From GP practice managers

[Bagamoyo1]

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@RosesAndHellebores

Or those qualifying should work full-time. At least for a minimum of 10 years post qual.

So a ban on doctors having children until they are over 35? And what happens to doctors with disabilities or caring responsibilities? Should they leave medicine?

@Changechangychange - no, there would of course be exceptions for those who are too ill to work full-time but you seem to have forgotten the fact that many parents take maternity leave, sometimes not all of it, and return to work full-time. Overall I believe 10 years full time work should be rendered and would bring back teaching and nursing bursaries on that basis

IMO if a place needs a sign asking people not to be rude/aggressive to staff then it needs to look at how it deals with customers, and as a customer I’ve found that service is generally poor. Either ridiculous operating hours and/or massive inflexibility. Places where customer service is good don’t need signs asking customers to be pleasant... I generally expect something bad to happen to me in places where they have signs, and that’s already put me on edge. See also the Royal Mail sorting office...

Or those qualifying should work full-time. At least for a minimum of 10 years post qual.

I strongly disagree with this. Two doctors working part time may well be better than a single doctor working full time. I'd rather be treated by someone who isn't exhausted, and has a decent work-life balance. People who are tired, unhappy and past caring are more likely to make mistakes.

In terms of cost, it is also better to spend money training two doctors who work part time for 30+ years than having to train three because they each burn out or move to private practice after 10.

And that's before we get started on the fact that requiring full time is likely to be indirect sex discrimination. Women are far more likely to need or want part time work so blanket bans are likely to push women (particularly single parents) out of the profession. Not ok.

Why should junior doctors have to work full time? Or better still can you define full time? I work 32hrs a week is that full time (24hrs in hospital, 8 in a vaccine centre....)? According to my GP training program I am working 50%. You can only apply to reduce hours if you have occupational health agreement, a dependant relative with special needs or a child(ren) under 12 - and then you have to explain why your partner cannot do the caring....you cannot just qualify and decide to go part time....

I am one of those less privileged northern working class state school educated people this thread seem to think should be encouraged to enter medicine. Other than the standard student loans and having my tuition paid by the nhs in the last year of my degree I got no help from the state in qualifying. I worked as a waitresss as well as studying to fund my degree. I then married as a foundation doctor and was denied leave for my (weeks) honeymoon despite giving my hospital 6 months notice. My husband who is also a doctor was then allocated a job for two years 300miles away by the national job allocation system. I was not allowed to apply for a transfer as being married and wanting to live together is not seen as a good enough reason (example of good enough reasons where such as being on dialysis). It therefore had to quit my training to move to be near my husband and then reapply a year later. The training program moves you over 50miles every 4 months to a new hospital but no longer provides accommodation and if it does does not usually provide double rooms etc and the rent is extortionate (one hospital demanded a marriage certificate to allow my husband and I to share a room in 2016!!!) I have had mushrooms growing in the damp on the carpet and razor blades left in the shared shower and a tiny single room with no heating for the pleasure of £150 a week however as you move every four months you struggle to commercially rent as contracts are 6months and as you get a new job every 4 months no one will lend to your for a mortgage.

When the above and a punishing shift s caused my inevitable breakdown I was allowed 1 day off work and then threaten with the GMC I I didn’t come in. Trainee well-being arranged some counselling but I wan not allowed time off work to go to the appointments. Finally I was permitted by occupational health to train at 80% meaning I worked around 42hours a week on average. However what no one realises about this is that it’s an average and your annual leave is “fixed” when they tell you to take it- so you work 5x13hour nights (65hrs) one week and then you are made to go on leave for the next week so it averages out at 33per week and you are told it’s an easy Rota....

