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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To feel this GP are being a bit unreasonable

36 replies

Wildtimes78889 · 02/07/2021 11:05

Ds 25 moved out to try living alone. He has quite bad mental health problems unfortunately. He has now moved back with me. The local GP haven’t been taking any patients since February and every time they are called they say another three to six months despite guidance stating it should have a clear end date when they are to accept patients again. There is a clause that they can accept immediate family members of patients already registered there. However they refuse to do so and say they are full despite having had the list closed for well over three months which means people must have either moved or sadly passed away in that time.

OP posts:
Wildtimes78889 · 02/07/2021 21:35

Any advice please

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MissLucyEyelesbarrow · 02/07/2021 21:38

The problem is that many GP practices are unable to recruit new staff. Many GPs already have well over 2000 patients each. You can't keep adding more if you don't have the staff to care for them.

If you look on the NHS website, it will show you all practices in your area. Unless you are in a very rural area, there should be more than one.

girlmom21 · 02/07/2021 21:54

If they don't have space they don't have space. He needs to register elsewhere.

Wildtimes78889 · 02/07/2021 22:14

There is another one but it’s awful.

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doyouneedtowean · 02/07/2021 22:34

despite guidance stating it should have a clear end date when they are to accept patients again.

It’s only guidance; they don’t have to follow it.

Most likely, they can’t follow it. If they’re full, they’re full. They can’t just keep taking patients on and have nobody to care for them.

Wildtimes78889 · 02/07/2021 22:59

Yes but between now and February people must have either moved or died therefore surely creating some space.

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girlmom21 · 02/07/2021 23:11

But if there's a 3 to 6 month waiting list and other people moving into the area, or if they were already over-subscribed, those people won't make much difference

WildWestWanda · 02/07/2021 23:13

@Wildtimes78889

Yes but between now and February people must have either moved or died therefore surely creating some space.
It doesn’t create a space if they were already over subscribed
Wildtimes78889 · 02/07/2021 23:15

People that had moved into the area wouldn’t have been able to register as they haven’t been taking anymore since February. I would imagine all practices are unfortunately oversubscribed

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NommyChompers · 02/07/2021 23:18

Unfortunately they aren’t being unreasonable - they are humans with limited hours in the day. The SYSTEM is unreasonable (hideously understaffed and over worked). So don’t moan to the GP - moan to your MP!

girlmom21 · 02/07/2021 23:20

@Wildtimes78889

People that had moved into the area wouldn’t have been able to register as they haven’t been taking anymore since February. I would imagine all practices are unfortunately oversubscribed
You'll probably find new babies and the vulnerable, i.e. elderly or with life limiting conditions are prioritised
Wildtimes78889 · 02/07/2021 23:23

Yes but surely if the guidelines saying they can register immediate family members they could at least consider it.

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Noway100 · 02/07/2021 23:30

YANBU the system is set up so you have to register in your nearest catchment, so what do they expect your son to do? Has he stayed registered in his old area?
What would they do if a visitor to your house needed medical help...presumably take them on as a temporary patient?
What about students returning to the family home after University?

The NHS allows virtually zero patient choice in our choice of GP practice so the least the system could do is ensure that everyone can register somewhere within a reasonable distance.

Freecuthbert · 02/07/2021 23:31

As frustrating as the system is, it is likely they were already oversubscribed and I doubt people moving/passing away would be enough to offset this to the point of being able to accept new patients within a few months. PP pointed out some people may be prioritised. I had a baby this year and it was a given that she would be registered at my GP's. Is there no other GP local enough?

Wildtimes78889 · 02/07/2021 23:39

There is one other but is awful. I feel people should have a choice of at least two. In my old town pretty much all the gP covered the whole town so you loads to choose from.

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juryquery · 02/07/2021 23:47

Complain to them and NHS England

Get him seen

It's not a favour, the nhs is a paid for service.

Fucking sick to the back teeth of people implying we should be grateful.

Zilla1 · 02/07/2021 23:52

Who in the surgery said no, OP? Was it the receptionist, your GP or PM? If the receptionist, have you spoken with PM or your own GP nicely without statements like 'they should at least consider it' and 'I feel there should be a choice' but with a request hung on a justification around your child's return and MH issues.

Good luck.

Merryoldgoat · 02/07/2021 23:56

Isn’t there another surgery? I can think of at least 4 surgeries I could walk to. Do you live remotely?

Zilla1 · 02/07/2021 23:56

@juryquery, actually if they are full and have closed their lists to avoid more complaints of patients not being able to get appointments and there is another GP in the area with open lists then what would be the basis of a complaint? There might not be an obligation for an over-subscribed GP to open its list to a family member even if there is provision for them to choose to do so.

Missillusioned · 03/07/2021 00:08

Write to the health authority. They will allocate a practice who will then be obliged to take him.

