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?

Person starting treatment shd have initiated. Also if there is a letter can be prescribed off that. Initiating doctor shd also have done the conversation on side effects and mode of action...

@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.

This is such bollocks. One small practice near us has 6 staff off sick. Out of 10. It's a miracle they are keeping any services going.

This is therefore a complete non issue and the person to be blamed is the hospital consultant but as usual the GPs get the flack

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

It is to do with the funding of the prescribed medication (which in some cases may be many thousands of pounds each year). The hospital doesn't hold the budget for these.

Ireolu , Darkstar and any others saying consultant should have started the meds. Read my post, and understand that they are likely not allowed. Otherwise they just would just go ahead and do this.

It’ll be the CCG agreement with secondary care.

Stop talking nonsense, saying that the consultant is to blame, or that the consultant is treating the GP like a junior. Complete nonsense.

@DeathMetalMum

Yes it's a ridiculous wait but why didn't the consultant issue a prescription? Both are at fault here.

My OH has cancer and his oncologist constantly refers him back to his GP whenever the blood tests throw up anything such as deficiencies, and also for x-rays/scans etc. It's a right pain in the arse, especially when the GP won't prescribe without doing their own tests, so usually need repeat blood tests to "prove" the deficiency before prescription issued. The whole thing is a shambles. Latest is that he has a vitamin D deficiency, first contact with GP was just telling OH to get an over the counter vitamin. A few months later, oncologist still flagging up deficiency so OH told him he was on an OTC vitamin, oncologist said they're not strong enough and he needs a prescription for stronger dose - so message left with GP who has now replied that a blood test is needed. Why the hell can't the consultant just send a sodding email to the GP with test results and telling them to issue the prescription. Patients are piggy in the middle between consultants and GPs and it's a lot worse now the way that GP surgeries have put up so many barriers!

@MissLucyEyelesbarrow

You're defending the huge number of surgeries that make it difficult to see your Doctor at all times (pre pandemic included) on the basis that one near you surgery has high absence? A six week wait for an appointment is not due to temporary absence, but symptomatic of a systemic problem.

@TheYearOfSmallThings

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

It is to do with the funding of the prescribed medication (which in some cases may be many thousands of pounds each year). The hospital doesn't hold the budget for these.

It would be far more efficient if consultants did prescribe the relevant medications in ALL cases. This divide between secondary and primary care (especially in terms of who funds what) drives me nuts! It's a messed up system.

Why the hell can't the consultant just send a sodding email to the GP with test results and telling them to issue the prescription. Patients are piggy in the middle between consultants and GPs and it's a lot worse now the way that GP surgeries have put up so many barriers!

Weird. Where I work, the GP can access the same blood results (from same system) as the local hospital. If not on same system, an email with results should have been sufficient.

Damnusername21

Yes that would be much more efficient for the clinicians involved as well as the patients. It’s management that negotiate these practices, not the doctor you are seeing. No point in blaming them. I’m sure they would very much like to just hand over the prescription.

[quote Hereward1332]@MissLucyEyelesbarrow

You're defending the huge number of surgeries that make it difficult to see your Doctor at all times (pre pandemic included) on the basis that one near you surgery has high absence? A six week wait for an appointment is not due to temporary absence, but symptomatic of a systemic problem.[/quote]
One does wonder though if the practices where patients are struggling to get appointments are small ones though.

I attend a practice that always seems to have appointments available f2f or over phone but it is a large (to me) practice with about 11 GPs and over 20,000 patients.

@canary1

Damnusername21

Yes that would be much more efficient for the clinicians involved as well as the patients. It’s management that negotiate these practices, not the doctor you are seeing. No point in blaming them. I’m sure they would very much like to just hand over the prescription.

More than likely, Canary. It definitely is a system issue (funding, pots, management, etc).

I’ve written a letter to my MP this week about the lack of access to my GP. It would, quite frankly, be easier to get an audience with the Queen than see one at my surgery.

I saw my pain consultant on Monday who said I needed a face to face appointment with my GP for a couple of reasons. My cardiologist, also, wrote o in January saying I needed medication but this is yet to be actioned. I phoned from the car to be told by the receptionist that I’d need to be triaged by the nurse practitioner on 19th April and she’d decide if I needed to see a doctor or not. I reiterated that the pain consultant said I did, she said she didn’t care. Unfortunately the line got cut off.

On Tuesday i rang again to be told by a different receptionist that I didn’t need to be triaged but they had no appointments to give out, so to ring back on Friday and I might get one before the end of April. We’ll have probably moved house and area by then.

