AIBU to wonder why it has become so impossible to get a Doctor's appointment?

[Bluebananas01]

I remember when I was a child in the 80's, if you were ill you could always get to see the Doctor the same day. I even remember the Doctor doing a home visit when I had the measles. I called up this week to try and get a Doctor appointment and it is a three-week wait (South East).
Everybody seems to talk about there being no Doctors appointments but what is the real reason? Is it just down to underfunding? Are people not turning up for appointments? A sicker population?

Even when I get to see a Doctor it is as if they are trying to get me out of the surgery asap and heaven forbid if you need a referral. Two years ago I went to the Doctors with joint pain, shooting pains, weight gain etc. I told him that autoimmune disease runs in my family and it felt AI as it came in waves (like flare-ups). He pretty much told me I was a hypochondriac. Asked if I exercise (because of the weight gain) and when I told him 6 days a week he told me to take up yoga and sent me packing.

Fast forward to this year when I was going overseas with my husband to his place of birth where it is super cheap to see consultants and have blood tests done. My symptoms had been progressing so I have blood tests etc and saw a Doctor there and discovered that it wasn't all my mind as suggested by the Doctor and that I actually had:-

Hashimoto's Thyroiditis (Autoimmune underactive thyroid)
Pernicious Anaemia
Severe Vitamin D deficiency.

How the hell did my Doctor miss so many warning flags about my health? I only ever go to the Doctors for smears and pregnancy so hardly one to visit the Doctor for the slightest sniffle.

It makes me wonder how many other people are being fobbed off and are living with a poor quality of life because their Doctor just can't be bothered to give a proper consultation.

[LellyMcKelly]

Doctors don’t want to become GPs anymore.
People aren’t taking responsibility for their own health
Aging population
In some areas population increases have not been met by increases in services.
Funding cuts

[Aquilla]

Over populatuon, op! Have you heard the '8 out of every 10 new houses built...' statistic? Bit of an eye opener and I say that as an immigrant.

[Purplelion]

Honestly never experienced this! For a routine appointment at my doctors it’s the next day or 2, for an emergency it’s always same day, if not within a couple of hours of phoning!

[GrumpyMiddleAgedWoman]

It's definitely a population growth problem round here. Aging population, huge new housing estates and any growth in GP facilities not keeping up. I recently tried several times to get an appointment for cystitis. No appointments for days, all the on the day ones gone by the time I got through in the mornings. Fobbed off with a phone call and told to get over the counter palliatives. I ended up with a day and a half off work, feeling like bloody death and phoning 111 on a Sunday for a walk-in appointment. I ended up costing the NHS more (many phone calls plus a Sunday GP, rather than one phone call plus a weekday GP) plus lost working time. Talk about a false economy.

[Processedpea]

Do you have the online booking scheme ? Ours is pretty good and I have managed to book appointment and repeat prescriptions very quickly. What is frustrating is booking for family planning clinics plus they are shutting our local fm walk in clinics though that's another thread.

[EastMidsGPs]

In our area you often see the same people at the surgery or pharmacy.
There has been quite a bit of work done on the loneliness and isolation and their effects on the number of GP appointments that person has.
It has been suggested that they visit their doctor more often, (older) patients have more falls and attend A&E more often.
If you consider such patients are visiting their GPs regularly out of habit, for reassurance or because they simply feel they need to, and it is a small surgery. Then a significant number of appointments are being taken up which could be released for acute/earlier appointments for others. One local surgery reckoned around 50% of their appointments are really about loneliness and isolation.
To this end, I am a volunteer in a couple of local small associated projects where we are trying to involve patients who are for whatever reason, identified as lonely or isolated in community based activities and meet ups.
After 6 months, we'll review their surgery visits and see if there has been a reduction.
We'd never let the people know they are perceived to be lonely and isolated.
I'm personally interested in trying to engage isolated men, who seem to be hidden in society.
Apologies long post but am really excited about our little project.

[StephenQueenBooks]

I got an appointment okay for the next day but went in 20 minutes late, was rushed through my issue and only in for 4 minutes. When I mentioned something she said "Is this important or can it wait until next time? I'm running late and there are people waiting"

I just shut my mouth and left. Felt like a right idiot.

[CherryPavlova]

There is really mixed GP experience but then GPS are usually private businesses that the NHS contracts with.
There is increased accountability, CPD and regulation that takes up huge amounts of time dealing with bureaucracy (as so many people develop ridiculous expectations and mention suing every five minutes).
There are fewer GPs and even fewer partners. Young GPs can often no longer afford to buy into practices and don’t want to as the return is so poor.
GPs aren’t always treated very nicely by patients. In many cases google is assumed to know more.
There are increased numbers of frail elderly patients with complex healthcare needs.
Contracts were changed many years ago to remove routine out of hours work. Most went to third parties.
Funding has reduced chronically. Doctors are being replaced with practice nurses, physicians assistants and even paramedics for all sorts of healthcare problems.
GPs don’t determine who to refer. It is strictly controlled by local referral pathways. The referral rate is managed by the CCGs and over-referral is sanctioned.

