GP practice "not offering appointments"

[Darkestseasonofall]

This is a new low. Just called to make an appointment to be told they aren't doing any for the foreseeable future.
If it's an emergency you can call on the day and try to get a telephone consultation, but that's it.
I can see a huge rise in people attending ED in appropriately or just becoming very ill with avoidable things.
This isn't NHS bashing, I'm a nurse, but I can't understand how primary care can just opt out of 90% of their contract.
AIBU to think this is just silly?

@Heatherjayne1972 I don’t know of any dentists opening in June, like yours, and I don’t see the hate on here about dental problems getting worse because services were shut for 3-4 months.

I know my own GP was open throughout, although it’s now with buzzer system and, obviously, over the phone first. They have a tiny waiting room (think normal house front room), so that’s understandable.

Loads opened straightaway. We had a backlog of lost fillings and broken teeth so get sorted
Plus it’s a business. So the sooner we were back to it the sooner the money comes in

Mind you our fantastic government only told us one week before! All 4 of my bosses found out from the bbc news!!

Some nhs dentists aren’t open yet but that’s down to funding

www.pharmaceutical-journal.com/news-and-analysis/news/boots-suspends-flu-vaccinations-for-under-65s-as-pharmacies-report-huge-demand/20208378.article?firstPass=false flu vaccine stocks are low, even big chains have difficulty doing them.

I don’t buy the tiny waiting room thing

What do you think we do? Dentists are required to keep patients outside until their appointment time and then go straight into the surgery. We are required to be in full ppe before the patient enters the room Doctors should do the same

@LadyWithLapdog the point is that there is a total lack of consistency both for dentists and GPs. Some opened throughout, others practically closed up shop. Why?

Actually I am pretty cross about my dentist tbf as are others, not that they initially closed down, but that it had taken them so long to open up compared to other dentists and they still aren't doing routine check ups. Not a single peep about even a partial refund.

I hope no dentists ‘worked throughout’ Dentistry was illegal in the U.K. between 23 March and 8th June. With hefty fines for working anyway
Except for urgent dental centres - that’s where 111 and ordinary dentists were sending people with issues that couldn’t wait

@Heatherjayne1972 I think you’ve misunderstood me. The tiny waiting room I mentioned was in relation to now having to ring the buzzer to get in, rather than just sauntering in as before. My DC’s orthodontist schedule has been delayed by a few months by dentists being shut. She’s young and it’s a cosmetic issue so, fair enough, she’s had to understand why she has to wear her braces for that much longer. I suppose I should’ve come on MN and had a go at all dentists etc. I thank my lucky stars I’d finished my own implant procedure the week before lockdown as I’d have been so depressed without my teeth. It’s been shit for everybody.

You clearly haven’t read the thread Jacks.

There has been no sweeping generalisation but plenty of posters saying how well their gps are doing with condemnation for those practises taking the piss.

My gp surgery is not open for routine appointments, and i get at least one text (x 4 as I'm the contact for others in the house) as every few weeks in capitals telling me not to come to the surgery.

My dentist is also not doing appointments at all but my son sees his orthodontist in a separate practice for his braces. My dentist had told me they don't anticipate reopening for appointments until 2021. It's almost beyond comprehension that some essential services have almost come to a standstill.

Our DR surgery makes it very hard work but you can get an appointment if you persist. You have to go through a phone triage first which isn't great as they don't tell you when someone will call. I was on work calls when the nurse called me back and she was quite stroppy when I got to speak to her. As I explained I also have a job and cannot sit and wait for you to call! But once you have gone through this you can go in if needed (although then no chairs in the waiting room..so some very ill elderly people literally having to lean against the wall whilst waiting!). I would escalate this..they cannot be taking money for a service they are not providing.

Sorry I meant to just say GPs for that bit. But it still stands, a lot of this is down to individual practice business decisions for both GPs and dentists and there are huge disparities.

I think that the dental sector is too far gone down the road of privatisation to do anything about it (many people are effectively either forced to go private or do without dental care), but that isn't the case for GPs.

I personally think that the effective exemption that GPs got during the creation of the NHS has outlived its usefulness. All I see is an inconsistent system of primary care where individual surgeries act in totally different ways in terms of how they serve patients with little actual power to change this.

