Unlock the doors please, GP surgeries

[Tiari]

to think, if restrictions are lifted on July 19, then GP surgeries will open their doors?
We should be able to walk in freely and up to the reception desk for queries, appointments etc?

Liz, we've got 9,000 patients to two GPs. There were four but the others retired and have not been replaced.

The other surgery in the town has 12,000 patients to one permanent GP and locums as and when they can get them. Although on that one I blame the GP, he tendered for the contract knowing he didn't have the staff. His was the only tender so it was awarded rather than shutting down the surgery altogether.

@Tiari by telephone, I’ve never had to wait longer than 15/20 mins but it’s really surprising how different the level of service is from one place to another.

@GingerFigs for some it's a genuine interest in primary care. For some, it's arguably more family friendly than some but not all roles in acute. Conditions are harder and it's relatively less attractive than it was compared with alternatives over the last 15 years. It takes time for GPs to be trained and for GPs to retire so the consequences of government decisions take time to be apparent outside the profession.

Government decisions in England have been awful during the pandemic and the decision to ordering lots of vaccine early seems to have hidden many poor decisions.

We're stopping our PCN vaccination due to government incompetence. We're having to plan a huge September flu and COVID booster campaign and have full responsibility for QOF while managing a workforce burned out from COVID and vaccinations.

Haven't decided whether or when walk ins will restart bubt we never stopped seeing patients face to face throughout which I think has saved some lives.

GP's are all emigrating or retiring. The government doesn't pay doctors properally. The public abuse them.

Start appreciating them or prepare to have to pay privately for health.

@LizJamIsFab,

It might be helpful for you to tell PPs what full time for a GP would luck like. People often see PT and think it's PT of a 37 hour week. What would the hours of a full day look like for you when you've finished the essential administration relating to patient care?

@Rhinothunder

GPs are generally with a few exceptions private companies but it looks like a corporate multinationally-owned market structure is an intended destination rather than an accident. It won't increase the number of GPs but will be sold on increasing capacity. Virgin Care and others. Some scary figures of the aggregate donations from US and international companies to UK political parties, I can't find the source but I recall seeing a couple of studies that showed some donations unusually correlated with

I've just been on hold 78 minutes to get through to my doctors surgery (although it's merged with about 6 others to form this god awful "partnership") - the receptionist said on the day appointments are all gone - no shit if you are on hold nearly an hour and a half! I said that's fine when's the next pre bookable one....next Wednesday....over the phone.....I have a lump on my breast that needs seeing 🤷‍♀️

GP “popularity” as a specialty waxes and wanes. It’s been waning for years now. I’d argue it is not to do with pay, it’s workload/perception and patient expectations. Also less Drs want an all encompassing job / it’s hard to put limits on what you will do when you know a patient will be worse off if you don’t do it. That’s my view.

I feel I’m increasingly acting as the granny who used to give minor advice. Eg teething, parents know there is no serious consequence, all the info is out there, but still might want an appointment to discuss.
Before you jump on me I know teething is horrible, it’s easy for me to say, yes an occasional bit of calpol is ok from 8 weeks old, however where is the community/family/ granny that you can ask? Try what is in the chemist, read the packet and see if it’s suitable.

Some people have an unrealistic expectation of cure/symptomless life, we’re all going to suffer to various degrees. Babies will teethe, joints will ache, bowels will misbehave. We are looking for a disease, suggesting things to help ease but there is no textbook for an individual body and even if there was there wouldn’t be answers! At least working in a hospital specialty you can say I have done all I can - but then they are back to GP. I’m accepting the limits of medicine but society less so.

The waiting lists are painful, I see so many that are just asking me to “push them” forward in the queue and I try to advocate for them but what about the others waiting?

I’m a partner so if our surgery “collapses” and closes, patients will be reallocated (heartbreaking for me) and I will be liable for all staff redundancy. Big practices are more stable /resilient but they have to have a more protocol driven approach to appointments etc for fairness but no system perfect. My receptionists know high proportion of the patients personally and this cannot be the case for most of UK. I think this is a great help (but not perfect).

I don’t want to mislead I get 5 weeks holiday in a year and we are closed all bank holidays but we split leave up to have less impact over the summer. I love my job and it’s a total privilege. Maybe I’m too sensitive but every time I hear someone say GPs are closed or they try and block me from an appointment it’s awful. I’m acutely concerned about the patients who weren’t ringing during lockdown. I think the closed door didn’t help but we did have a sign that says ring and we’ve seen people every day we’ve been open this year.

On the other side, your surgery could be collapsing/ badly run or full of maniacs and I don’t want you not to complain or raise concerns. However email your MP that there is not enough access to GPs is my best bet. I’m more and more convinced they want to privatise GPs and pushing up to collapse will help.

I’m off today before anyone thinks I’m mumsnetting in work.

@ivfgottwins

I've just been on hold 78 minutes to get through to my doctors surgery (although it's merged with about 6 others to form this god awful "partnership") - the receptionist said on the day appointments are all gone - no shit if you are on hold nearly an hour and a half! I said that's fine when's the next pre bookable one....next Wednesday....over the phone.....I have a lump on my breast that needs seeing 🤷‍♀️

Did you say you had a breast lump? That's should definitely be seen.

All the GP surgeries in my town are severely understaffed, due to: retirement, change of career direction, pregnancy, ill health. Our GP's are overwhelmed by their existing caseloads. Covid has only exposed the unworkable pressure too many GP's are under.

I do find it incredibly frustrating not being able to access medical help when needed, but have chosen to send emails to my MP voicing my anger rather than at the GP surgeries.

