to wonder what GPs are doing at the moment?

[MaMaLa321]

I couldn't give blood last time, because my iron level was so low, and I was strongly advised to see my GP.
I called my GP to be told that there are no face-to-face consultations and that I had to have a phone consultation (in a month's time) which will be of no use whatsoever because I'll need a blood test from the nurse. And no, I can't book an appointment with the nurse directly, I have to go through the GP.
And yes, I am aware that this is in no way an emergency but it means that serious conditions aren't being picked up.
But no wonder A and E is overwhelmed. And what are GPs doing?

So I'm a GP. Right now I'm eating ice cream and watching Kung Fu Panda with my son. I work three days. This is a choice I made for the same reasons as everyone else... childcare, work life balance, personal preference etc. Today is my day off but I spent 1hr 30 in a meeting about running the business and will spend my evening having my appraisal...

We have 14k patients and would absolutely love 12 GPS (as was quoted above) but we can't recruit that many. They just don't exist. The government promised to train several thousand more GPs but this has not happened. We have 6 partners and 3 salaried GPs.

Yesterday I did 45 phone calls to patients before lunch time and then another 30 phone calls afterwards. Approx 25% needed review face to face and I organised these appointments for them. Two of the calls were from patients on holiday and we managed to sort their medical issue remotely and arrange prescriptions where they were staying.

Currently we are working harder than we ever have. We are just non stop from 7.45am to 6:30pm. In addition to the calls I signed approx 200 prescriptions, completed several medication reviews, supervised the work of a paramedic, clinical pharmacist and nursing staff. I read 42 letters from secondary care and made medication changes and contacted patients where needed.

I can't comment for other practices but we have seen patients face to face literally daily since the pandemic started. We have spoken to them on the phone first to make sure this is the safest and best option for them. We have re-organised our practice to ensure we can see patients who might have COVID without them exposing other patients in the practice. Literally every patient who calls will get a phone call back on the same day. Yes the time might not be the best time for you but unfortunately when we are trying to fit in that much work we can't give specific times.

I think it can be hard to really imagine what people do in their working day and difficult to see why they can't do what seem to be obvious things... I hope this gives some insight.

I had problems seeing a GP before covid. You’d have to do that mad dash at 8am to try and get through and hope that you’d get an appointment for your ill child. There haven’t been enough GPs for a long long time now.

It just illustrates how thin the NHS has become after austerity.

I remember what it was like pre 2010, and boy it was so much better.

I had a blood test last week supposedly routine for my diabetes type 2
Phone call from the nurse this week, the diabetes test was not done (Why?) but I am borderline with microcystic anaemia.

I asked what sort of anaemia that was.

‘I don’t know, you can google it’ .

That sort of anaemia seems common and treatable according to Dr Google, lucky he is usually available even if no other doctors are.

I work in admin in a GP surgery and I have never known it so busy,. People put off going to the doctor last year and are now contacting us in droves. I no longer have a lunch or any sort of break, though I am part time. The doctors are rushed off their feet dealing with patients. Also health care staff in general are leaving in droves as the pressure is so great. GP vacancies are becoming impossible to fill. Waiting lists for routine appointments in hospital clinics are sometimes months away. And people grumble and grumble and just don’t seem to see the miracles GPs and their staff are achieving every day. We all need to be a little bit more understanding about the situation and remember NHS staff are in the same boat when it comes to getting appointments with their own health care providers. I will have been waiting seven months for an appointment at hospital for some much needed dental work my local dentist could not do and was forced to pay privately recently for a steroid injection for agonising shoulder pain.

You're right OP, we're doing fuck all. Now leave us alone so we can get on with gossiping over coffee and cake.

(Im a nurse practitioner in a GP surgery. Its 1627 and its my first break today)

We can't ignore wrongs that are directly associated with a particular group just because that group also experiences discrimination

@Magicalwoodlands GPs. Quite hard to retrain and replace dead ones within a year.

