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?

Lots of people are struggling. Schools certainly are, ditto those losing jobs.

It’s not pandemic top trumps 🙄

I’m very well aware lots of people are struggling. I’m just sharing my experience.

I also failed to see how a squashed finger is appropriate to be seen by a GP. If you're concerned about a possible broken bone, that's A+E surely. As was advised.

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.

They closed the local minor injuries centre (not particularly local either). We were encouraged to see a nurse at the practice for all minor injuries instead (which is who we saw) and as far as I'm aware based on the leaflets they keep sticking on social media that hasn't changed. Those same leaflets also advise against A&E unless it's a proper emergency which it didn't seem to be (and wasn't). Maybe we got it wrong but if they are advertising the same service, it's to be expected I feel.

My Sil is a GP in England and it sounds like she's having a horrendous time so I do have every sympathy but when you've had it drummed into you that A&E is for real emergencies, that's hard to break. I took the same child last year after he managed to fall at soft play and cut his head badly. A "charming" Dr told me after we waited six hours that I should just have stuck a plaster on it. He ended up with a Harry Potter scar and I felt like shit.

My daughter did 11 hours for an 8 hour shift yesterday. She saw people aplenty. Including a child whose mother thought he needed a psychiatric referral because he’d split with his girlfriend and fallen out with his best friend. Mother hadn’t bothered to ask him about why he was miserable.

I have to say, @CherryPavlova , that your daughter sounds utterly unprofessional, bitching to you about her patients.

The suggestion to make GPs NHS employees is interesting. I don't think people realise the volume of work that a GP partner, who runs the business, does behind the scenes. Replacing the extra work done by GPs would involve outsourcing a lot of work or employing extra staff.

Also, I think people would be shocked at the reduction in a GPs workload if they were employed to do two standard surgeries a day and no extra patients etc just squeezed in. Imagine a controlled workload! Maybe it's best for all of us! GPs would have a better workload and patients would get what they think they want. But then possibly realise it would result in a more shit service .

@Cumbersome

My daughter did 11 hours for an 8 hour shift yesterday. She saw people aplenty. Including a child whose mother thought he needed a psychiatric referral because he’d split with his girlfriend and fallen out with his best friend. Mother hadn’t bothered to ask him about why he was miserable.

I have to say, @CherryPavlova , that your daughter sounds utterly unprofessional, bitching to you about her patients.

If you dealt with what the average GP had to deal with, you might need to offload to protect your own health. How is it unprofessional? It might be if they shared identity but, obviously she didn’t. I don’t know anyone who doesn’t talk a little about their work.

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!

Ha I’ve had that. They don’t seem to realize that anyone else except them has a job!

It must be down to individual surgeries and their capacity.

My surgery is in Gr Manchester, I made an appointment for a suspicious mole, and I was referred and had removal by a plastic surgeon within the space of 14 days.

Similar experience with my daughter, she's 3 and had a suspected UTI. I called in the morning and she was on antibiotics by the afternoon. I also have a routine smear booked for Nov.

I would speak to the practice manager to try and understand the rationale behind no appointments at all.

I personally think that the effective exemption that GPs got during the creation of the NHS has outlived its usefulness.

Personally I think that should never have been allowed in the first place! Certainly the govt/nhs could have trained up its own gps and put them in as nhs gps and told the ones that didn't want to be part of the nhs, fine! Sod off and be totally private then! They wouldn't have had enough patients for them all to profit/stay in business, so some of them may well have them had to agree to be fully part of the nhs.

The lack of regulation and enforcement we have as a country with gps is a joke! They have far too much ability to refuse to do any number of services and hours and aren't meeting the needs of patients.

There are other issues too with the whole set up being they're essentially private businesses which affect patient care but as I said before that's really a whole other thread, as they're not just due to covid/current situation.

@Dinosauratemydaffodils ha! Don't get me started on mh! I've a whole saga coming on for 3 years of poor practice and neglect here!

Perhaps it’s down to a collective guilty conscience?

I think it is. They seem, as a group, very poor at taking any kind of criticism and don't like having plain common sense suggestions made to improve the service and patient care.

Maybe people who have been working 15 hour days... I do get quite fed up when this type of line is trotted out. Not all gps are doing this and even if they are, they're not the only workers under such pressure, they're not even the only hcps under such pressure.

Yes it's not how it should be but that's not patients' fault, and it shouldn't be taken out on patients.

@Marsis even reading half the thread should surely have made clear what I said a few posts ago, patients DO know there are necessary limitations on face to face consults at the moment but even the op was about not getting ANY appointments at all, not even phone or video or econsults for far too many patients.

Working out where it's breaking down? I would say a combination of factors but SOME gps not fully fulfilling their responsibilities is clearly part of the problem. Yes underfunding and understaffing are issues too, even pre covid there were massive problems with gp practice which added to the number of appointments needed by patients. If those problems had been addressed properly years ago we wouldn't be in this mess.

Gps as a group are a powerful force, but I've yet to see in recent times that power being used to advocate for better practice for patient care.

