AIBU to think we should just get rid of GPs and triage in ED or MIUs instead?

[Blueskydrink]

So many threads here and elsewhere, so many articles and so many complaints that no one can see a GP. Not enough GPs anyway and their job is either gatekeeper or refuser.

Throw health centres over to nurses to do baby clinics, flu vacs, smears, blood tests, adult health checks etc and everything else straight to the hospital to be triaged.

Would save lives and a fortune too.

@persnickle

Suppose someone is on heart medication and needs regular reviews. That doesn't fit into emergency or minor injuries.

This is my DM, she's not getting reviews & has ended up in A&E & short of medication. Fab pharmacist though.

Oh no Why won't the GP review?

I think GPs are needed but I don't see why some of the system couldn't be changed.

Not all GP surgeries are difficult to get an appmt at. I can get a phone consultation on the same day, and a face to face on same day if they want to see me in person. I'm not sure what they do differently to other practices, but mine is a busy inner city practice in a deprived area so I don't think they're getting an easier ride.

@Blueskydrink
I'm a Community Mental Health Nurse
Many of our service users have additional needs e.g. their meds mean they need regular cardiac monitoring or diabetic screens. Many are heavy smokers or substance misusers and are too chaotic and/or insightless to go to to different providers. Having a central health provider is essential.

Who is seeing all the patients? Who’s looking at the blood results taken by the nurses?
What facility would be big enough to deal with that many people?

Average sized GP surgery probably does over 100 GP appointments a day plus home visits, countless actions on hospital letters, numerous emails and blood results. Multiply that by the number of practices in an urban area and you’re looking at 1000s of patients.

Why not invest more to create a properly functioning GP service instead of shunting everyone to hospitals.

@Ostara212 because they don't answer the phones, the surgery is "closed" & online service not working.
I've already complained. Even the hospital tried to get in touch for more blood thinners on our behalf but couldn't so prescribed them there.

Who would be seeing all these patients in A&E? GPs who don’t know the patient without access to the patients full notes and letters so everything would take twice as long (at least) and patients would have to travel all the way to hospital not their local practice.
General practice is on its knees due to increased demand, lack of staff and resources, reduced funding. It’s crap for everyone but there isn’t a way to ‘fix’ it without reducing the demand and drastically changing what people expect from the service, or funding in line with other comparable countries, or at least keeping up with the increased workload and population growth the last decade.
Specialist nurses and other HCPs are great and absolutely have an ever expanding role in primary care but they don’t grow on trees either, and aren’t cheap.

What's an ED, and what's an MIU?

Well I'm finally thinking of going private the whole system is broken.

Well I'm finally thinking of going private the whole system is broken.

I think that's the aim tbh.

How would this work rurally? A GP is a first stop if your nearest hospital is 15/20 miles away.

OP clearly doesn't understand the job of a GP or the fact that what she's suggesting is completely unworkable. Imagine everyone trotting off to hospital for everything? How mad!

My GP surgery is great. I would be sorry to lose it.

[quote persnickle]@Ostara212 because they don't answer the phones, the surgery is "closed" & online service not working.
I've already complained. Even the hospital tried to get in touch for more blood thinners on our behalf but couldn't so prescribed them there. [/quote]
That's appalling

My GP surgery seems closed but I had assumed patients like your mum would be seen.

Getting rid of GPs and shunting everyone to hospitals is mad.

Also, away from those with complex needs....my needs aren't particularly complex. However I'm getting on, and currently battling gallstones and cataracts. The cataracts in particular, because they're not painful, don't need a&e attention but because I'm off sick (can't work as can't see computers etc) need someone to advocate for me to get me appropriate treatment to get back to work. I don't think a&e is appropriate for cataracts. [Hmm]

@sbhydrogen

What's an ED, and what's an MIU?

Emergency Department and Minor Injury Unit

I will add that my GP surgery is fantastic. We only ever hear negativity and GP bashing. Those of us that are happy with our surgeries need to speak up to counter the vitriol against GPs. They've become public enemies whilst also having a significantly increased workload due to the demands of the pandemic. How sad it must be for a GP to come across this post.

@Missgemini

I will add that my GP surgery is fantastic. We only ever hear negativity and GP bashing. Those of us that are happy with our surgeries need to speak up to counter the vitriol against GPs. They've become public enemies whilst also having a significantly increased workload due to the demands of the pandemic. How sad it must be for a GP to come across this post.

Agreed. Now that schools have been back for a while they’ve become the new teachers on here.

We need Gps but right now the whole system is bonkers .
Why other frontline workers are getting on with it overpaid Gps are hiding away from their duty of care. The government need to step in and demand face to face appointments again or we face a lot of illnesses getting undiagnosed.

@Gilead

How would this work rurally? A GP is a first stop if your nearest hospital is 15/20 miles away.

Agreed! My nearest hospital is 26 miles away, and takes 43 minutes in the dead of night, let alone in rush hour. My GP is about a three minute walk away.

@NakedAttraction

Fuck me, can you imagine the queue at A&E?

My GP surgery is great. No problem getting an appointment for tomorrow, in person, booked about a week ago on the nhs app. I’m in London by the way, so not exactly lacking in patients.

The patient list was 122 when I arrived a couple of weeks ago at my local A&E, five-to-six hour wait time. Using A4E as a GP replacement would drive specialists from their roles and increase waiting times in incomprehensible levels. The government wouldn't plough money in to sort provision either, their actions towards the NHS over the past decade+ have set their stance in stone.

Then there's the questions of what to do with all the GPS, nurses and ancillary staff...

My GP surgery is brilliant. On the day appointments, will see you face to face when needed, kind, compassionate. My GP knows me, I have complex health problems, I dont want to have to rock up to a&e. My surgery are so busy, the idea that they are closed is laughable. Some surgeries have got things really wrong, but they are terribly underfunded and in my experience (personal and professional) I've never seen people work harder and juggle so much.

@Ilovegreentomatoes

We need Gps but right now the whole system is bonkers . Why other frontline workers are getting on with it overpaid Gps are hiding away from their duty of care. The government need to step in and demand face to face appointments again or we face a lot of illnesses getting undiagnosed.

Why do you think GPs are overpaid? Have you been reading the Daily Mail?

5 years at medical and 5 years postgraduate training is the absolute minimum time for producing a GP. Medical school is £9000 x 5 for tuition even if you don't have to take out a maintenance loan. Postgraduate exams must be paid for at a few £100 at a time, then there's indemnity fees and GMC registration on top.

If anything all doctors are underpaid for the investment of time and money they have paid. And to top it off the general public insult their profession relentlessly.

@ilovegreentomatoes I'm afraid you're mistaken. GPs are at work! They are doing online, video and face to face consults! The suggestion that they are not at work is just crazy. I and family members have seen GPs multiple times over the last year.
Not sure what a Gp's salary has got to do with it. They're highly trained professionals. I don't see you begrudging other highly qualified professionals their salaries.

Hospital is much more expensive than GPs. Gps/primary care are v cost effective I thought - and under-funded compared to hospitals. In addition, hospitals are a long way from rural parts of the country.

I think the needs of working-age people with no chronic problems are different from those with chronic illnesses (sometimes multiple). Walk-in clinics next to hospitals and at polyclinics might be a good middle ground. Named GPs giving continuity of care could be reserved for people with chronic illnesses and funded better?