Whilst every practice is different, I work in a GP practice and we have never been so busy. We used to do admin (tasks, docman, econsults and emails and prescription requests) in-between calls/on reception. Now it's a full time admin job which I'm doing and there still isn't enough time. Our GP's have been seeing patients face to face throughout where necessary as well as phone calls and video calls. In-between GP's sign off hundreds of prescriptions a day (this involves checking they've had a med review recently and bloods if they're on certain medication, not just a tick box which takes them time), referrals, checking clinic letters, econsults and actioning emails from hospitals and care homes. They're also called into the nurses rooms throughout the day to check ECG's or something needing antibiotics that a practice nurse can't prescribe.
A lot of patients have saved up many ailments so may have 4 or 5 different complaints and maybe something that could have been easily sorted initially, has now grown into a bigger problem needing extensive tests.
Everyone is on their knees. Some of our GP's are part time but nearly everyone either works in another surgery or hub, hospice etc when they're not with us.
The backlog is huge, the patients are understandably frustrated and in all honesty, everyone has just had enough.

Hello

We hope you don't mind, but when these threads are flagged up to us we usually add a link to our Mental Health resources. You can also go to the Samaritans website or email them on [email protected].

Support from other Mumsnetters is great and we really hope you will be able to take some comfort from your fellow posters, but as other MNers will tell you, it's really a good idea to seek RL help and support as well.

They're flat out seeing patients, there's not enough to go round because of chronic under-resourcing of the NHS designed to stress the system to breaking point so that everyone rushes towards private healthcare.

But y'all voted this shower of shite in to do just that for the last ten years and probably the next ten. Good luck, everyone.

At the end of August my pharmacist advised me that the worsening of my symptoms was because the drugs I’d been prescribed (after an email only) were unsuitable for my symptoms. I then kept calling and emailing to get some sort of consultation. I got through two weeks ago and have a telephone consultation booked for the end of November (yes I know it’s still October right now). The doctor will call me between 9am and 4pm. I explained that I will be at work from 8am until 1pm and unable to receive phone calls so can it be after 1pm. “Sorry we can’t do that and if you don’t answer after two attempts the consultation will be cancelled”. I can’t take the day as leave as I work in a school. Saving up for a private doctor visit……. I bet private GP services are raking it in right now!

@Supersimkin2

So when did all these missing GPs leave?

Cos appointments in person took place before Covid.

How many GPs left during Covid? Enough to cripple primary care?

Thought not.

I think the number of GPs has fallen by 10% over the last 5 years or so, so things were getting worse pre-Covid. And in that 5 years, the population has increased by approx 2 mill, so we would have needed a slight increase in the number of GPs to meet demand.

Add in the extra demand arising from Covid, because of longer waiting times for specialist appointments, and it's not hard to see how the pressure on primary care is increasing.

I'd like to see more use of nurse practitioners, as I think they could ease the pressure somewhat. And the govt needs to start some sort of retention incentive for nurses, and look at other ways of improving working conditions for all NHS frontline staff.

Personally, I'd write off their student loans after 10 or 12 years of NHS service.

@Purplewithred

The question is, why don't all practices have such options to access consultations and treatment? Also, what about people who find it difficult to access their GP through such routes?.

GP surgeries are private businesses who can run however they want as long as they meet the requirements of the contract they are under to supply services to the NHS. They don't have to have a messaging system or e-consult or whatever. Most do, but some are websites are rubbish and some surgeries don't do it at all or only during 'office' hours.

If your surgery is rubbish tell NHS England, your local Healthwatch and your local Commissioning Group, because otherwise nobody knows and nothing can be done.

If everyone who can use the internet services does use them then there is more bandwidth for those who can't to use the phone.

Kind of my point really.

My current surgery is not so bad. Previous one was terrible, made formal complaints including via the routes you suggest, got nowhere.

We shouldn't be tolerating a system that allows such variation in quality of care. Hence why I've always felt that proper nationalisation is what is required.

@MynameisJune

And I don’t blame the GP’s we have a shortage for sure. But I know quite a few GP’s who only work part time now, and again I can’t blame them it’s down to the government and shit funding etc but it’s difficult to stomach when you need help and it feels like no one will help you.

On previous threads on here, several "part-time" GPs have pointed out that part-time for GPs can often exceed 40 hours pw.

Most of the public sector does a 37-hour week as standard, and some of the private sector still does 35 hours pw. I don't know why we regard GPs as part-time, when they are doing what would be full-time hours for most people.

