AIBU to be annoyed that my GP seems to have no plans in place to see patients as we come out of lockdown?

[everydayiwritethebook]

After reading another poster's thread where she couldn't be seen by a GP and ended up at A&E, it struck me just how angry I am about not being able to see a GP face to face (socially distanced of course).
I have had a couple of instances where I've needed to see a GP, and my DC urgently needs to see one face to face, but we can't. I understand during lockdown it was necessary, but I haven't been able to see a GP in 14 months and now that most places are back at work (I work with the public and have been back for several weeks), it feels like they're taking the piss.
It's actually got worse at my surgery - today I took a letter in for my GP about being referred for a condition, and whereas previously they had a locked foyer which you could enter one at a time, now the front door is locked and you speak to the receptionist via intercom! I was also told my letter would be quarantined for 72 hours, even though I said it is urgent.
I feel like they are really failing their patients now, and I wondered what other people's experiences or thoughts were about this?

Completely agree that it's ridiculous. Dentists and orthodontists have continued to work. No reason GPs shouldn't be seeing patients properly at this point.

And deadly sick of receptionists triaging when they haven't a clue and frankly, it's none of their business why you need to see a GP.

@QueenPaw

To add I don't mind telephone triage but when I have tonsillitis (bacterial) I can't take days off work to press redial and pray for an appointment before I get sepsis

So you say you’re neutropenic and need antibiotics urgently but you won’t take time off work? You need to go to bed, stay away from other people and rest and recover. Antibiotics aren’t given so you can continue working, it’s not an unreasonable assumption that if you’re that unwell you will not be at work

Health services have been very seriously affected and if you want treatment for anything that isn’t medically urgent then you may be subject to delays or less than what you feel is ideal treatment.

My relative had open heart surgery & a stroke, not being able to get a prescription for blood thinners is medically urgent!!

@everydayiwritethebook

After reading another poster's thread where she couldn't be seen by a GP and ended up at A&E, it struck me just how angry I am about not being able to see a GP face to face (socially distanced of course). I have had a couple of instances where I've needed to see a GP, and my DC urgently needs to see one face to face, but we can't. I understand during lockdown it was necessary, but I haven't been able to see a GP in 14 months and now that most places are back at work (I work with the public and have been back for several weeks), it feels like they're taking the piss. It's actually got worse at my surgery - today I took a letter in for my GP about being referred for a condition, and whereas previously they had a locked foyer which you could enter one at a time, now the front door is locked and you speak to the receptionist via intercom! I was also told my letter would be quarantined for 72 hours, even though I said it is urgent. I feel like they are really failing their patients now, and I wondered what other people's experiences or thoughts were about this?

Take it up with NHS England. GPs are working this way because that is what they have been told to do. GPs have repeatedly asked for this to be made public but so far they have been ignored and the bashing in the Press continues

@BungleandGeorge

I think people are missing the point that this isn’t a decision made because they don’t want to see patients. Medical facilities are subject to much stricter guidelines about how they can operate. People keep mentioning dentists, they’re certainly not operating normally or fully either. Health services have been very seriously affected and if you want treatment for anything that isn’t medically urgent then you may be subject to delays or less than what you feel is ideal treatment. Things aren’t normal, it may be worth looking into private treatment

This doesn’t remotely explain why some surgeries are doing considerably more than others.

It’s not about treatment being delayed, it’s about it being completely inaccessible in some cases. Which is simply not acceptable.

Casually suggesting people look into private treatment shows a complete lack of acknowledging that for many people, especially at that moment, that’s a completely unaffordable privilege.

@BungleandGeorge WFH. If I catch it early (I've had numerous bouts) I'm ok because they give me antibiotics at the first sign of it usually before covid
But my point is even if I'm in bed off work sick, crying with tonsillitis then I can't get an appointment
Because I ring at 8, and am 26th in the queue and you can't pre book. So you have to ring back the next day, and the next and then next

@BungleandGeorge

I think people are missing the point that this isn’t a decision made because they don’t want to see patients. Medical facilities are subject to much stricter guidelines about how they can operate. People keep mentioning dentists, they’re certainly not operating normally or fully either. Health services have been very seriously affected and if you want treatment for anything that isn’t medically urgent then you may be subject to delays or less than what you feel is ideal treatment. Things aren’t normal, it may be worth looking into private treatment

Trouble is that even medically urgent treatments are dire at the moment too. My OH has cancer and currently in the middle of Chemo, but both the GP surgery and the oncology dept are incredibly hard to contact and even when contact is made, they're just fobbing him off to the other. It's a nightmare. He should have been on chemo for the past 3 weeks but hasn't even started because both his oncologist and GP have gone AWOL and won't communicate with eachother.