That said, most people with sensible action will recover from most things quite quickly. A doctor wouldn’t need to see a child with measles very often in U.K. nowadays. Most home visits waste time, aren’t the best place to see patients and most patients can get to the surgery. People seem to have lost common sense around when it is necessary to see a doctor.

[StinkyVonWinky]

Switch to a different surgery OP. Or ask to see a different Doctor. Some surgeries are just badly run! My surgery was, but has improved massively after the CQC came in and rated it inadequate, so they had to make lots of changes.

[Tessalectus]

Also take into account what the NHS does now compared to what it was set up for originally. Far more technically unnecessary procedures, more preventative care, more elective measures. Not all of these are bad, of course, but they do take up vast amounts of practitioner time, rather than being able to deal with actual care and emergencies as they were originally set up to do.

[Doilooklikeatourist]

Same day appointments available at the surgery we use.
Just turn up in surgery hours ( 5 mornings and 4 afternoons each week )
Give name at reception and say which of the Drs you want to see
They also have a dispensary , so pick up the meds on the way home

[Ellenborough]

Maybe because we've gone from 52 million population in 1960 to 67 million now, and the number of doctors hasn't increased in equal proportion?

And because the NHS has entirely different spending patterns now than it did 30 or 40 years ago. It is expected to fund things now that didn't even exist on its radar then.

[DeloresJaneUmbridge]

Good lord Jasmine, you do have a chip about GPS don’t you?

We have too few of them and the fact nobody wants to do the job these days speaks volumes about the thankless task it has become. Not surprising if the people they see think like you do.

And “fobbed off with a nurse” ODFOD...do you realise how highly trained and educated some of these nurses you get “fobbed off with” are?

OP it’s down to underfunding, a bigger population and a thankless job. That said my local surgery is fully staffed and I can usually get an appointment via their online system if I keep logging in and refreshing the page ...usually a cancellation comes up that way,

[Bluebananas01]

A doctor wouldn’t need to see a child with measles very often in the U.K. nowadays. Most home visits waste time, aren’t the best place to see patients and most patients can get to the surgery. People seem to have lost common sense around when it is necessary to see a doctor.

Totally agree CherryPavola - just mentioned the home visit as a point of comparison to then and now. Also, you mentioned that people have lost common sense in regards to when it is necessary to see a Doctor. I think this is what has made me cross about my treatment by the GP. When I went to the Doctors about my symptoms it was the first time in 5 years when I was pregnant with my second child. Prior to that the gap was 4 years between pregnancies so hardly going to the Doctors for the slightest thing. I hate going to the Doctors and have to force myself to go so was absolutely stunned to receive that treatment. Do I sound like a hysterical woman visiting the Doctors at the slightest throat tickle to you?

[Bluebananas01]

Very interesting findings re loneliness EastmidsGps.

[Theworldisfullofgs]

More doctors wants to be specialists than GPs but actually we need more generalists. We have more old people with more complex health needs. More care is done in the community but no transfer of resource into the community or extra resource to manage. Healthcare like everywhere else has been stripped of funding and it's hard to plan.

More old people. Immigrants have little impact, more like positive if extra tax was actually put into resourcing.

Banking crisis was managed badly and most people seemed to have forgotten that private debt was made into public debt then somehow blamed on immigrants. Amazing sleight of hand.

Its funding and poor planning by government (they also commission uni places). Oh and constantly wasting money of reorganizing deck chairs to say it's too early to tell yet...

And just think if we hadn't wasted £60 billion on Brexit, what we could do.

[scaevola]

Doctors appointments are much longer now. It used to be only a couple of minutes, now it can be 7 or more.

No shows aren't really the problem (without them, the system wouid buckle)

One factor is that GPS now employ non-doctor practitioners for many routine things - contraception etc - meaning they see mainly the higher need and more complex patients, who need more time (and can overrun even with the longer standard appointment).

Also, there is a demographic timebomb, GP numbers are beginning to fall, the number expected to retire shortly outstrips those joining by a considerable margin. Many practices are carrying gaps already. Often they cannot afford 'handovers' ;any overlap) between part-time doctors (and anyone who has worked parttime in what is in effect a job share system knows how that can make things worse for service users)

And yes, some surgeries are considerably better run than others.

