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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

GPs leaving the UK

130 replies

Traveller3367 · 25/11/2021 23:40

DP is a HCP with lots of doctor friends.
In less than 2 years, 6 GPs have left the UK to work abroad (or are imminently leaving).
I read in the papers that 1 GP can care for upto 2000 patients so that's 12000 patients who have lost out.
AIBU to think there must be something about job that's driving them away?
The papers make it out to be easy and well paid but clearly not easy/well paid enough for some to stay and do it!
How can we keep our GPs in the UK to help us?

OP posts:
happydramatic · 26/11/2021 13:38

BoPeeple

He works a three day GP week, and he does a 2 day a week (poorly paid but heart is in it) youth worker job and an evening at out of hours walk in centre. With these jobs needed overtime, he works around 6/6.5 days a week.

happydramatic · 26/11/2021 13:42

@BoPeeple

DH works a three day GP week, and he does a 2 day a week (poorly paid but heart is in it) youth worker job and an evening at out of hours walk in centre. With these jobs needed overtime, he works around 6/6.5 days a week.

user1497207191 · 26/11/2021 14:02

@Octavia174

GPs need to refer for specialist treatments... imagine demanding to see a Neurologist, just because Dr Google told you that headache was in fact a Brain tumour.... the system would collapse.

For some things, yes, a referral from "someone" is required, but not for the really simple things like hearing aids, ingrown toe nail removal, x-rays for suspected fractured fingers/toes. You don't need a gp referral for a dentist appointment or a pair of spectacles, so why do you need one to get NHS hearing aids or NHS glasses at Specsavers?

Only a couple of weeks ago, my OH (cancer patient), mentioned a very sore foot to his haematologist, thinking it may be neuropathy caused by chemotherapy (something he was warned about when treatment started). Haematologist suspected it was a fractured bone in the foot, but was unable to send him for an x-ray, so told him to get a GP appointment, for the GP to send him for an x-ray. Took many attempts to get a GP phone appt, then had to explain symptoms etc for GP and relay what haematologist had said, only for GP to say she had to see the foot before she could send him for x-ray, so took yet another F2F appointment for the GP to "look" at the foot, so she could do the x-ray referral. That was 2 GP appointments just to do a bit of paperwork to refer to x-ray, even after the haematologist had already looked at it and said it needed an x-ray.

It's that kind of waste of resources that's causing the GP appointment shortage, i.e. 2 "wasted" gp appointments just to get an x-ray that a consultant wanted.

It's exactly the same inefficiency/waste of resources, when the haematologist notices abnormalities in his blood tests (that he has 2/3 times per month for the chemo treatment). Sometimes it's low iron, sometimes low calcium, latest time was low vitamin D. Every time, the haematologist tells OH to contact the GP to ask for prescription for iron/calcium/VitD tablets. Every single time, the GP receptionist insists on making an appointment with the GP and won't just pass the message on. Every single time, a wasted GP appointment, just for my OH to tell the GP what the haematologist has said, every single time, GP says she can't see the hospital blood test results and needs her own, so OH has to make an appointment at the GP surgery for a blood test (increasingly difficult), then follows another message from surgery asking for OH to make a phone appt with GP, only for GP to say she'll issue a prescription. Why the hell can't the haematologist either just issue the prescription himself (along with the other bag of drugs prescribed every month) or just email the GP to ask the GP to issue the prescription, with a note of the blood test result?

The whole thing is far too fragmented, no one talks to eachother directly, leaving the poor sod of the patient with the task of the ever increasing difficulty of contacting the GP themselves. How about a bit of joined up thinking and NHS staff liaising directly between themselves. We often say it must be nigh on impossible for the elderly and confused people to navigate the NHS if they have major health issues. My OH is in his 50s, fully compus mentis, with a managerial/professional job and he finds it exhausting trying to navigate all the obstacles put in place by the NHS to try to manage his condition.

Darkstar4855 · 26/11/2021 14:10

I’m a doctor and no amount of money would be high enough to make me want to work as a GP.

The pressure of the job, the unreasonable expectations a lot of people have, the constant hatchet jobs being done by the press and the way the government are using GPs as scapegoats to cover up their mismanagement of the NHS… no thanks. No wonder they’re all leaving.

BoPeeple · 26/11/2021 14:24

@Darkstar4855

I’m a doctor and no amount of money would be high enough to make me want to work as a GP.

