To think that a wait of 46 days for a routine appointment to have a call with a GP is outrageous?

[MrsKebble]

I saw a consultant who has said I need to start some gastric meds. He wrote to my GP this week and the practice have now told me that the first available telephone appointment to discuss this is 46 days away - is this not bloody ridiculous? Referral was Oct, procedures were Feb, results were March and now this. Why not just start me on the bloody meds?

@Hereward1332

This is unacceptable, but not an isolated event. The problem isn't Covid - it was bad before the pandemic- but the structure of general practices. Surgeries are private businesses (or part of a larger Group) rather than part of the NHS. There is no incentive for them to increase costs by hiring more staff, so they seem to operate in normal circumstances with the bare minimum. When something unexpected happens, the systems fail to deliver the necessary care. If they were incentivised based on the service actually delivered rather than the services they claim to offer, they might perform better.

But we can't get any staff. And they're leaving in droves. Three with over 100 years experience between them in our practice in the last month alone. The consultant should have initiated the prescription but this is yet another example of passing the buck to general practice. That's why you're waiting. Our clinics are rammed for weeks ahead. Full. People wanted more f2f so they've got them, resulting in longer appointment times and a lengthier wait. Frustrating when at least half a dozen patients each day will fail to show.

Oh dear that is outrageous. I can think of a few options for you.

1. Go back to the consultant and make them aware of the situation and request they start you on the medication

1. Get a letter from the consultant stating what you need to start and pay for a private GP consultation. Depending on what the medicine is that will also cost you at the pharmacy. And some can be ridiculously overpriced.

1. Ring your GP surgery and say that it is classed as urgent that you start this medication as soon as possible.

Personally I would be going back to the consultant!! If a consultant originally prescribes you something then a GP would be used for repeats without the need for an appointment.

@Ledkr I had a bad toothache 18m ago. Took 6m to get an appointment. They said I'd need to return for a 2nd appointment. Last Aug they attempted to extract the tooth ( a large back molar now beyond saving). Snapped it off & left live roots(very painful). Took 3 weeks to get a 'temporary patch' & advised not to eat or brush on that side but to use Corsidol to keep area clean. Roots finally drilled out 4 weeks ago. I now have a huge gap, a bown mouth (from 2x daily Corsidol) & another nagging tooth (no routine appts avail meantime). I also had to travel 25miles to st appt, and 40miles to 2nd, 8 to 3rd. The oral surgeon at the Hosp where the infected roots were finally drilled out was really angry & said some surpringly indiscreet things about local NHS dental services.

Sorry OP. Yes, its ridiculous. I'd send an email expressing your disappointment. Then consider a complaint if no joy. Can you contact the Consultant's secretary & advise you can't get your meds too?

sb: 'brown mouth'

Usually don't need an appointment for this
The GP would read letter, decide if meds appropriate and add to your regular meds. You should be able to view when this happens by checking your meds in patient access

As others have said, I would ring Consultant's secretary/email (if necessary go through PALS) and ask them to provide a prescription until you can get appointment.

That really doesn't sound right. If my consultant wrote to my GP recommending a treatment, the practice pharmacist would issue the prescription and there's a 48 hour turnaround for that.

Gosh how awful 52 and blue.
You must have been in agony.
I dont get it at all. If there's a covid backlog surely the routine appointments are the answer to avoid things getting worse.
I'm going to have to get a second opinion I think, more money to shell out.

Well you can complain about a long wait. Clearly that is a very long wait. However, those suggesting complaining perhaps don't understand that complaints take up the time of practice staff including GPs sometimes and this then reduces the time the can spend on other things including seeing patients. Why do you think the wait for GPs is so long? Is it all because they are off having boozy lunches and playing golf? I would suggest not. It's because of chronic underfunding by the Tory government, constant political and media led criticism leading to more GPs leaving and less trainees wanting to choose GP, the government failing to see the looming crisis in GP numbers (this was pointed out to them by the profession). Even Javid admits that they will fail to meet their target to attract more GPs. On top of the lack of GPs, what is now required of the profession is totally different compared to 20 years ago, so many more, complicated treatments available, constant guidelines to keep abreast of, constant worry about litigation which was previously not a worry. Thirdly, the population is entirely different, many more elderly patients with complex needs which are much more complex to manage. Fourthly, patients are discharged much sooner by secondary care and some are failing to do their job properly as in this example (and then GPs get blamed). So for those suggesting that everyone complains, just think it through first. If you do behave like a bully to the practice staff (some patients absolutely do), you might get a slightly sooner appointment but you are only making things worse for other patients as they will wait longer and you make the staff's day much worse so they may leave and then you end up with a worse service.

@TrickyD

Thanks girlmum21. Yes the CQC deal with complaints etc, but they are a big, national organisation, which is fine in many ways, but a GP version of PALS smaller scale, and aware of local GP services would be very welcome.

Local Clinical Commissioning Group or healthboard. Names keep changing! They contract GP services.

@TrickyD

Complain, yes but to whom?

We have had a couple of issues that were resolved by PALS, but they were connected to hospital services.

What is the equivalent of PALS for GPs, if there is one?

There should be PALS dept for the CCG who commission GP surgeries so Google your local CCG PALS dept.

A lot of people blaming it on Consultant- you’re wrong, there will be different agreements between primary and secondary care for different CCGs. In our local one, only emergency meds are initiated by secondary care, everything else consultant requests GP to prescribe. That’s what the CCG I.e. the GPS themselves have ‘purchased’ from secondary care. So not within consultant’s choice to do for you.