Since qualifying 8years ago my husband and I have managed two holidays of 5 days at the same time as each other and one of those was when I was on mat leave (as an aside did you know most junior doctors don’t get maternity pay as they move jobs too frequently and only last year was shared parental leave formally allowed for junior doctors)

Since covid I have sacrificed my time off to provide more shifts and both my husband and I caught covid and have been seriously ill. I have serious cardiac complications due to covid and the insufficient PPE we were given...I have given medicine my mental and physical health, my 20s, my child’s formative years...

Why do I owe the country 10years full time work again?

Overall I believe 10 years full time work should be rendered and would bring back teaching and nursing bursaries on that basis

IME, majority of science and maths teachers would never have even trained if that were the requirement. Teaching is a far lower salary than we could have earned elsewhere so committing to limiting your earning power for a decade for a job you've never even done would be a daft thing for most to do. I quit as an engineer and trained as a teacher because I thought I'd be good at it. I've stuck it out because I enjoy it. I wouldn't have taken the risk if I'd been required to sign up to a 10 year full-time contract.

@Cbtb unfortunately I don’t think anybody who hasn’t worked as a junior doctor has any idea how hard it is to combine with parenthood.

I had my son as a registrar, so much more stable in terms of mat leave/rotations. I still had to put him in nursery for 60 hours a week when he was 9 months old. I went part time (60%) after 6 months of that, and now he is just in nursery for 36 hours. Obviously DH can cover childcare at weekends and on nights. What a lazy doctor, eh? Barely doing any work at all.

@RosesAndHellebores I’ve worked in clinics for 15 years and have never encountered male patients being addressed as Mr and female as first/second names. All patients are addressed as first/second names. We check DOB in a private environment to ensure we have the right patient. Should say this is what I used to do as I’m a retired nurse but back giving vaccines atm

@HildegardNightingale - it's common place in the outpatient depts of my local hospitals. I heard it last Thursday morning. It is an atrociously sexist micro aggression. In my experience neither is much regard given to confidentiality in relation to one's personal details.

@Cbtb I know how much pressure is put on junior doctors/the awfulness of doctors accommodation/moving every 6 months. It’s soul destroying. Some people on here have not got a clue.

The training program moves you over 50miles every 4 months to a new hospital but no longer provides accommodation and if it does does not usually provide double rooms etc and the rent is extortionate (one hospital demanded a marriage certificate to allow my husband and I to share a room in 2016!!!) I have had mushrooms growing in the damp on the carpet and razor blades left in the shared shower and a tiny single room with no heating for the pleasure of £150 a week however as you move every four months you struggle to commercially rent as contracts are 6months and as you get a new job every 4 months no one will lend to your for a mortgage.

That is your experience. There is a trainee GP in my family. They did their F1 and F2 years in another deanery; and lived in a nice three bedroom semi. They were asked to do locum shifts, which they would only do for £50 an hour plus (£125 per hour over Christmas, but then they never want to work over Christmas - because of the great food)

They did plan to do a F3 year, locuming for the money, but decided to start with GP training instead, because it takes 3 years rather than 10 to be a consultant; and they only want to work 4 days a week to spend 3 days a week, on their hobbies. They moved here (and lived in our house for 3 months, so I got to see their shift patterns), and then got a lovely one bedroom flat - on a one year lease, which they renewed for their second year. Hospital placements are done at the one general hospital half an hour's drive away and the GP placements at training practices in local towns, one is a 20 minute drive; and the other is in the same town as the general hospital. They still do locum shifts at the hospital for the money, as and when they feel like it.

They have not had to move every 4 months; because all the placements are within half an hour's drive! They are looking to buy a house, when the lease runs out this summer, so they must think they can get a mortgage - which I imagine they could, with the salary and overtime they do?

@Intercity225 I am a TPD, and your relative’s experience is extremely unusual. Most people move annually.

Placements within 30min drive would be amazing. Some deanarys are smaller than others I guess ours is around 200miles from one end to the other (chesterfield to Northampton and out as far as Boston) and you can be placed anywhere within that every 4-6months with 4 months notice. We’re not the the worst tho - Scotland is all one deanery for example....but I think seven is quite small....