GP have to wear PPE for every patient as it is NHS England guidance for all contacts at the moment
As do all healthcare workers at the moment
Same with remote triage - again this is NHS England guidance and primary care standard operating procedures have been changed
Currently it is advised still to remotely manage as appropriate and see when you can’t . As opposed to dentist : hairdresser etc which is all practical really
Just pointing it is not a choice that GPS have made themselves
Our doors are not locked but controlled vie entry system
This is because at the start of the pandemic we had several patients coming in with temps and cough or after contacts asking for advice - sadly it is a case of a few people ruining it for everyone.

Telephone triage is harder and tougher than usual appointment system IMO , my work day is a lot longer than before and demand is huge . Have been a GP for 15 years and have never known it as busy as the last year . We used to have a break between morning and pm surgery for admin/ visits
. This has gone and just have a huge list of telephone triage with fitting people in for face to face appts when we can , but all of our appointments are gone by 850 we know we have people who ring who cannot get an appointment but we are working flat out
There is literally not a minute left in the day . I do not know the answer to this . We have increased our capacity as much as we can and employed a new ANP who is fab but everyday is full and mostly all people who do need to be spoken to or seen on the day . I can only assume that the people who can’t get through equally need seeing .
Before we were and still are a small practice that had no issues with patients getting appts on the day if needed .
If we’re struggling this much then must be amplified a million times for practices that struggled before the pandemic.
Again don’t really have the answer - we have tried to restructure appt , increase e consult times for patients that can access and have supported access for those that can’t but aware that everything we are doing is a drop in the ocean but also we cannot sustain this level of work

All admin is done at the end of day now and usually taking until 8pm , starting before 8 am to get the lab links done.
Have never stopped seeing patients in common with all GPS in the area , we have all worked in the red sites and run the nursing home visiting schemes so please stop saying when will GPs start seeing patients again as lots of us never stopped beyond having to triage by telephone first .

Some of the demand has come from work transferred from secondary care as they weren’t seeing patients in outpatients hopefully this will improve - for example as the person up thread said - if a max fax consultant wants to check that a jaw is healing it is his job to check up with you - he is the expert

@JustLyra I wouldn’t usually recommend private treatment. However things aren’t normal. I had a private online consultation it was £20 including the cost of treatment, an NHS prescription charge is about £10. For some it’s not an option but if people can afford holidays, takeaway, pubs etc then it is. Yes a complaint should be made but I wouldn’t personally be suffering for days just to make a point. I don’t expect to do it long term

@piratepee Yes, it’s definitely worth switching to an online NHS GP if your practice is that hard to access. I think this is the one DH uses
nhsgponline.uk/?gclid=EAIaIQobChMIrqTp1tqW8AIVk2DmCh3DCwQjEAAYASAAEgIGuvD_BwE

It means deregistering with your existing surgery, so that the NHS payment for having you on the list goes to the online GP.

Thanks @NotOnMute

I want to look into that too

I'm in Ireland and it's the same here.
DD(23) rang for an appointment, she's covered in a rash, head to toe. First she had to tell the receptionist why she wanted to see the doctor.
DD: I have a rash all over my body.
R: But do you really NEED to see the doctor?
DD: Well I'd much rather spend the €65 I have to pay him on clothes, so yeah I do need to see him.
R: I can organise a phone consultation.
DD: How is he going to sort out my rash through the phone, x-ray vision? Is he going to listen to my rash?
R: Emmmmm can I call you back?

She eventually got her face to face appointment but it's madness, my mum needs an appointment but they only offer over the phone appointments which won't work and she won't push as the receptionist is quite forceful about not giving out face to face appointments.
You basically have to tell the receptionist what's wrong with you and she decides if it warrants a face to face visit.

Oh and I know DD was a bit short with the receptionist but

1. She's covered in a head to toe rash (it's anxienty linked psoriasis and she's started medication)
2. Not happy detailing said rash to someone, not a doctor, not a health professional
3. Paying out €65 (probably hurt the most) and she was adamant if she was paying for an appointment she wanted face to face.

DH and DD2(13) are both diabetics, her clinics have continued throughout the pandemic, his have been cancelled and cancelled, he spent weeks chasing an updated prescription as his was out of date.

Chronic illness, long term medical issues don't stop affecting people and we need to get back to reality........DD3's dentist was able to do 4 fillings the two weeks DH couldn't get his diabetic consultant to see him. Seriously she was working in DD3's mouth and he couldn't get the doctor in the same room as him!!!!!

Rant over

My large GP surgery in a small town is running better than ever. We’ve had doctor’s appointments on the day most times we’ve rung throughout the day( get late appointments but that’s fine), photo system very good,loads of face to face for blood tests, necessary GP appointments and obs 2 of my dc need with nurse, meds sent to pharmacy. Had a lump dealt with v quick by gp and hospital( scan and consultant), an ENT appointment in hospital....

Our practise is fab though. Superbly run.

