To think this is partly why the NHS is fucked?

[Babysharkdododont]

Newly pregnant with 2nd dc. Went to GP practice today to ask to book in with Midwife. Was told I have to see a GP first, I queried this as last time was direct Midwife booking. Was told definitely have to see a GP, so I asked why, was told "well otherwise everybody would just be booking Midwife appointments". Surely only pregnant women would book, even if it was open access
Anyway, asked for a GP appointment, they have none. I'm to go to morning surgery and wait.....the receptionist seemed completely oblivious to the fact I was having to take a GP appointment I don't need, when there are none available.
I'm a nurse and love the NHS dearly, but this petty beurocracy is killing it off.

In my second pregnancy I was referred straight to the midwife, no gp appointment needed. When I had my first appointment she said "home pregnancy tests are so efficient these days, if you've had a positive on one you'll definitely be pregnant" and so never checked herself that I was actually pregnant.

At my surgery we don’t even do booking in appointments any more - when a patient rings up they are told to fill out a form that’s available on our website and either email it to us or drop it in.

I have always had to book a gp appointment before seeing the midwife. They never have done a test to confirm, they have always gone by my word. Its was the most pointless appointment I have ever had. Such a waste of nhs money.

In my area you don't see the midwife until 10-11 weeks and it's direct access. You can see the GP before them if you are worried but most woman don't bother.

Then there is the waste over blood tests. I am aware they are paranoid if they aren't done in the same hospital but in my case the midwife repeated blood tests for genetic disorders which are not standard as it depends on your ethnic background, were on the same system as done by the same hospital and don't suddenly disappear if you have one of them.

The latter led to a hospital doctor ringing me in a panic when they could have saved money and time by just screening my partner.

We did some digging and the NHS does this all the time. They then blame the couple for not coming forward for genetic screening quickly when the couple's can prove they both know that one or both of them are carriers/have a blood disorder and it's in their medical records before they got pregnant.

Yes I had to go to the gp. At some work inconvenience. It went like this:

Gp - how can I help
Me - I’m pregnant and apparently you need to refer me to the midwives
Gp - ok have you done a pregnancy test?
Me - yes of course
Go - date of last period?
Me -
Gp - ok they will write to you with an appointment. Here is a leaflet on pregnancy health advice. Bye then.

Not a good use of his time or mine tbh. Zero value add for anyone.

oh dear!

You book into the midwife online via the hospital website in my area. I didn't see a GP until much later in pregnancy.

It was the same when I was pregnant 10 years ago. I thought it made sense til I got to the GP and he didn't even do a test, just asked if I had done one.

Complete waste of time.

Same with my waxy ears. I have to see a GP before I make an appointment with the nurse for syringing. Surely it's better for me to "waste" a nurse appointment if they don't need done (which they always do!) than to waste a GP appointment.

A bit off topic, but getting my smear yesterday the nurse was chatting away and we got on to the topic of numbers for young women being down yet appointment numbers being up in our area . She says this is down to a requirement to book all transgender women and people identifying as female an appointment to rule them out as they don't have a cervix. Even though she could easily do a phone appointment ( far quicker) these have to be offered every 3 years ( Scotland).

In no way transgender bashing at all, but what a sheer waste of time and money.

That's ridiculous and a completely inefficient system

Even the people who think they are pregnant but aren't will still have to book a gp appt, so it's just a choice of wasted gp or wasted midwife. But if straight or midwife then it's less appointments overall

So 100 women think they are pregnant, 10 aren't. If gp first then midwife that's 190 appointments (100 with gp 90 with midwife) if midwife first then it's just 100.

And realistically what woman is going to book in with a midwife if they haven't taken a pregnancy test?

MIL has a number of health issues, and I have to take her to our GP or hospital most weeks. Every time I am left gnashing my teeth at some totally unecessary nonsense exactly like this.

It just ends up with a whole load of people sitting around in hospital twiddling their thumbs, often taking up valuable parking spaces, because of an unwieldy and inefficient bureaucratic system. I don't believe it has anything to do with shortage of money, just incompetence clogging up the whole system.

I do agree that it's a bit backwards.

Here you just call & speak to a nurse or gp on the phone & they tick a box that refers you to the mw. Apparently during the 12 month self referral trial period & large number of ladies weren't pregnant by the time of booking. I'm still a bit at how talking to the nurse/GP on the phone stops this though.

I often wonder just how much NHS money our local Trust waste on postage each year.

My two sons have six-monthly appointments and it used to be that the next one would be made before leaving outpatients and that system worked well. Now it's done by letter and quite often the appointment date isn't workable for them so has to be changed, resulting in another letter being sent by the hospital. We often get duplicate letters and quite often the hospital change the appointment meaning another letter has to be sent.