I'm not particularly impressed with ours. Dc1 got his finger trapped in a door the other day. They wanted us to make the 45 min trip to A&E. Dh refused and he was seen within 10 minutes.

It's not just the GP though, I have mental health issues (trauma related) and phone calls are absolutely useless as I also have young children whom I really don't want overhearing. I can't however see my psychiatrist in person unless I'm an inpatient.

My old GP practice ran on this basis all the time, this was pre covid. You could only ever phone on the day you needed an appointment. I always thought it bizarre as there are many reasons you need to see a GP and not all are emergencies!

@Coffeeandaride

So if you rang and spoke to the GP and said (for example) I’ve been checking my blood pressure at home and it is above target. (Routine) then they would presumably ring and speak to you and likely be able to do this by phone (dietary advice, medications review). If it is a smear, speak to GP and they will get a routine appointment. What routine issues are not being dealt with?

Not here. Earlier in the year they were offering pre bookable phone appointments. The service was fine. I was even seen face to face and had some blood tests.

The pre bookable phone appointments have now stopped. Now the only way to access a GP is to ring on the day and hope you get a call back when you can answer your phone, or fill in the online form and, again, hope you can answer the phone.

Which is why OH, having developed high blood pressure and with a family history of related issues, cannot speak to a GP as he is unable to take calls when working.

I am not knocking all GPs, not at all, but the system is frustrating at best and downright dangerous at worst.

@Cleanmean our dentist the same, nothing routine for the time being, but they are doing urgent stuff (DH was seen). Orthodontist has restarted and my private dentist has restarted. They need a thorough clean between patients so I can understand why they have fewer appointments available, even if I really don’t like it.

The defensiveness on this thread is not helpful. Perhaps it’s down to a collective guilty conscience?

@Hopoindown31 I agree with you regarding lack of consistency but I don’t think privatisation is the answer. Look at how dental care is in the UK, then imagine that for every organ in the body.

@LadyWithLapdog sorry I think you've misunderstood me. I was actually saying the opposite. I actually think it is time to bring GPs into the fold properly and make them NHS employees rather than independent contractors. My point about dentists is that I feel the opportunity to do that has long past for them.

@Hopoindown31 sounds like I got the wrong end of the stick but no, please don’t let Hancock and this government organise anything else ever, let alone something important like healthcare. We’re doomed as it is.

[quote Heatherjayne1972]@LadyWithLapdog
Yes went back 8th June. Working totally normally in both practices with appropriate ppe and within the guidelines obviously
Offering everything Check ups fillings etc Invisalign hygienist treatment- although I’m only handscaling We can’t do anything that involves water spray yet unless we use enhanced ppe

This is why I’m astounded doctors think it’s ‘unsafe’ to be working normally
If we are deemed safe enough to get within 6inches of a patients mouth then they need to ppe up and crack on[/quote]
Is this a private dental surgery? Because I’ve been told by several people who are registered with NHS dentists that they are only seeing real emergencies - accesses etc. Nothing else.
My dentist is private and closed for a couple of months but has been open since. But like I say, it’s private.

@Janegrey333

The defensiveness on this thread is not helpful. Perhaps it’s down to a collective guilty conscience?

Maybe people who have been working 15 hour days , constantly worrying about their patients and how to provide safe and effective care on a background of long-standing understaffing and massively unrealistic workload feel defensive when they are described as lazy, entitled etc.

It’s not ok that people can’t access timely and appropriate GP care whether that is by phone, video or face to face. Some of the stories on here are very distressing to read. It should be addressed as a matter of urgency why some practices have been unable to offer adequate care.

I don’t think suggesting that GPs are hiding or sitting around doing nothing is particularly helpful to anyone. It doesn’t improve care and worsens already rock bottom morale.

The reasons for such patchy / inadequate services are more likely to be logistical issues eg due to lack of staff eg local to us practices usually heavy reliant on locums struggled due to redeployment to hot sites / 111 etc.

