To think that people don't realise...

[OhNoHelloSnow]

That there's way more healthcare professionals who can help them other than just the "GP or A and E NOW " options?

Seen so many threads recently where people haven't been able to get an appointment with a GP so think A and E is the only option left but are unwilling to try GP Nurses, Nurses Practitioners, Pharmacists, Rapid Response Care Teams (where available and if applicable), Self Referrals to services like Podiatry, or Physio, or IAPT (where applicable), 111, Out of Hours Hub GPs etc.

Just feeling like this all contributes to our over stretched GPs and A and E departments at the moment.

Other services aren’t directly accessible though. Regardless of whether you need GP, nurse, podiatrist, physio, they would all be accessed by calling the GP surgery and getting referred. Obviously I would go direct to dentist, optician or pharmacist.

I know plenty of people who ring the GP for every little thing and the number of ambulances I've seen in our street that leave without taking a patient or the patient walks unaided to the ambulance when there's a car on the drive and a driver in the house never ceases to amaze me.

The ambulance leaving without the patient doesn't mean that calling the ambulance was unnecessary.

A couple of examples from my own family

• frail elderly relative started to look acutely unwell with a known UTI. Called the GP. The GP called us back very quickly and told us to call an ambulance as it may have been sepsis. Paramedics spent about an hour assessing her, determined that it wasn't sepsis, and that there was nothing that could be achieved in hospital that couldn't be done at home. They left without her.
• a different elderly relative who fell over fairly frequently, and was confused. They couldn't get themselves up off the floor, and nor could the spouse, nor could the son living nearby. Ambulance was the only option - even if it was only to pick the relative up off the floor and check no damage had been done.

I have been struggling with a displaced coil for months now - despite numerous trips to the GP, scans etc (and intense pain), I was told there was a six month referral time to be seen by gynaecology. I saw my GP again yesterday as I have been bed bound all week with nausea, dizziness, cramping and severe pain. She told me to go to A&E as there wasn't anything she could to do expedite the process for me. I went to A&E last night where I saw various nurses who couldn't do anything to help but they did refer me to gynaecology and this morning I finally had the coil removed. It is depressing that the only way to get immediate help (and relief) is to go straight to A&E, but I can understand why people do it if the normal channels aren't working.

@PodgePie

I have been struggling with a displaced coil for months now - despite numerous trips to the GP, scans etc (and intense pain), I was told there was a six month referral time to be seen by gynaecology. I saw my GP again yesterday as I have been bed bound all week with nausea, dizziness, cramping and severe pain. She told me to go to A&E as there wasn't anything she could to do expedite the process for me. I went to A&E last night where I saw various nurses who couldn't do anything to help but they did refer me to gynaecology and this morning I finally had the coil removed. It is depressing that the only way to get immediate help (and relief) is to go straight to A&E, but I can understand why people do it if the normal channels aren't working.

That's an excellent reason to never use that sort of invasive uncontrollable contraception. At least you can stop taking a pill whenever you like.

@WoodchipNightmares

I know plenty of people who ring the GP for every little thing and the number of ambulances I've seen in our street that leave without taking a patient or the patient walks unaided to the ambulance when there's a car on the drive and a driver in the house never ceases to amaze me.

The ambulance leaving without the patient doesn't mean that calling the ambulance was unnecessary.

A couple of examples from my own family

• frail elderly relative started to look acutely unwell with a known UTI. Called the GP. The GP called us back very quickly and told us to call an ambulance as it may have been sepsis. Paramedics spent about an hour assessing her, determined that it wasn't sepsis, and that there was nothing that could be achieved in hospital that couldn't be done at home. They left without her.
• a different elderly relative who fell over fairly frequently, and was confused. They couldn't get themselves up off the floor, and nor could the spouse, nor could the son living nearby. Ambulance was the only option - even if it was only to pick the relative up off the floor and check no damage had been done.

My street is full of young families though not elderly people!

@bigbluebus

Where I live the Pharmacies all shut at 5pm (I think the 'late' one on rota might be open until 6pm). The MIU is only open 9-5 Monday to Friday. The nearest supermarket with a pharmacy is 15 miles away . So it's not really surprising that people don't use resources other than GPs or A&E. I also held on for 20 mins the other day to my GP surgery just to make an appointment for me & DH to have our flu jabs - I rang between 4 & 5 which is what they say is their quiet time, so goodness knows what it's like at busy times! No idea what the response time is on 111 as I haven't used it recently.

I have used the Pharmacist for advice (which was you need to see a GP today!) and have used private physio for me and private podiatrist for DS (the latter resulting in needing an op on the NHS), but we are lucky enough to be able to afford to pay. I know plenty of people who ring the GP for every little thing and the number of ambulances I've seen in our street that leave without taking a patient or the patient walks unaided to the ambulance when there's a car on the drive and a driver in the house never ceases to amaze me.

I totally agree @bigbluebus but just wanted to mention something about people walking to ambulances - last year my husband had a seizure out of the blue (turned out to be caused by a brain tumour) I called an ambulance during the seizure and they took him to hospital, but he did walk the few steps from the door to the ambulance. Not only did he want to move around (which I now know is common post-seizure) it was easier given our awkward door/position of the staircase. They didn’t even mention me driving him, but I wouldn’t have wanted to in case he had another one en route - and besides, I wasn’t really in any fit state to do it, I was barely holding it together. Loads of people definitely take the piss with ambulances but not every walking, conscious person is ❤️

@bigbluebus the point that you don’t know the details still applies though. We once had an ambulance come for DD when she was a few days old. I’d called 111 just for some advice on an issue I thought was not serious, and they sent an ambulance. The paramedics checked DD over and were happy that she didn’t need to go to hospital, so they left. If you’d seen it from down the street maybe you’d have thought that we were wasting resources because they didn’t take anyone to hospital, but we hadn’t called them!