I'm wondering how medico-legally it is affecting GPs. Have the GMC had to rewrite guidelines? I would feel very insecure not seeing or examining some patient presentations. Some things just have to be seen, some situations mean that you pick up relevant signs on a face to face that you simply couldn't over the telephone. Many people esp elderly cannot do a video consult. It's all rather chilling if this is the way it's going to be. Having said that, there are some areas that can/should be overhauled and reappraised, but I fear change borne out of crisis is not the best way to change....

[quote NotOnMute]@piratepee Yes, it’s definitely worth switching to an online NHS GP if your practice is that hard to access. I think this is the one DH uses
nhsgponline.uk/?gclid=EAIaIQobChMIrqTp1tqW8AIVk2DmCh3DCwQjEAAYASAAEgIGuvD_BwE

It means deregistering with your existing surgery, so that the NHS payment for having you on the list goes to the online GP.[/quote]
A word of caution with this. The online GP will quite happily take the funding for you as a patient when they don;t have to see you. But as soon as a F2F is needed they ask you to go back to your reg GP who does not receive the funding for it when you temp reg with them to do the actual work that is needed.
Online GP services like GP at Hand are making a mint from this service so the local GP practices are left with the most vulnerable and complex patients and insufficient funding to treat them. Please remember that funding per patient is based on the average a patient visits a GP - it takes into account that a x% will come tot he practice weekly and Y% will contact the practice every 2-3 years. If all generally healthier pts go online for their basic needs the online provider gets rich and your GP surgery will close.

My gp surgery pre covid was crap. Couldnt get an appointment in 2 weeks or even a call back for the following day.

Now you submit via the portal you fill in your symptoms and you can send photos, ask for referrals, there is general advice and a blank box at the end where you can add anything else.

I have used this system to 5 or 6 times in the last 6 months(long term health both physical and mental issues)

I sent a picture of my infected cellulitis. I got a call back that afternoon with a referral to mobile care at a&e and a doppler appointment. I also had a prescription sent via Echo,my online prescription delivery service, which I recieved within 2 days.

I've also had intermitted vaginal spotting, I had a phone call the following day, a smear within 2 days and a referral 3 weeks later for gyne for samples to be taken and coil removed.

I got a referral to my lymphadema clinic through the portal.

I really cannot fault my gp surgery. They have now merged with 2 of the local surgeries but lost a number of gps due to retirement. This system works and I hope it stays.

[quote BungleandGeorge]@JustLyra I wouldn’t usually recommend private treatment. However things aren’t normal. I had a private online consultation it was £20 including the cost of treatment, an NHS prescription charge is about £10. For some it’s not an option but if people can afford holidays, takeaway, pubs etc then it is. Yes a complaint should be made but I wouldn’t personally be suffering for days just to make a point. I don’t expect to do it long term[/quote]
People with no income, or who have no income until payday, shouldn’t be denied medical treatment.

My DH was told by his surgery he needed to be seen, but they aren’t doing face-to-face appointments. Not that they have none left, or that they’re busy, or any of that, just none. That’s not acceptable, and people who can afford it going private isn’t going to help sort that.

It should be people with the luxury of having a spare £20 who can get medical treatment.

We would love to open more fully. I hate the way we are working but we cannot open fully as our waiting room would not be socially distanced and whilst I feel the risk is very low I can just imagine the headlines if our waiting rooms were as busy as they used to be and someone potentially caught covid there.(not sure how you'd prove it but just a thought). We are dealing with far more patients than a year ago(pre pandemic) and it all takes longer. There is a place for telephone appointments but nothing beats face to face. All governments are pushing for more telephone and online access and after 30 years as a GP it is not a substitute.

Our Gp waiting room was always half empty(3 patients max in a big area). They also had waiting areas outside in lockdown. We can q outside fir shops so don’t see the problem for doing it to see GP.

Tistheseason, I can see the funding and case complexity issues.

But in practical terms DH goes to a local clinic (10 minute drive, so not as near as his old GP but not far) if he needs a blood test or to be seen face-to-face, he isn’t directed back to his old GP. So that doesn’t happen in all cases.

And he is at least receiving NHS primary care now, which he wasn’t before as it was so hard to access that he didn’t bother.

Our old GP was accessible, probably because he was utterly shit at the job.

All I can say is if I can get GP business doen via the portal and avoid ever speaking to a receptionist on the phone again I shall be delighted. What has become clear to me is that half the problems I have had with the receptionist as the middle man is because they don't correctly understand what I am telling them and then relay something different to the Dr.

@RosesAndHellebores

All I can say is if I can get GP business doen via the portal and avoid ever speaking to a receptionist on the phone again I shall be delighted. What has become clear to me is that half the problems I have had with the receptionist as the middle man is because they don't correctly understand what I am telling them and then relay something different to the Dr.

That's exactly my OH's problem with his GP and oncologist. Neither are contactable and everything has to go through the receptionists who either don't pass on the message or get the message wrong. It's a nightmare, especially in the middle of Chemo when you can't get any advice etc. Their "default" answer is to go to A&E. It's madness.