Wildtimes78889 · 03/07/2021 00:08

These one other surgery which is awful and people never stop complaining about it so I believe it would be detrimental to him

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Wildtimes78889 · 03/07/2021 00:10

I’ve rung and an appointment at the practice for a non emergency and been called back the same day so they are clearly coping better then the other practice in the area which people can’t even get through on the phone

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jacks11 · 03/07/2021 00:21

This is going to be long, sorry. I am a Dr (not a GP, but very good friends with several) and have some understanding of the system and how it works,

It is a frustrating situation for you and your son OP- YANBU to be frustrated. YABU to think the GPs are being unreasonable though.

The practice list has been closed to new patients. The only reason this can happen is if the practice cannot cope with the list size it has. This is most likely to be because at least one GP has left or retired or is going to be absent for a prolonged period and they cannot recruit new GP(s) to replace or cover for them. Or there may be some other reason why their population has suddenly jumped significantly- for example, another surgery closing and patients needing to register elsewhere. If the list was closed as they had too many patients, then even if a small number leave the practice due to relocation, or because they are sadly deceased, that just makes the oversubscription less significant/brings numbers down to sustainable levels. If that is the case, the surgery are hardly likely to then start taking on more patients and getting themselves right back into the situation they were in before closing the list, are they?

Therefore, it’s perfectly reasonable/understandable why the surgery won’t consider registering family members of current patients (I imagine exception might be new born babies or a patient taking on the care for a terminally ill/very frail elderly relative, for instance).

If they make exceptions (other than perhaps these very specific cases mentioned above), then it just opens a can of worms, sooner or later. Sooner in many cases, as someone works out that x recently moved into the area and they say they are at y surgery/were seen going into y surgery/someone said they go to Dr Z at y surgery (that you/friend/friend of a friend/your mum’s friend’s son etc could not get registered at) and it gets out. Then lots of people will have their own reasons why their case to be exceptional/more important than other peoples… and the complaints start. It is far more logical, and generally speaking, fairer to have a policy and stick to it unless individual circumstances are significant (such as a new born baby whose mother is registered there).

If there is another surgery within reasonable distance/that you are within the “catchment area” of and that surgery are open to new patients, it is not unreasonable to ask you to register there until this surgery are taking on new patients. You will still have access to a GP, even if not your preferred choice- which I recognise is far from ideal, but until the system changes and there are enough GP’s to staff all surgeries properly, this is where we are.

I think it’s important to understand that practice lists are not closed lightly and are done largely for patient safety- if they have too many patients then patient care will suffer. For example, access for patients (i.e. appointments available) becomes increasingly difficult as patient numbers per GP become very high- each clinician can only see so many patients per day, but there are more patients needing appointments. The clinical and admin workload (both face to faced/telephone consults, but also repeat/acute prescription, chronic disease monitoring, managing/actioning hospital letters/medication requests/test results, as well as the day to day running of the practice) becomes unmanageable. So mistakes creep in/things get missed- it’s simply unsafe to work beyond a certain patient:GP ratio. Most people will only tolerate that so long before leaving or burning out. Burnt out Dr’s are not good for patients, nor for themselves or their families. At the moment their is such a shortage of GPs nationally that if a GP leaves one job will find work elsewhere either as partners, salaried or working as a locum.

Practices which have a reputation for being chronically understaffed/ having too many patients find it very difficult to recruit new GP’s (and practice nurses, for that matter) when someone leaves or retires. It then becomes a vicious cycle- few people want to work where they know things are tough/unsafe and so things get worse. More and more practices are being handed back to healthboards to run- mostly this is not working out well (in our area at least) as they end up being staffed largely by locum GPs- if they can get them (and that’s not guaranteed- locums can really pick and chose in some areas). However competent or nice a locum is they usually don’t know the patients, often don’t know the area well, and may not be back for some time (if at all), so follow up and continuity of care is hard.

I think it is important to know that GP practices have to give notice of the intention to close their list (not take on new patients) and give reasons justifying this intention/evidence back that up. They cannot just shut the list on a whim or because they feel “ a bit too busy”- it would be in breach of their General Medical Services contract. In addition the health board would have to accept their reasonings and it is kept under review. The fact the surgery is able to continue to hold the list closed strongly suggests to me they have an longstanding problem- i think this is most likely too high a patient:GP ratio- and the list will remain closed until that problem is resolved.

Wildtimes78889 · 03/07/2021 00:29

Thank you for your response. I’m registered as my sons carer and he has long standing mental health issues. Yes he could register with the other one but the likelihood of him ever getting an appointment or even getting a prescription on time unfortunately appears very slim.

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RogueMnerHidesUnderABigHat · 03/07/2021 00:38

Brilliant informative post @jacks11

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