see a Doctor or a nurse in your surgery, you don’t do it in a chemist and they have access to your records.

It depends on the practice size, how can you compare a 2 GP practice to an 8 GP practice. The list size at the smaller one is probably 3000 but the large one it’s going to be 20,000+!

If they are offering at least 25-35 appointments per day in a small practice for 2 GP’s this is what 250 a week? And a large practice 1000?

Pandamodium

Mine is actually in the GP surgery and you book an appointment to see them much as would the GP or practice nurse. It wasn't the dispensing pharmacist in the chemist.

If they are offering at least 25-35 appointments per day in a small practice for 2 GP’s this is what 250 a week? And a large practice 1000?

I get that. But wouldn't it be proportionate?

It seems then that as a patient you are much better being registered at a very small practice rather than at a large health centre type practice.

@Pandamodium

Contact your local district nursing team and ask whether they can do the jab. They will see housebound patients for this service when they are aware of them

It depends on the needs of the practice alongside the day to day patient requirements they are also a functioning business so need to deal with finance, payroll, HR, complaints, estates, managing staff, appointment rotas, staff rotas. These things are all time consuming, I am ‘back office’ so to speak and without all the practical issues being dealt with it just piles more pressure onto clinicians. As I am there to do it they don’t have to worry about it. I spend a lot of time sorting out and solving problems - someone has gone off sick, finding a replacement or moving patients, dealing with payroll and staff bookings. Upkeep of patient record system (in a practice there would be an unholy ton of paperwork to scan), some practices still aren’t fully digital and hold older paper records. I work for the consortium (not in one practice) but I also hold another back office job in the NHS and if is we who keep the equilibrium and often a lot of the actual shit from the clinical staff so they can be out there - seeing patients
And we are cheap

My surgery is the same. I then say something annoying like cheers I’ll be dead by then. I used to pay about £40 for an online consultation if I thought I really needed to be seen and have been prescribed things online as a result.
For me the nhs take my taxes and prove utterly useless. When I worked FT I’d just go around sick until I really couldn’t put things off too much longer and yes I also ended up inA&E as a result. Pathetic ill run service imo.

@Parker231 I also had a GP have me go through how I got into what I do as they were so desperate to leave their practise and also another GP who is my friend change careers to become a dentist as much less pressure apparently.
Such a shame I really think the whole system could work but it’s being run so badly.

I think pp are correct about a charge solving the issue. Adults here are charged 25gbp equivalent, less if it is an accident covered by acc and free for children.

Sometimes if I call late in the afternoon I have to wait until the next day for an appointment. Never longer than that.

A week is too long. Six is inexcusable.

It's an unfortunate situation, but not one that the surgery chooses to be in. There is so much pressure on GPs now, with people living longer, people abusing the system, less money to employ more doctors etc. The worst thing is when people don't show up for appointments without cancelling first, as many as 10 per day where I used to work. Mostly repeat offenders too, wasting hours of appointments that others in need could have had. Speaking as a former GP receptionist, it's as frustrating for us as it is for you. However, some surgeries are better than others with regards to appointments - are there any others you could register with that may have a better system? At my old surgery I would regularly wait 4 weeks for an appointment, but since I changed I've always managed to get one within a week. Check out the reviews on the nhs site.

are there any others you could register with

I am very tempted. My only concern is that I am currently under the care of 4 different hospitals and having treatment that can't be paused that needs regular monitoring. I'm worried that changing surgeries might mess everything up.

I see what you mean. However a lot of surgeries are implementing an electronic system whereby your records can be more easily shared between services. Keep in mind though that if you do change, the onus would be on you for ensuring that all 4 hospitals are aware of your new practice.

Keep in mind though that if you do change, the onus would be on you for ensuring that all 4 hospitals are aware of your new practice.

Exactly. How do you manage that when you can't speak to anyone on the phone and my latest consultant letter cites the wrong dosage of a drug that I'm on and promises to send the results of my lumbar puncture asap never had a lumbar puncture in my life. I can't trust that it will work and it's too frightening to risk it.