Mortgage wise it also depends if you are being moved around. If you only have 4 month contracts then most banks won’t lend to you - shout out to Scottish widows who do a specific mortgage for junior doctors to take account for this- despite us both being in full time nhs training jobs and having a 20% deposit only specialist companies would take us as we had worked between us 12 jobs in 3 years...

@RosesAndHellebores What a ridiculous suggestion! Forcing people in public service roles into forced employment. Yes I can really see how that would make your local doctors / nurses / teachers more caring tether than resentful?!
@Cbtb Your experience sounds similar to many of the doctors I know. I don't think the general public realise how much you actually give up and how dehumanising the job is. Hope things are better now!

@cbtb you do get maternity pay - it just comes in the form of maternity allowance.

All these people blaming the GP's receptionists for not getting appointments are barking up the wrong tree. I work as one and we are given instructions BY THE GPS to a) ask the reason for the call, b) not pass messages asking for calls to the GPs (it has to be booked as an appointment). The reason it takes a while to get through is because there are literally thousands of calls every week. We have maybe 40-50 appointments a day on offer and they are released at 8am and that is how it works. It's not our choice. When the appointments are gone that is it! We aren't allowed to book them in for future dates. And if it is urgent, we can take details to pass to the GP for a triage. Patients seem to think we are trying to stop them seeing the doctors - obviously it would be much easier for us if we had unlimited appointments but we don't. We are doing what we are told to do. And getting loads of shit for it.

The trouble is that whilst I am sure the vast majority of GP receptionists are decent people under extreme pressure there does seem to be a key contingent who love the power and using the gatekeeping system to create their own personal fiefdom. In a scenario where that behaviour has devastating impact to unwell people there will be a reaction.

I've met some amazing NHS admin staff , one of whom , a receptionist in a maternity unit , genuinely was part of a group that saved mine and DS2 life for which I am eternally grateful.

That said a few weeks ago a GP receptionist told my 74 year old Df to stop making a fuss about shoulder pain and to do an e consult because they didn't have time for minor issues on one to one's (heard on speakerphone by a family member and that was the exact wording used ). Fine we accept she was rude but we all said she must be under a lot of pressure. DF diagnosed through online system and messages from GP with shingles and put on medication that is dangerous with Warfarin which he is also on

After DF and DM contacted once I had alerted then they needed to get him a fast INR test due to this interaction. The receptionist refused to put him on the telephone call list twice as he hadn't given enough time for the medication to work. Wouldn't let him explain what the concern was , spent a good 2 minutes telling him overworked and stressed she was. Dsis tried , told to go away (sort of fair enough as DP have full capacity ) , finally I tried and professionally have the right words to say to scare , finally got the nurse practitioner on who told him to stop the meds immediately and sent him straight to the hospital.

INR result through the roof. Diagnosis was wrong and admitted to be so. DF then starts having his legs go under from him and fell twice a week later. Rang for a GP appt and receptionists response was "Long Sigh ...oh you have created another issue have you ? Let's start this rigmarole again I suppose ". She then told him he wasn't classed as urgent and would be given an appointment in three weeks time. My Dsis made them put it on speakerphone so there could be no doubt what she said after the previous experience (the previous speakerphone was not deliberate ). My DP are going to A and E tomorrow if they can't get an earlier appointment at the emergency 8 am line as today his lips have started to grey out and we recognise the symptoms from a heart bypass he has had in the past. If I could make them go earlier I would but they are worried about putting extra pressure on A and E who are overworked on weekends.

So yeah , I would have a lot more sympathy of people didn't keep having these experiences and hiding behind how awful their jobs are. I am sympathetic to a point. Hell I've spent 23 years in Social Care , very very frontline. I promise you this if DF has long term issues from this I will light that receptionists name ( and the GP I fully recognise she did not misdiagnosed but she certainly blocked access) throughout every ombudsman relevant. I will scream from the rooftops. I've spent a career getting treated with abuse and vilification but I chose to do it and it has never impacted how I deal with service users.