The pressure of the job, the unreasonable expectations a lot of people have, the constant hatchet jobs being done by the press and the way the government are using GPs as scapegoats to cover up their mismanagement of the NHS… no thanks. No wonder they’re all leaving.

Do you think people have unrealistic expectations?

I would expect, for example, my GP to be able to diagnose an infection, or perimenopause, or to care enough about symptoms of rheumatoid arthritis to do some blood tests. I would expect to see my doctor within a month of asking for an appointment, or for the surgery to contact me about blood test results if there are abnormalities.

I don’t think patients are asking the world.

Musicaltheatremum · 26/11/2021 14:41

We have been given extra money for the winter to improve access. But we can't get locums or extra GPs to take the free slots. It's awful. Saying that however we went back to almost complete face to face appointments this week with a few telephone slots as we were bringing in 70-80% of our telephone calls so it was a waste of time. Demand has fallen dramatically since we did it. Somehow it isn't urgent if you have to come in. We have had free appointments quite far on into the day.

The staff say it is so much better. I would say 80% of consultations need to be face to face to be safe. We have a big waiting Room and open windows. I actually enjoyed my job this week.

Badbadbunny · 26/11/2021 14:42

@Darkstar4855

I’m a doctor and no amount of money would be high enough to make me want to work as a GP.

The pressure of the job, the unreasonable expectations a lot of people have, the constant hatchet jobs being done by the press and the way the government are using GPs as scapegoats to cover up their mismanagement of the NHS… no thanks. No wonder they’re all leaving.

Depends on what you mean by "unreasonable expectations"?

Is being able to book a blood test requested by the GP unreasonable?

Is it unreasonable to be able to phone and make a GP appointment without having to phone every day at 8am and getting a message you're 42nd in the queue, then being cut off without speaking to anyone?

Is it unreasonable to need several appointments with a GP before they finally diagnose a life threatening condition or finally refer you to a specialist, after they've fobbed you off repeatedly?

Badbadbunny · 26/11/2021 14:44

Saying that however we went back to almost complete face to face appointments this week with a few telephone slots as we were bringing in 70-80% of our telephone calls so it was a waste of time.

That's what I've been saying. Every single time my husband has need a GP appointment this year, it's been a wasted phone call (for GP and husband) as the GP wanted to see him anyway. That's 2 appointments when one would have done.

scaevola · 26/11/2021 15:03

BMJ on GP situation this year

www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice

@user1497207191 - your DH's situation would be resolved if the hospital doctors could write 'green' prescriptions for you to take to an ordinary pharmacy, and then include the information in the letters they write to GPs anyhow after cibsuitations. Maybe something to suggest to PALS?

Larryyourwaiter · 26/11/2021 15:30

I don’t know a GP who works a full week. We have a good friend who works 3 days a week on contract and then just picks up locum work on b/h for triple time.
He has a great life. He earns plenty and he takes on little responsibility and has loads of free time. He regularly takes a month of in the summer to go away.
I imagine there’s a lot of GPs working similar, but it means a lot of his work is actually passed on to permanent staff. He refuses to get a ‘proper’ job and I can’t see why he wouldn’t. I imagine it’s a drain on the system though.

Exhausteddog · 26/11/2021 15:51

I know a GP. They are a partner in a surgery, and have about 10 weeks holiday a year, and from the outside, seem to have a nice lifestyle. I don't doubt however that its incredibly stressful and pressured.

linelgreen · 26/11/2021 16:07

I have totally given up with our local GP surgery can't stand the queues on phones then having to explain to reception before being allocated a phone/video appt that they cannot guarantee a specific time slot for. It's far easier to call the local BMI hospital where there is a private GP happy to see you at a suitable time you get an unhurried appointment where you are actually listened to and immediately referred for any tests or investigations. If private healthcare can provide without the 'covid' excuse perhaps the time has come for NHS to be privatised.

NearlyThereMum · 26/11/2021 16:15

@sst1234

These GPs are ripping off the taxpayer. Training at the expense of UK taxpayer and then leaving to make big salaries abroad. As if surgeons and consultants working privately wasn’t bad enough. The NHS is a gravy train. It no longer exists for the people that pay for it.
I think it's reasonable to ask GPS to stay in the UK for a certain length of time after they have accessed so much free (I am Scottish) education at such a high level. They should have to 'pay it back' either in time Worked or a financial penalty if they want to leave the UK shortly after qualifying
kashazzam · 26/11/2021 16:22

I posted this a couple of months ago in response to a similarly themed thread. DOI - not a GP.