"The worst thing is when people don't show up for appointments without cancelling first"

When someone i know put in a complaint about neglectful care she got a report back accusing her of missing two appointments She has never missed any.

shes now talking about filming herself on her mobile sitting in the waiting room at future appointments so shes got proof.

PookieDo - Re nurses referring - Rules/policies can be changed if the will is there. Nurses are perfectly capable of making those decisions.

Re post at 17:11 a lot of that is the result of GP's WANTING to act/be self employed, running their surgeries as businesses rather than being fully part of the nhs.

I hope you're wrong about privatisation but I fear you're right - and I don't think just due to brexit.

"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." That would only be true if we had a govt that gave a shit about those in need! This govt I can well see being happy to make childcare cheaper for mc families BUT any money they save as a result won't go to those in need it will go toward eg more tax cuts for those already well off.

"I also don't agree that childcare costs are a shared expense." Why on earth not?! Those children belong to BOTH parents.

"It will also really help address the current shortages of clinicians and reduce wait times." I think it would have a very minimal effect on this.

"finding quality childcare on weekends is very tough" I can't remember the last time any GP of mine worked at weekends. Within hours of 8-5 mon-fri, maybe 5.30.

"Someone making £8.50/hr isn't covering their childcare costs in full. They will be receiving benefits to offset the cost" having been a working single mum on a low wage with a child in full time childcare I'm pretty sure I wasn't better off than a GP! Even with the help from benefits. I'm also well aware that unless you can afford a nanny or au pair it's pretty much impossible to get childcare outside roughly 8-6 mon-fri. An issue which I agree needs addressed as it severely restricts what jobs parents and especially single parents can do.

Also I think I'm right in thinking you live in America? Not sure if you're an expat or if you're American married to a Brit who's lived in U.K. Too?

"GP’s in the UK provide an amazing high quality service, not seen in many other countries" which countries are you comparing to? Because some of us have lived/are living/have friends and family living in other countries and experiencing/hearing of better services including in social health care models.

"but the system needs a major overhaul and investment of time and money, neither of which the NHS has." On that we agree. But it won't happen under this govt, too many of its members have vested interests in taking us into a privatised USA style set up.

I too wouldn't want to discuss my MH issues with a pharmacist. It's too nuanced an area of health and I've experienced too often overkeen hcps who've tried to take me off meds that are working to put me on some new "wonder drug".

"I think pp are correct about a charge solving the issue. Adults here are charged 25gbp equivalent, less if it is an accident covered by acc and free for children." That's EXACTLY what this govt wants us to think - the reality would be those most in need (like myself or dd) wouldn't go to the GP because they can't afford it, resulting in the medical issue worsening which means they'd then end up in hospital - possibly via ambulance and a&e - which would be a damn site more expensive to whatever was left of the nhs than properly funding, resourcing and organising primary care. And would put patients at risk. (Also see attached pic)

Re "missed appointments" I too am sceptical - I've mentioned this before on mn but I'm now at the point when if I make an appointment I either get THEM to write it down and initial it or record the call - because too many times I've been given the wrong information - date and day of week don't match, wrong time (receptionist SAYS ten to 3 when actually making apppointment for 3.10 for example). I've also had the experience of being physically stood at the reception desk, receptionist too busy Blethering about her weekend or holiday, keeping me waiting over 10 mins and THEN trying to tell ME I was late and can't have the appointment! When that happened I did complain to the practice manager (it happened a few times at my last surgery with one particular receptionist who was a bloody nightmare!)

Appointment info error has also been a problem with specialist depute though to be honest - at one point got 3 different letters for an appointment for dd in ONE envelope!

Just another example of why the NHS is NOT working for our country.

Graphista Yes we are expats losing in the US. Childcare isn't a joint expense when the wage differential is massive. His income totally dwarfs mine and is the income that provides. If we both earned less but around the same then we would consider childcare a joint expense because both of us would need to work if that was our individual incomes.