Whilst I am sure there are decent ones hiding behind the emotive nature of the job and Covid does not absolve the ones who are more interested in their own pity party than supporting genuinely vulnerable patients. Just claiming you are one of the nice ones so it's not fair to complain is not on.

And we have been open for face to face and telephone appointments right through covid, and also setting up and running extra clinics for flu and then covid vaccines, all extra work. Luckily most patients are lovely, and we get lots of thanks and presents from them. We also talk to people when they call up crying and do everything we can to help them.

@PearlclutchersInc

I'd never treat anyone like that - but, by gum, my practice receptionists can leave a lot to be desired sometimes.

I'm sorry, but there some NHS staff whose attitudes leave a lot to be deisred (and that was before COVID)

Sadly I agree with this.

@fishonabicycle
I am always, always very polite and respectful to the receptionists (despite sometimes being practically in tears when I finally get through).
My problem is with the systems that torment people unnecessarily. Just say in your long “fuck off” recorded message that there isn’t a hope in hell of your call being answered, rather than leaving people to hold on in an imaginary phone queue for HOURS. It’s just cruel.
Someone sets these systems up, and I’m guessing it’s not the doctors.

Just thought of something - in frustration a while back (prescription query for a child, e-consults accepted for adults but not for children), I typed an actual letter to my GP on paper, formally set out, yours faithfully, the whole shebang, setting out my request and within 48 hours it was all sorted. May be worth a try for important but not urgent things? Maybe it was the novelty?!

@RosesAndHellebores exactly! They could very much improve things if the will were present! They just cba

@NoIDontWatchLoveIsland exactly - there are ways of wording and addressing things that don't get peoples backs up - as above poster says it's not really that hard IF the sight effort is made. My own gp surgery has a similar recorded message patients hear when they call in. But tbh the recorded message thing EVERY time you dial when constantly having to redial IS annoying especially as at the moment also includes COVID info and is about 4.5 mins long!

IMO if a place needs a sign asking people not to be rude/aggressive to staff then it needs to look at how it deals with customers, and as a customer I’ve found that service is generally poor

I'd agree with that

@HildegardNightingale you may be correct on the name thing where you've worked but as both a nurse myself and as a patient I have come across what was described being considered perfectly acceptable or even all women being addressed as one title (all mothers addressed as Mrs, all non mothers being addressed as Miss for example)

Utterly unnecessary and sexist for sure.

But the sexism is far more deep rooted and frankly dangerous than this issue

@fishonabicycle I'm sure you are a great GP.

My surgery has had nothing to do with the vaccination programme.
I know about 9 ppl registered at the same practice as me. It has has 6 GPs. 4 work mon-friday. 1 works 4 days 1 works 2.

None are currently off sick or on any maternity leave.

We have all had varying problems and it's not Covid related.

I would never be rude to the receptionists who are are excellent. Nor to any staff at the practice.

However if a GP withholds tests requested by another Dr and a radiologist ( un related to Covid)

Would your advice be to find a new practice?

Sorry @fishonabicycle, I meant to say receptionist not GP.

You do a tough job.

If another dr has recommended the tests why haven’t they organised them? If you see a specialist then they (as in the trust they work for) have been payed a fee for your care by the nhs, they don’t need to send you back to your Gp for the tests, that’s them trying to get paid twice. If dr blogs the fancy hospital consultant thinks a test is indicated then dr blogs has an ethical and contractual obligation to arrange the test and follow up the result themselves. Hospital doctors dumping work they have already been paid for onto GPs and then GPs getting blamed for it is a big part of the issue. I suggest you find a new specialist who will actually put their money where their mouth is and sort your problems out themselves (doi trainee GP currently working in hospital - hospital docs can arrange tests and referrals and follow ups it’s just more work for us so most of my colleagues just say “see your gp”)