@BuggerOffAndGoodDayToYou - it goes to show how practices vary. Where I work (10,000 patients) our calls are between 8am - 6pm. We give either an AM or PM choice so if you finished at 1pm we would put under your name 'after 1pm please' or 'not between 10-11 as in a meeting ' and the clinicians usually oblige. It is difficult taking a call if you're working so we do try to be as accommodating as possible but it doesn't always go to plan if a clinician is running late etc.

@Tilltheend99

Why do you think they were running an hour late if there were no patients there being seen face to face?

I presume they aren't seeing patients face to face and doing phone consults at the same time.

As others have pointed out, if not managed properly phone consults could easily take up more time than they save and also significantly increase the risk of misdiagnosis. For example, relying on patient-taken photographs must be a very poor second to actually eyeballing it yourself. I often have to rely on photographs of situations at work for an initial response and know how much lighting and angles can affect how something looks.

Called my surgery yesterday morning. GP called me back at lunchtime, had my bloods taken this morning.

You’re generalising your situation to all GP surgeries which isn’t fair. Maybe find a different surgery?

Because I think GPs had one of the best levels of protection available. Certainly at my surgery no one could get in or out.
@Magicalwoodlands
They were the ones running community Covid assessment hubs!

You're right OP, we're doing fuck all. Now leave us alone so we can get on with gossiping over coffee and cake.
Do you work in the NHS? Are you normally this hostile when someone questions you? Do you think you're in the wrong job?
Also - where did I say you were doing fuck all? Nowhere. I just expressed surprise that my waiting time has gone up from 2 days to 48 days. And it's only for a referral because I need to see the nurse. And I can't see the nurse without seeing the GP.

Surely the problem is that every appointment is now potentially 2 appointments. One to speak to you to determine whether you need to be seen ( as if we don't know that ourselves) and then one to see the patient and do whatever needs to be done? So surely that is potentially doubling the work load.

My husband saw his GP a few months back (after the obligatory phone call to decide) and the Dr said that the best thing to come out of covid 19 was that it had lowered people's expectations of local GP surgeries. That is sad.

I hope you get it sorted soon op.

GPs (and practice nurses, receptionists etc.) are doing an awful lot.

There's a finite amount of GPs and subsequently a finite amount of appointments. They can't simply magic up more. Does anyone really think GPs are sitting behind closed doors sipping tea and rubbing their hands with glee that the pandemic has meant they can simply opt-out of their work? Demand sadly outstrips supply and, as evidenced by this thread, the result is very sad, both for healthcare professionals and for those who cannot get the medical help that they need.

If anyone is interested, this article by a junior doctor explains just some of what GPs do each day. unherd.com/2021/10/the-nhs-is-betraying-doctors/ I found it a difficult read. I have nothing but respect for the GPs I know.

Go to the shop and buy iron tablets. This is something that you can manage yourself at home. Yes you may need future monitoring but a massive part of the problem is issues such as this that could be managed at home.

Another reason GPs are overwhelmed is because, as well as being overworked before covid, there's now 18 months worth of additional problems that people "put off" during the pandemic. Our practice is open. We've seen people F2F throughout.

@MaMaLa321

You're right OP, we're doing fuck all. Now leave us alone so we can get on with gossiping over coffee and cake. Do you work in the NHS? Are you normally this hostile when someone questions you? Do you think you're in the wrong job? Also - where did I say you were doing fuck all? Nowhere. I just expressed surprise that my waiting time has gone up from 2 days to 48 days. And it's only for a referral because I need to see the nurse. And I can't see the nurse without seeing the GP.

Is so hard when we're as run off our feet and people question what we are doing though. No one is questioning what A&E staff are doing. I've recently moved from A&A to primary care and am working just as flat out. It's not surprising that waits have gone up every where. The NHS is a mess and no one in government seems to want to address it. It's not hostility, it's morale so fucking low and being kicked when down constantly.

I saw my GP 3 weeks ago as I am having balance problems which are so bad my employers have had to do a risk assessment as I keep falling over, the medication he gave me did not work so had another appointment today its ongoing and h has no idea what the problem is but at least I am being seen