Back of the envelope plan to become a GP for those who'd like to:

(Not considering the 4A*s at A-level, or the other hoops to get through in order to get to the point of medical school if you come at it from a different direction - as a graduate/professional entry you would probably pay for preparation courses, exams etc etc)

5-6 years of University. About £10K fees per year. Don't pay fees the last year. Cost of living on top (in a University town). Add £10K per year. Pay extra if you want to add a 'science' year (BSc). Have to commute to placements. May or may not be compensated for that (if not, pay for your room, and pay for where you need to stay on placement). Academic year is longer, but get a job in holidays and work in the evenings when you can at university.

Complete University: pay to move to a random place that you've been allocated a job in without family support. Pay for your GMC license, and insurance. (Sucks up about £500 or so out of the first pay packet). Pay for your professional exams to allow you to apply for your next stage of training (varies depending on whether you want to be a GP, or a psychiatrist, or a hospital doctor or surgeon - probably around £1-1.5K to do the set of exams). Fail them because revising whilst doing 70 hours a week switching between days and nights is hard. Pay for them again. Pay for a course so you don't fail them again (lets add an underestimate of £2-3K for this).

Apply for GP training. Get sent to a random part of the country away from your support. Self fund some more 'essential courses' and life support training. Pay some more insurance. Pay some more GMC fees. Note - not earning the 'mega bucks' just yet, and still paying that cracking student loan.

Do this for a minimum of 3 years, then start work as a GP, hopefully able to stick around in one place for a while.

At any point - exams, job applications expect to have hiccups. Sadly I think that the UCAS deadline has already closed this year, but for those who are interested then applications close on 15th October 2021 for Autumn 2022 entry).

There's a good breakdown of the costs in this article (although I'm pretty sure it includes cost of living which confuses matters somewhat).

www.healthmatters.org.uk/uncategorized/the-true-cost-of-becoming-a-general-practitioner/

I don't doubt that the system is not working, but the people who are in it have committed so much from themselves over many years. I have GP friends, I watch them try so hard to paper over the cracks, and become unwell themselves with stress.

fuddleducks · 26/11/2021 16:32

'Only a couple of weeks ago, my OH (cancer patient), mentioned a very sore foot to his haematologist, thinking it may be neuropathy caused by chemotherapy (something he was warned about when treatment started). Haematologist suspected it was a fractured bone in the foot, but was unable to send him for an x-ray, so told him to get a GP appointment, for the GP to send him for an x-ray. Took many attempts to get a GP phone appt, then had to explain symptoms etc for GP and relay what haematologist had said, only for GP to say she had to see the foot before she could send him for x-ray, so took yet another F2F appointment for the GP to "look" at the foot, so she could do the x-ray referral. That was 2 GP appointments just to do a bit of paperwork to refer to x-ray, even after the haematologist had already looked at it and said it needed an x-ray.

It's that kind of waste of resources that's causing the GP appointment shortage, i.e. 2 "wasted" gp appointments just to get an x-ray that a consultant wanted.

It's exactly the same inefficiency/waste of resources, when the haematologist notices abnormalities in his blood tests (that he has 2/3 times per month for the chemo treatment). Sometimes it's low iron, sometimes low calcium, latest time was low vitamin D. Every time, the haematologist tells OH to contact the GP to ask for prescription for iron/calcium/VitD tablets. Every single time, the GP receptionist insists on making an appointment with the GP and won't just pass the message on. Every single time, a wasted GP appointment, just for my OH to tell the GP what the haematologist has said, every single time, GP says she can't see the hospital blood test results and needs her own, so OH has to make an appointment at the GP surgery for a blood test (increasingly difficult), then follows another message from surgery asking for OH to make a phone appt with GP, only for GP to say she'll issue a prescription. Why the hell can't the haematologist either just issue the prescription himself (along with the other bag of drugs prescribed every month) or just email the GP to ask the GP to issue the prescription, with a note of the blood test result?'

@user1497207191- I agree this is an absolute waste of your DP's time and energy. I'm afraid the Haematologist is at fault and is placing very unfair pressure on the GP. Of course the GP will want to see the results of the blood tests and have some knowledge of the symptoms if they are taking responsibility for prescribing/ referring for an Xray. Any professional would require this.
The Haematologist is able to prescribe to the hospital pharmacy and some are even set up to prescribe to a community pharmacy. They should have arranged this and then written or emailed the GP to communicate clearly if they want something further done. If they had done this, the GP would have prescribed without wasting everyone's time. The Haematologist should also have been able to refer for an Xray within their own trust or directed your DP to a minor injuries unit. They are wasting the GP's (and their staff's) time and your DP's time and don't seem to understand the terms of their contract with primary care.