GPs will be working outside of the hours they see patients. The paperwork they need to complete is immense. I would imagine for a day of appointments until 5:30pm they probably aren't leaving until 7-8pm. It's easily a 12+ hour day.

Also, you might not have found GPs working weekends because it's too hard to arrange childcare. I know so many nurses who have walked away because they can't find affordable flexible childcare.

That is awful op.

At my surgery you ring at 8am and always get a same day appointment and people still moan that Doctor X/Y/Z isn't available.

6 weeks? some people would literally die waiting, that's a really long time if you needed antibiotics for example.

want2besupermum you’ve made some great points, and my life shares many parallels with yours.

It really saddens me how the public seem to think they own doctors. It doesn’t matter what their domestic set up is or how their own physical or mental health is, or the fact that some decide that they don’t enjoy the job they’ve trained to do (it happens) the mantra seems to be “we’ve paid for your training therefore we own own and we’ll dictate the hours of your working life until you die” (I was going to write “until you retire”, but I’m sure plenty would just come out and tell me that GPs retire too early and should be made to work til they are older —and drop dead in the surgery—).

As hospital consultant on a similar wage to a GP my take home on a standard nhs contract after childcare, travel, professional fees —but mostly childcare— is £2/hr. and it hasn’t got any better since DC started school as DH and I leave the house at 7am, so our only option is to pay a nanny (because I have yet to find any alternative childcare that starts at 6.45am) who essentially does —nothing— very little for 6 hrs/day during term time. And like want2be my husband’s salary dwarfs mine.......so actually financially there is no point in going to work at all.....but for some crazy reason I still do......but part time, and as a locum, which makes the childcare costs more manageable.

And the £2/hr doesn’t include the last 3 weekends (approx 60hrs in total) that have be written off studying for an exam, that I need to have. Those 60 hours are essentially a voluntary donation of my precious time to the NHS.

But none of us work hard enough, do we ?

It really saddens me how the public seem to think they own doctors.

I don't think that I own my GP (or anyone come to that). Their working hours, home set up, domestic arrangements are their own business and I have no opinion on them.

What I am concerned about is that I, as a patient, can't get to see a GP. That my health has to suffer because of the way my surgery and my CCG choose to run the primary care services in my area.

Do you suggest that we as patients stop being selfish and go off and die quietly so as not to inconvenience the over worked doctors?

I do find the attitude quite frightening tbh. Me asking to be able to see a GP without jumping through a million hoops which would mean not being able to work is just ludicrous. Those of us with long term serious health conditions are still expected to work yet our dependence on health care makes it an enormous struggle.

One silly example. I have a blood test every month due to the medication that I am on and the fact that it is affecting both my blood count and liver function. They have closed down community blood test clinics in several places leaving either the hospital or 1 clinic to have blood tests in. The waiting time? 3 hours unless you can get there a couple of hours before it opens. My hospital blood test department opens at 7am. I have been there at 5am before and still not been seen until 8am.

Once a month I have to do that just to have my bloods checked. How do I manage this and still work? How do I manage seeing my GP and still work when it takes hours to even get through to them and you can't get an appointment for weeks? Or now that you can only phone for an appointment between 8am and 10 am and 4pm and 6pm. So just too bad if you work at those times and can't make a phone call.

I am sure that doctors are having a very hard time in the NHS. I don't know how you carry on. But you know what, patients are suffering and having an awful time too. Particularly if you have the temerity to develop an illness that means you need more than an occasional appointment.

And sorry to have to point this out but how can you factor in child care when working out your hourly wage?

Your hourly wage is what you are paid and then expenses come out of that.

How much do you think one of your nurse colleagues earns per hour once you take off childcare and registration costs and professional membership costs and training costs?

I was a nurse in a private hospital. Our consultants all worked in the NHS and privately, during the week and at weekends. I know an NHS consultant now. Two days a week he works in his private clinic. How does that factor in to an hourly wage?

Sorry this is the pic I meant to attach