Yes @Zilla1 good point, I work “3 days a week” and am in around 34 hours. I used to do out-of-hours (only 6 hours a week) and so did 40 hours but still consider myself part time.

My full time colleague is around 50 hours.

@LizJamIsFab,

We never had a day when we didn't see patients face to face this year or last. I agree collapse and dissatisfaction look deliberate intended destinations with the removal of small GP practices and establishing large corporate concerns.

I know the picture is mixed across GP surgeries but the reason I post is to give some context to the 'it's the same everywhere' posts. I can onlky speak for my practice, the practice in which I am a patient and the practice in which my DC is a patient. All of which answer the 'phone after the long COVID message and all of which have continued to offer face to face. Recruitment is hard for all HCP roles here. Wasn't surprised about government PCN vaccination and QOF decisions and Lord Bethall 'lucky to have a job' implications which seemed so tin eared I thought it was deliberately setting up a situation for the PM to save the day. I was wrong, though I am usually wrong.

@ivfgottwins

I've just been on hold 78 minutes to get through to my doctors surgery (although it's merged with about 6 others to form this god awful "partnership") - the receptionist said on the day appointments are all gone - no shit if you are on hold nearly an hour and a half! I said that's fine when's the next pre bookable one....next Wednesday....over the phone.....I have a lump on my breast that needs seeing 🤷‍♀️

I would be fine if you complained to me about that. Suggest employing most receptionists/phone lines.

This has a solution.

I presume most people then also don't mind seeing GPs and other staff who have tested pos or who are a Covid contact.
Currently 3 poeple off at DH surgery; GPs are still carrying on with telephone consultations but as you don't want this, should he come in, or do nothing (as you all say he would be doing nothing at home anyway)

@Zilla1 and @LizJamIsFab thanks for replying. It's good to understand the other side of things and how it all works as I think as "the public" we have our perception of how things run/should be run.

Lots of interesting points but one I would definitely agree on is the appointments for things that in the past people would deal with at home. Purely my anecdotal experience before anyone jumps on me (agree that if you have a breast lump that you need to be seen).

Thanks for taking the time to reply

@LizJamIsFab I expect you know but I've had the PT thrown at colleagues. I know long hours are a feature in many jobs but I think some patients see PT and FT and don't associate this with the actual reality of the actual time taken for a session in which one mistake can lead to court. I saw Dr Bawa Garba had a little good news after being thrown under a bus by the system and arguably an individual.

@ivfgottwins

Please ring and say you need to speak to GP today, or ring again tomorrow morning.

GPs will carry on triaging appointments rather than the unfair free for all that was happening before. If patients can’t be trusted to know when they need to see a GP urgently (and sadly too many can’t)

It’s still a free for all at our surgery just to get to the triage, so it’s not that much fairer. Although I do think an initial phone call is generally a much better and efficient way for a lot of people to speak to the GP.
Your last point is a little unfair, yes of course there are time wasters who go to the GP for every little thing, but generally speaking people cannot be expected to have the medical knowledge to know whether something is urgent or not. A few years ago I called the Dr wanting to book a routine appointment in a couple of weeks but as soon as I mentioned the issue to the receptionist she had me come in immediately. I’ve also had it the other way round, with an issue not being as serious as I’ve initially thought. I agree a phone call triage is a good system, but I think it’s unfair to characterise it as being because people can’t be “trusted” to know better.

Ours has opened its doors.

It’s still at least 30 minutes on hold and then a two week wait for a phone triage appointment. God knows how long for an actual face to face appointment.

@LizJamIsFab If it were a family member, I would call the receptionist back and say you have a breast lump and will not wait for an opportunity to have a repeated miss next week. You might not need a prebookable appointment but you do need to speak to a clinician today. On explaining the context, if they won't offer a call back today then ask to speak to the PM or your named GP. Parts of the system is breaking but if you've not had the opportunity to set out the symptoms before being told there's no appointments then you might need to help them.

Good luck.

YABU

As not all GPs practices are as bad as your own.

My GP's surgery door has been open through out.

I had to go in to check which pharmacy they sent my prescription to during the first lockdown.

If the receptionist had answer the phone rather than hide from it when I rung while standing outside so I could see her, I wouldn't have gone in to ask her.

Sorry @LizJamIsFab, I meant @ivfgottwins.

I think having a hybrid of f2f and telephone appointments works well. I don’t want to have to go in if there’s no need.

However I agree the service should be available as it is for everything else.

I’m intrigued by the distinction you make between being able to “walk in” and having to knock - I’m not sure what difficulty knocking causes if the door is opened, and I can see the sense in having some sort of gatekeeping as to who enters the surgery. An intercom system to buzz people in perhaps?

My GP surgery is still very much a closed shop. Telephone triage only and they really don't want to see you face to face.
I called in December about a problem that was impossible to assess and diagnose over the phone. Refused to see me. Told to take ibuprofen.
I finally managed to see an actual real person last week, after three pointless phone calls and a pointless video consultation. The upshot is that I need surgery and I could have joined the waiting list 6 months ago but because no one would actually look at my problem it was incorrectly assessed as being inconsequential. It's not a life threatening thing but it does affect quality of life and surgery is more successful done earlier before it deteriorates.
My GP surgery is a huge practice with 13 Doctors so it's not down to lack of staff.

Hope they open soon. Fed up of talking over the phone to be told we need to see you. Not seeing people. Video call no good as we need to examine you. Even worse when they start the call saying they are sorry to see you was recently in hospital. I'm surprised I have any tongue left.