I think there are many areas where gps and other primary care hcps are working harder when what's actually needed is working smarter!

I'm kind of astonished at the number of posters who claim to be gps (not casting aspersions but anyone can claim to be anything here) so therefore highly educated yet apparently missing the main point that we DO understand the issues of ftf but this isn't the main issue we're querying.

I shouldn't be that surprised I've had consultations with gps that go like this! I make appointment with gp about x and they spend most of the consultation going on about completely unrelated y and I keep having to bring them back to why I'm there!

Very frustrating.

it’s simply explaining what most of you don’t seem to understand

We DO understand we're not idiots!

Just because we disagree and have concerns about how the situation is being managed and are frustrated about the lack of communication on certain matters doesn't mean we're lacking understanding!

@DrFoxtrot I don't believe making gps part of the nhs would majorly benefit gps, if that were likely they'd be all for it!

Remember when Hunt promised 5,000 new GPs? Where are they?

www.rcgp.org.uk/about-us/news/2020/october/general-practice-is-open-and-has-been-throughout-the-pandemic.aspx Here’s the RCGP answer.

If you think GPs are not regulated to the hilt you don’t know what you’re talking about.

www.rcgp.org.uk/about-us/news/2020/october/gps-should-be-proud-and-patients-reassured.aspx And more reading matter here.

I agree. Not sure what GPs are being paid for right now. I called my GP one Friday and was told they were busy and I should call 111 instead. It's a joke. Every other healthcare professional is in the thick of practise.

www.rcgp.org.uk/about-us/news/2020/october/college-writes-to-health-secretary-with-concerns-over-supply-and-demand-of-flu-vaccines.aspx Problems with the vaccine supplies somebody was complaining about.

www.rcgp.org.uk/about-us/news/2020/september/college-sets-record-straight-on-face-to-face-appointments.aspx More here about the face to face appointments.

So if a surgery is not offering an acceptable service, where can we complain? Who can look into the issue and try to sort it?
Is there any way to get into contact with other patients and put forward a collective case?

Is it the local Healthboard? At least that is the only I can really find so far......

YANBU When my Dad was poorly 3 weeks ago, DM phoned their GP, he was diagnosed, over the phone , no tests, with a urine infection. Prescribed antibiotics. 5 days later, feeling worse so DM called 999, Dad was taken into hospital. He died 2 days later of pneumonia.

@Graphista making all GPs NHS employees would likely result in a drop in salary. However, if that comes with a more manageable workload for all GPs and not having to run the business side of the practice, I think a lot would go for it. There would probably also be better employment benefits like enhanced maternity pay and protected study time.

The lack of regulation and enforcement we have as a country with gps is a joke! They have far too much ability to refuse to do any number of services and hours and aren't meeting the needs of patients. This suggests a lack of knowledge about how GP services work. We have to provide core hours and services. The only things we can refuse are extra services like joint injections or minor surgery which are enhanced services.

There's no guilty conscience here if we sound exasperated or defensive, it's because we're tired of shite being spouted about us. Genuine complaints aside, my comments are in response to the general 'what are GPs being paid for' nonsense.

Its nightmare, I needed to replace my marina coil last April but could not do it as in lockdown and GP still won't do it and its not something I can do on video call . Due to sexual abuse I am quite particular who does it , so sending me somewhere else is not going to work for me . gp would not even look my child ear when it got infected , in the end I went to walk in centre during lockdown and I got told off for it by a nurse as there as no emergency gp working there and they only open for injury but was seen by dr reluctantly. Yes I do feel in some way its has let some people down in some ways , I also miss the days of face to face appointments .

cherrypavlova my teenage son has lost a few of his friends to suicide.

The triggers were petty.

I would respectfully suggest this anecdote is a little glib.

Remember GPs are not NHS employees. GPs run private businesses that have contracts with the NHS to provide services. E.g. offering appointments to a community. But they don't get paid based on the number they actually carry out.

I think things would look different (now and in a normal year) if they had to operate under a "fee-per-service" model like in Canada, where they got paid a fee for each consultation or treatment they carried out. Don't think we'd see a shortage of appointments then!

@bettythebuilder

YANBU When my Dad was poorly 3 weeks ago, DM phoned their GP, he was diagnosed, over the phone , no tests, with a urine infection. Prescribed antibiotics. 5 days later, feeling worse so DM called 999, Dad was taken into hospital. He died 2 days later of pneumonia.

God this is awful. So sorry about your dad @bettythebuilder

cherrypavlova

I didn’t think gps were supposed to discuss conversations they have with their patients.

Really worrying how little your dd knows about mental health and how cold and dismissive she is to a probable desperate parent.

Depressed people often don’t know why they’re depressed. Ime they don’t often engage in detailed conversations about their depression to loved ones either. Distancing themselves from friends and partners is a huge red flag.

Really reassuring to hear your dd as first point of call dismissed such a red flag and then chose to gossip and belittle a parent’s worry.