Sorry haven’t read full thread got half way before feeling the need to respond. GPs are operating this way due to the advice from NHSE of ‘total triage’. It is not just to protect them but patients, imagine a member of staff tested positive if they were seeing patients routinely that could be over 30 people per day and if they pass it to colleagues the people they see etc etc. And these could be vulnerable people the tracing would be a nightmare and if a patient tested positive after being in the practice what would you do send everybody home for 2 weeks? GP practice staff are working harder than ever they didn’t enter the profession to spend it on the phone rather then seeing f2f and btw they are private businesses but they provide NHS services which is why there is variability a large practice with lots of GPS and a big list is not going to operate like a single handed GP with 2000 patients. It’s frustrating as I know GPs are working flat out and I also know people are struggling to see them when they feel they need to and I don’t think either are lying so it’s just working out where it’s breaking down.

I’m a GP.
We have been given quite strict guidelines by NHS England about how we work.
We have to have 2 “clean” rooms to see patients. One for shielding patients and one for non shielding. These rooms must be cleaned between each patient.

There are 5 GPs in my surgery, so we are all sharing the face-to-face consultation rooms. We have full lists of phone calls every day, and if we feel someone needs seeing, we book them into a face-to-face room. But a bit of basic maths shows that with 5 GPs doing phone calls all day, and just one or two rooms to see patients, it is only possible to see a small number of people.
We clean the rooms between patients ourselves.
We are spending a huge amount of time on the phone to people who are waiting for hospital treatment, and want to beg us to speed up the process. We have to write letters for each of those patients.
Every day there is a government Situation Report, which is emailed to us, and we have to meet to discuss it. This comes through about 6-7pm, so after surgery we meet every day to go through it. It always contains various new mandates from NHS England about what we need to do next.
We have had to learn to do telephone consultations and video consultations, which is way out of the comfort zone for most doctors, as part of the basic assessment of patients is visual.

I am currently speaking to about 3 suicidal patients per day. Some seriously suicidal, some less so. Covid has taken a huge toll on the mental health of many people, and they turn to the GP. I’ve never had to speak to so many depressed people before. These are not quick consultations.
I’ve been a doctor for 30 years. I worked as a junior hospital doctor in the days before the European Time Directive banned inhumane hours, so I have worked weekends without getting a single minute of sleep for over 50 hours, whilst still being expected to make sound clinical decisions. But I have never felt as exhausted and beaten as I do as a GP during this pandemic.

Thank you for explaining @Mintychoc1, I'm sorry you're feeling so exhausted. Take care as much as you can

@Dinosauratemydaffodils GP surgeries aren’t an emergency service. Why would you expect a GP to see a squashed finger which may well need an X-ray? Surely a Minor Injuries Unit is more appropriate, and if not open or available then yes A&E is the right place to go.

This is part of the problem. Primary care has become a dumping ground for all things - medical, social, emotional, family problems, health, lifestyle, government initiatives, public health campaigns, letters for schools, gyms and employers. With fewer staff and less funding than ever. And this was before a global pandemic hit.

Of course not all surgeries are working to capacity. They were short staffed before and now with shielding staff, vulnerable staff, self isolating staff (who have family members testing positive, positive close contacts etc) they’re stretched to the limit. And I have no doubt some are relishing the Covid situation to reduce their pressures even more (which doesn’t help patients at all).

But in my experience most are working above and beyond. I work in primary care. I’m fucking knackered. My GP colleagues are fucking knackered. I’ve been in work for 7 hours today giving flu vaccines, as have 5 of my colleagues. We had to cancel 250 under 65s due in today as we didn’t have their vaccine delivered. We now have to work an extra weekend next month to get them given. Our reception staff had to stay late the other day to cancel them.

I’m not looking for sympathy. I would like people to understand that @jacks11 post isn’t patronising, it’s simply explaining what most of you don’t seem to understand.

@Heatherjayne1972 we don’t have enhanced PPE. We don’t have FFP3 masks. We have simple surgical masks, gloves, aprons, and wipes. Oh also a few visors. Hot patients are directed to the Covid hub but some slip through like the patient who came in the other day with a sore foot, saw the pregnant GP who took his temperature to discover it was 38.8 and he had a new cough. He failed to mention this during his triage call...

This year has been bonkers. I’m struggling.