One situation we had last year was that one son had a letter giving him an appointment on Christmas Eve at 3.30pm. That worked fine for him as he was finishing work at 1.30pm. However, the next day he received another letter informing him that his appointment had been changed to 1.30pm, meaning that he wouldn't be able to get there and working in retail meant that he couldn't really leave early on Christmas Eve. Another appointment was then made and another letter was sent out.
It wasn't the first time that had happened either.

I needed my Mirena coil changing. Had to book appointment with GP to get "approval" that took 6 weeks. Then had to wait another 8 weeks to book a mini surgery appointment with said GP and a nurse. Oh and get the coil from another pharmacy as they can't get them.

I can't book any longer with our local sexual health clinic as they don't see over 25s. Which actually angers me as they are far better at getting coils in and out than a GP who does perhaps 12 a year!

Madness.

It's crazy, but I've often thought the same thing. Considering how in demand GP appointments are and how keen surgeries are to drum into us the cost of appointments and wasted appointments as well.
I've been made to have several completely unnecessary GP appointments where I've been in and out in minutes and could have easily been sorted over the phone or not at all. At my surgery they won't even give you basic blood results over the phone anymore they say you have to see your GP.

I had to see the GP, before the receptionist would let me make a midwife appointment. Then said midwife appointment turned out to be not, as I expected, my booking appointment, but a useless "first contact" where they did almost nothing except tell me I had to wait another 3 weeks for my booking appointment
Oh, at neither of these appointments has anyone asked me for any bodily fluid to confirm my pregnancy.

my first pregnancy I had no idea what the system was, and I have IBD which I take meds for so I went to the GP. Never got as far as a booking in appointment because I had a miscarriage.
Next time I'd moved areas, and obviously still have IBD so went to GP to check what the process was there as I couldn't find out online.

At my GP you have to see a Dr about contraception not a nurse and each time I need a blood test (repeat tests for meds I'm on) I have to see GP and then separate appt for blood test.

Is it a data-sharing protocol problem, I wonder.

So if OP booked with MW there's no mechanism (permission) for GP to see & review her records, in case she was a patient who needed GP management. So basically, can only allow the GP to see her records (& make decision she doesn't need GP) if she has appt with GP.

Data sharing protocols & concerns lead to broken services.

I just phoned the midwife unit directly and my first appointment was booking in. No test to confirm pregnancy. Must be different in Scotland...

I was slightly surprised the other way round that nobody at any appointment (until the first scan, clearly) wanted any confirmation that I was actually pregnant beyond asking if I’d used a standard test myself. Clearly varies wildly by area.

I could rant at length about the idiocy that is each Trust getting all their supplies (eg Pregnancy Notes) separately rather than using their combined buying power. And that’s before, like me, you’re sent out of area because the hospital you were going to is full and the lovely midwife can’t find the details in the notes because they’re in a completely different order.

I never had a test to confirm any of my three. They just took my word for it.

Where I live in London, there is online self-referral to the midwife which worked fine for me.

I think there is no need to see your GP to 'confirm' the pregnancy- the test is no more sophisticated or better than anything you could buy in Poundland or similar!

It's crazy that sounds like a waste of a GP appointment (if you can actually get one!)

I had this with my first 2 pregnancies, by my 3rd i rang up saying i was pregnany for the 4th time (miscarriage between 1 & 2) and i needed to book in with gp so i cpuld get midwife started. The receptionist laughed and just said "i think you know what you're doing by now, I'll just book you straight to the midwife".

We've always had an excellent and common-sense service at our GP Practice but earlier this week, DH called to make a routine appointment to discuss an ongoing, but not serious, health issue. We have always been able to book non-urgent appointments up to two weeks in advance so he called in good time to hopefully set this up for his day off in a couple of weeks. The receptionist told him he couldn't book directly with a doctor - despite his ongoing issue being noted on his records - and would have to see their new Health Care Assistant first. She was insistent that they can only offer same-day HCA appointments so he ended up taking time off work, 30 min drive from work to GP, waited 20 minutes in waiting room, was called for appointment and was in with the HCA for less than 2 minutes as she said "I see you want to see the GP about X and I see you've seen him before so you're obviously on top of things, I'll book an appointment for 2 weeks today". Another 30 minute drive back to work and a whole lot of time wasted.

I do have sympathy though. There must be so many time wasters who don't need to see the GP or who can be redirected to the practice nurse or similar. Plus, I guess this removes the need to have to discuss issues with the receptionist but it really does seem like a sledgehammer cracking a nut and where it solves one problem it creates a whole lot of inefficiency in its place.

With DC1 I was referred straight to MW the 1st appointment was the booking app allow 3 hrs, including scan. I even left that appointment with a new babys toothbrush!

DC2 different area.
Call the practice how do I refer to MW.
You need to collect form and return it.
See MW, who clearly never read the form, is it a planned pregnancy, No IVF happened by accident. You need booking appointment urgently.
Booking appointment was with the same useless MW in a different building 3 days later who asked all the same questions
Then they had too book a scan at hospital.

FFS!!!

I actually think people should examine how each part of the NHS works and decide nationally on the most effective way to operate it.