He refuses to get a ‘proper’ job and I can’t see why he wouldn’t. I imagine it’s a drain on the system though. @Larryyourwaiter- how is your friend's job not a 'proper job' exactly? He is working in a demanding, clinical role and presumably working hard otherwise I doubt he would be called back repeatedly. In what way is a doctor working hard a drain on the system? He has chosen to be overrun with paperwork, management and running a business. That is a perfectly reasonable choice. I expect he feels that being a GP Partner simply isn't something he wants because of the hours and stress involved nowadays. Many agree and it is only getting worse due to the constant smearing of GPs by the government and the media.

Duckrace · 26/11/2021 16:59

So much rubbish on this thread. The average GP is not paid over a 100k, but 62 for a full time week.

Anyone without a right wing political agenda can see why doctors are leaving, or not joining general practice in the first place.

neverbeenskiing · 26/11/2021 17:06

OP you only have to spend 5 minutes on MN to see why GPs are leaving. Everyone hates us. I’m working harder than I’ve ever worked but it’s still not enough. I’m leaving as soon as I can.

Not everyone. I've had a lot of contact with my local GP practice over the past 12 months due DS and I both developing some health issues. I've never struggled to get an appointment when I've needed one (including at the height of the pandemic) and we have been treated efficiently and with great kindness by every GP we've seen or spoken to. Like Teaching and Nursing being a GP is one of those jobs that many people seem to feel confident they know the reality of, and are therefore entitled to criticise, despite never having done it themselves. I'm not sure why that is. But for the sake of balance I just wanted to share a positive experience and Flowers for all the HCP's on this thread feeling demoralised. For every person who comes on here and bashes GP's I'm sure there will be others like me who are grateful for what you do. Its just that angry voices tend to be the loudest.

googlegoode · 26/11/2021 17:16

The pay confuses me, as the friends I know say the pay is good eg 60k for 2 days so is it very varied.

googlegoode · 26/11/2021 17:21

Heart Sink patients have always been there - those that come in and you know they are really suffering - physically but often mentally - and you know there is nothing you can do as the cause of their problem is poverty/over work/poor housing/lack of access to basic facilities/the daily overwhelm and the help they need is simply not available or has an incredibly long waiting list.

I think this is a good point. Things aren't working for enough people at the moment.

googlegoode · 26/11/2021 17:22

Also the ageing population & the lack of proper social care must have an impact too

googlegoode · 26/11/2021 17:24

Re younger people with good skills leaving the UK I think this will actually grow as a trend. Life is too expensive here now & the grass is actually greener in other places.

Simonjt · 26/11/2021 17:24

My cousins wife is a GP, they left the UK, she now earns more, has fewer hours, shorter shifts, longer appointments and adequate support on the admin side of things.

threecee · 26/11/2021 17:24

Why is it there was no problem in march 2020 ? why has it only become a huge Drama since they were expected to get back to work ? everybody cant have emigrated since march 2020 ! it just seems so convenient to tack this crisis on to the covid restrictions what a god send to the BMA its been !

googlegoode · 26/11/2021 17:25

I compare conditions for these key workers, including doctors, paramedics and nurses with the comfortable, relaxed practices for those civil servants, lawyers, management consultants, accountants etc, etc, etc who are now working from home and demanding late starts, lots of breaks to enable them to do school runs.

Surely that's a bit of a generalisation?!

endofthelinefinally · 26/11/2021 17:34

GPs can see hospital lab results, they just need an appropriate password. I know this because I worked as a nurse practitioner in GP for years.
Consultants can easily print off lab results in their clinic. Mine does that for me every single time I have bloods done.
I email my GP with an update and I can either scan and send the lab results or copy and drop them in to the surgery.
My consultant letter usually arrives in the post a week or so after the appointment, I also have the option to access my hospital letters online.
If one NHS trust can manage this, they should all be able to do it.
None of these technical issues are difficult.
Before I retired I helped to develop a scheme to move chronic disease management out of hospital clinics and into GP surgeries. Lots of chronic conditions are managed by clinical nurse specialists, we are all experts in our fields. Instead of making patients trail to hospital all the time, we put the clinics in surgeries. The nurse can be a very effective bridge between the GP and the hospital. It works very well but needs a competent CCG to cooperate.
There needs to be the same basic standards and systems everywhere in the UK.

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