When people say "call the GP" i take that to mean call your practice and you'll be directed to the appropriate person..

The problem is many of the alternatives to the GP are services that are through your GP surgery as gatekeeper.

I am lucky that my surgery where I work has been doing Dave to face appointments all through the pandemic for those who need them.

Every incoming request for help we receive is triaged by the medical team but the reception team have clear training on certain areas. I like to refer to it as patients being able to 'help us help you'.

We always ask what patients have done to try and help themselves. For example, sore throat or rashes (having checked the obvious menengitis and sepsis signs), have you seen a pharmacist?

It still amazes me people think they need to see a Dr rather than nurses, HCAs, pharmacists etc. We really do need the NHS to educate people on this.

At our drs you just phone up ask for an appointment and the receptionist tells you if you need a nurse or doctor.
Not a chance am I asking a pharmacist anything in the middle of a busy pharmacy nor am I asking for a private chat.
I dont think we have any walk in centres around here only drs or a&e

That's an excellent reason to never use that sort of invasive uncontrollable contraception. At least you can stop taking a pill whenever you like

Not everyone can just take a pill. Hormonal contraception isn't great for everyone.

Heres a radical idea - instead of having all these disparate services scattered all over & people unaware as to what exactly is and isn't available in their area let alone where it is or how to access it, how about we group them under one roof and make it a single point of access. Phone the reception and get triaged and booked into the most appropriate service, then if they determine otherwise they can post you to the next most appropriate. It could be something like a 'Heath Centre'

Our gp practice directs us to those people if appropriate.

@Bigassbeebuzzbuzz

At our drs you just phone up ask for an appointment and the receptionist tells you if you need a nurse or doctor. Not a chance am I asking a pharmacist anything in the middle of a busy pharmacy nor am I asking for a private chat. I dont think we have any walk in centres around here only drs or a&e

Why wouldn't you consult a pharmacist? Going into a consultation room with them (chaperone if requested) is no different from being in a room with a doctor, nurse or HCA. It's still someone who is clinically qualified to either answer your question and help or direct you to the person who can.

A couple of pharmacies here have huge signs in the window that says what they can help with which is useful but it is about signposting and not knowing who can help with what. There should be a clear website or booklet for your area to help guide people to the best support rather than having to go via the GP. Our receptionists are really helpful to me because I ask for signposting but for example my mother in law will never tell them what's wrong so ends up waiting 3 weeks for a GP appointment when she could have easily have seen the nurse within a matter of days.

@Whatiswrongwithmyknee

Our gp practice directs us to those people if appropriate.

Lots of surgeries are slow on the up take.

I heard online on various forums that some GPs practices allowed patients to self-refer to a midwife or a physio.

It took until last year for my GP practice to offer both those options. The first you had to ring up reception to get a referral and with the second you had to see a GP first and sometimes twice.

When myself and some of my colleagues have gone to see a pharmacist we have been directed to GPs.

I know plenty of people who ring the GP for every little thing and the number of ambulances I've seen in our street that leave without taking a patient or the patient walks unaided to the ambulance when there's a car on the drive and a driver in the house never ceases to amaze me

I walked unaided to an ambulance for an irregular & very fast heartbeat.
So did a relative who needed urgent open heart surgery & had had a stroke. I don't think you actually need to be already dead to require ambulance.

@Dotoallasyouwouldbedoneby It isn't that simple, my body can't tolerate the additional hormones of the pill so the copper coil was one of few options and I'm not the only one to struggle with this. I am now in the position of having to start from square one as I am too scared to try a coil again.

The 111 service generally just points people to A and E, it's happened a few times to my son.
Then they wonder why A and E is full.

@the80sweregreat

The 111 service generally just points people to A and E, it's happened a few times to my son. Then they wonder why A and E is full.

That’s not been my experience of 111. However, here we do have an out of hours clinic at the hospital, so they book you an appointment there if you need to be seen but it’s not A&E level. I was sent there twice at the weekend when I had awful mastitis and needed antibiotics. I’ve also had them arrange for a dr to call me back, and they’ve then given advice and sent a prescription to the pharmacy for me to collect.

I agree, lots have lost sight of what an appropriate service is to access, and lots take it for granted- ie the paracetamol on prescription brigade.

My GP surgery is like fort knox. They are doing everything they can to avoid any contact at all with patients. It's a disgrace that they are allowed to get away with it. No wonder people are going to A&E.
I would be absolutely terrified if I had something seriously wrong with me. I have no faith in the national health service whatsoever.

I had wondered reading here if the UK has an out of hours GP service because I have never seen it recommended? Where I live once the GP closes at 5 or 6 or whenever they close and at weekends there is an out of hours service, usually it covers quite a wide area but that is where you would go if you need a dr at the weekends/during the night.

Although we do pay for GP care here and the out of hours dr is more expensive but a&e is more expensive again and when you are referred to a&e by a GP you don't pay a&e costs so it makes monetary sense to see a GP first rather than rush to a&e.

@BIoodyStupidJohnson

Someone needs to develop an app that takes people through their symptoms and clearly signposts which service they need: pharmacist, GP, hospital, physio, give it a week and see if it improves, etc

It can be difficult to find what you need, especially when ill or injured (and not always thinking logically and clearly).

Not only that, services can vary by area and also the availability of these things isn't always made clear.

111 have an app