IME, econsult doesn't work:

Late last year I needed to speak to a GP. I filled in three econsults and then ended up crying on the phone to a receptionist who finally sorted an appointment.

About a month ago I asked for additional pain relief and spoke to a nurse practitioner who suggested a change in dose of one of my medications. It didn't work (I gave it two weeks), so put in another econsult. I was given another appointment with the same NP who had already told me I would need to speak to a GP if I needed further help.

I put in another request last week as a prolapse repair I had has broken down. I specifically said I needed to speak to a GP. No prizes for guessing who I have got an appointment with - on the phone. Unless I am asked to self-examine on the phone, it's a complete waste of mine and the nurse's time (and even then she won't be able to refer me to gynae which is what I need).

I also put in an econsult for my DM who has around six to twelve months to live, saying that a symptom she has is causing huge distress and that a GP needed to see her - she got a phone call to say she should have an x-ray, which again is totally pointless. No offer of any other help at all.

I totally agree with the poster who wondered why there isn't rioting in the streets over this.

@canary1

A lot of people blaming it on Consultant- you’re wrong, there will be different agreements between primary and secondary care for different CCGs. In our local one, only emergency meds are initiated by secondary care, everything else consultant requests GP to prescribe. That’s what the CCG I.e. the GPS themselves have ‘purchased’ from secondary care. So not within consultant’s choice to do for you.

It's not wrong because that it how it works in the areas I have worked in (several) and other posters, who appear to also be GPs, have said the same thing. I can't speak for your specific trust but it is not 'wrong'. My understanding was that this was a requirement in the NHS contract. I'm afraid I haven't got time to look it up right now.

Thank you for all your tips.

I have spoken to a receptionist and she said she will go back to the doctor and see if it can be upgraded so that I have less time to wait.

I will call the doctor's secretary at the hospital and see if they can do something.

The surgery will have got the same letter I got today .

Our surgery is a disaster - they lose staff right left and centre at both reception and pharmacy. They only issue one month's meds at a time so people are in and out like yo-yos all the time. Someone said that they do this as they get paid per script - I am not sure if this is true. Whenever you go in there are always disgruntled people. Most people it seems never achieve what they want on one visit - meds are never ready . Out of 4 of us yesterday no one received what they came for. They are very poorly organised in general - they lose samples and seem to have difficulty communicating within themselves.

It is not any of the meds mentioned.

Thanks again.

IME, econsult doesn't work:

This seems to vary practice to practice. Works very well at the practice I attend and the one I work at. However, it is subject to having enough staff to process them! And illness and high turnover don't help.

@cptartapp

So it's the patients' fault for wanting face to face appointments? There are options - in the short term, outsourced video appointments to locum GPS. Longer term, offer partnerships more readily.

Partners should not be financially better off by offering worse care.

I would phone the consultant’s secretary and get them to get the consultant to write the prescription asap.

Orangemelon

I’m just saying how it works where I am. So all the posters, so certain, saying the consultant should have prescribed it, including the GPs, are unaware that the consultant may not be able to do as this may be the local CCG agreement with secondary care for that condition etc.

You can get esomeprazole from any supermarket. It’s sold under a few different brand names or you can get generic stuff from B&M.

My GP won’t prescribe it - they only prescribe omeprazole which doesn’t work as well. It would be free for me but I choose to buy esomeprazole. They don’t even prescribe generic Gaviscon.

Oh OP, this isn’t on!

I work in a GP practice - no wonder they’ve got no routine calls for so long if they are wasting them on things like that!

The letter should be scanned across to a GP for the prescription to be done, no phone call necessary! Please contact the Practice Manager and request they do this.

I hope you get seen sooner and everyone remembers this is what happens after a decade of under funding.
In my hospital the consultants are not allowed to prescribe new medications form clinic. They have to write to the GPs and ask them to do it. This has been agreed by the CCG - the local GPs. The only exception is if it’s an urgent medication that has to be started that day eg antibiotics or painkillers in end stage cancer.

I can’t even GET an appointment to speak to a GP on the phone in 40 or 400 days. There are absolutely no bookable appointments at the practice I attend. You call on the day to be put on a list for a call at some point that day if you can get through in time before the list closes. If you get a call but miss it, tough - not great if you work full time. If you aren’t quick enough at 8am - phone back tomorrow.

If you DO get a call, you need to be available to attend the surgery following the consult if the doctor thinks it necessary; again, not helpful if you work full time as the call could be 9am or 3pm or anywhere in between. You can’t even take a day off work to get routine meds sorted as there is no guarantee you will be spoken to on the phone that day…

I now pay for a private GP. I book on line when suits and they call me at the appointed time, discuss meds, send a link for me to pay and the meds arrive the next day by courier. It costs me 14 times what it would on the NHS (private appt and meds combined) to get medication that prevents me needing emergency medical care in A&E. If I couldn’t afford it, I probably would be dead. I asked the receptionist to get my meds put on repeat prescription but the GP refused as my condition needs monitoring!! It’s utter madness.

You're Not Being Unreasonable, at all, but you'll get people telling you that their GPs have been seeing people all the way through, and can you do an e-consult. The only thing I can thing is go private, if you can afford it, and complain to your MP.

Why on earth is the consultant treating the GP like their junior doctor/secretary and not simply prescribing the medication when they saw you in clinic and letting the GP know the details for a repeat in two months time? Hospitals have pharmacies and prescription pads.

No wonder GP surgeries are overwhelmed and nobody can get an appointment. What a colossal waste of their time.