[Redglitter]

My GPs practise is fantastic. I was diagnosed with a chronic medical condition purely down to my GPs insistence that something was wrong. She pushed for numerous blood tests and assorted scans. My condition would have finally come to light further down the line when I became very unwell with it. Thanks to her by the time I did become unwell my visit to OOH was triage quickly and taken seriously.

Our health board has started the system where receptionists ask for the reason for your call. Since this has started it's become so much easier to get an appt. Usually within 24/48 hours if you're happy to see any doctor.

I'm possibly very lucky where I am as we certainly don't have the waiting times people on here have - thankfully

[Bluebananas01]

More old people. Immigrants have little impact, more like positive if the extra tax was actually put into resourcing

These are my feeling too. I feel that the immigrants to our country are a positive thing but that the extra in taxes etc have not been reinvested into the NHS to cover for the increase in demand. When I gave birth to my second son I called my local hospital, Royal Berkshire Hospital and was told they were too busy and that they would try other hospitals to see if they could take me. They called Newbury, Basingstoke, Oxford and I was eventually accepted at Wrexham Hospital in Slough. Obviously, with an influx of young immigrants having families here, the demand for maternity services will increase, yet successive governments don't appear to have given maternity services the funding they need. Purely an observation from a lay perspective.

[ijustcannotdoit]

Or you could have gone back again after a month and said it's no better?

I think that you had a very vague presentation and 'watch and wait' is a legitimate approach.

Did you go back again after to keep telling them it wasn't getting better?

[SinkGirl]

Hashimoto's Thyroiditis (Autoimmune underactive thyroid)
Pernicious Anaemia
Severe Vitamin D deficiency.

Unfortunately for you, you’ve got three things there that are woefully under-diagnosed in this country. I finally found out I had a vit d deficiency via a private blood test. I’ve also had multiple private blood tests for the other two and am sure I have both - the private blood results are always consistently bordering on out of range, and yet every time the GP tests they’re normal. I don’t understand it at all.

The U.K. guidelines for diagnosing hypothyroidism are a disgrace. Chances are that the level you were diagnosed at in another country wouldn’t be diagnosed / treated here (unless your TSH was over 10). Very rare for an NHS GP to check thyroid antibodies, too.

I had an awful GP appointment a few weeks ago where I basically begged for help. I’ve been unwell like this for over 10 years and they do almost nothing - they run a few blood tests, see that things are in normal range and that’s it. She was so unbelievably rude and nasty to me, as if I was asking for something completely unreasonable in wanting to know what’s wrong with me.

I spent 10 years being dismissed and called crazy before my endometriosis was diagnosed. Now I’ve spent 10 years being fobbed off with all this. They “diagnosed me” with fibro a couple of years ago - they said “sounds like fibro to me”, that was the extent of it. Asked for a referral to a rheumatologist as I was not convinced (it would explain about 10% of my symptoms but what about the rest?) and rheumatologist rejected my referral because I’d already been diagnosed with fibro 🙄

All she would do this time is repeat some blood tests - most have come back normal, just waiting on thyroid antibodies which I begged for. She told me to quit smoking, I have. I guarantee when I go back she’ll just say “see, there’s nothing wrong with you, bye”.

It’s quite shocking when you realise that doctors will do nothing for you unless they a) think it’s cancer or b) can diagnose you very quickly and easily with a straightforward exam or blood test. I feel completely abandoned and left to rot and I know they’re never going to help me.

[BogstandardBelle]

Does anyone know how new GP practices are set up, in response to demographic or housing changes? Does the local health board / trust set up a practice then advertise for GPs to work there as employees? Or are they more like small businesses / self employed, and can set up where they like?

[camelstraw]

"And just think if we hadn't wasted £60 billion on Brexit, what we could do"

Well, we could start by waitin until Brexit has happened (even though it should have by now) before deciding if the amount spent on preparation was adequate

[LonelyTiredandLow]

@camel but it's self inflicted!
You can't come on here bemoaning results of cuts and then say Brexit is fine because we don't care about the financial hit! How does that even make sense?

[WhiteCat1704]

Something similar happened to my friend only she was in her late 20s. She went with uncontrolled weight gain, very irregular periods, hair growing everywhere, feeling low and tired. She was told she is overweight and that's the problem. She argued she was eating very little. They fobbed her off.
She went back few months later as it was getting worse and got fobbed off again and told it was her weight again.

Eventually she went to see a gynecologist and endocrinologist in her home country where private healthcare is accessible and not ridiculously overpriced like in UK.
Got diagnosed with polycystic overies and beggings of diabetes. Got medicine. She lost tonns of weight as it turns out it was more water/swelling up not real fat. She looks great and goes back to her home country for doctors appointments.