The whole system is an utter joke. Our practice has built an extra portacabin in the carpark and taken on two more GPs, yet we can’t get an appointment. They don’t do e consult either.

I had investigations for a heart problem. Tests have confirmed I do have a heart problem. GP has confirmed test results and told me to discuss with my cardiologist. Cardiologist has cancelled my TELEPHONE appointment 6 times. I'm still waiting to discuss medication. My first appointment was meant to he in February it's now in August. I have t toddlers to mind and have constant symptoms. It's a joke.

I did an econsult on 17th March. The online appointment booking system has been closed. Barking cough, burning chest, loss of Appetite. I have Asthma and I have in the past had Bronchitis. Within 15 minutes I received a text asking me to call the surgery. Whereupon I was offered a telephone appointment with the Doctor on the 28th of March. I thought I'd misheard so asked the receptionist to repeat it. Definitely the 28th, I was speechless. The next day I had bloods done so asked the nurse when things would be getting back to normal and she said they already were back!! Rubbish - you can't even book your own appointment any more.

I did e consult with a new and potentially serious cardiac issue. It clearly stated that I would be contacted within 48 hours.
Four days later, having heard nothing, I went into the surgery and had the conversation face to face with a hugely unconcerned receptionist, and offered a phone appointment in three weeks time. Everything is just such a fight at a time when you're anxious and don't need the extra hassle.

This must be incredibly stressful when you and your husband are going through cancer treatment. However if the oncologist wants to do a test for vitamin D deficiency (or anything else) they should also be willing to treat the outcome of that test (NHS contract is that secondary care provide the first month of prescription, then any repeat prescribing is done by GP). Thus allowing time for the consultant letter advising repeat prescription to reach the GP and be actioned whilst the patient has some tablets to get going with, and avoid the patient having to face the 8am calls and taking up a precious GP appointment (where the GP could be diagnosing someone else’s cancer, not doing a vitamin D prescription). The system sucks, but the consultant is at fault here.

@canary1

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.

Fair enough although I think that's unusual.

www.england.nhs.uk/wp-content/uploads/2018/03/responsibility-prescribing-between-primary-secondary-care-v2.pdf

Section 4.2 does clearly state hospital settings including outpatient clinics should be giving initial supply of medication.

@MrsKebble- this problem would not have arisen if the Consultant had prescribed you some medication. As has been already said, you shouldn't need a GP appointment to deal with this if the letter has been received and scanned into your notes.

Similar here!
My massive concern is when we have a huge influx of refugees how they are going to access healthcare too worrying times ahead

@canary1 many medications are initiated and prescribed in secondary care. Several cannot actually be prescribed by GPs so yes there are limitations but not across the board. If there is no letter/prescription GPs cannot issue the meds. The letters can take weeks to get to them. If a patient brings the outpatient prescription in, most people will get what they need within the usual 48 hrs. As long as dosing and handwriting is clear on it. The preference will ultimately be a letter because as usual people will want to blame someone if something is prescribed wrongly. The counselling about how to take or what the side effects are will not happen quickly though as there r no appts hence the 46 day wait. Clearly in cases of life limiting conditions discussions can and shd be prioritized as urgent .

The demand is crazy at the moment and it is across the board. Waiting for GPs to call pts to discuss medication not initiated by them is an inefficient use of clinician time in my opinion ie a repetition of what the patient shd have been told by their consultant but we can agree to disagree.

@Volhhg

YANBU. And it's like this all over the UK. No idea why there's no rioting on the street

It's definitely not like this everywhere. I'm in Scotland - at my GP I can usually get a phone appointment for the same day if I phone early enough or the next day if not.

Everyone I know (that all live in different areas) complain about the wait but that wait is usually 1-2 weeks not 1-1.5 months

@Kinkybutkind

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.

I think we must have the same surgery 😰

I used to wait this long for appointments pre covid, however i don’t understand why you actually need an appointment?
He consultants told your gp the meds, all they need to do is give them too you!

Ireolu
I’m not disagreeing at all, of course it’s a ridiculous waste of clinician time. It’s that in some places this is what the CCG have commissioned from secondary care, so the consultants don’t have the choice.

The consultant in this case would likely have been perfectly delighted to issue a prescription- why on earth wouldn’t they? It will be the CCG agreement that is preventing them .

@girlmom21

It seems strange that the consultant didn't prescribe. Call the doctors back and tell them it's an urgent appointment.

You'd think they would, but it's happened to me - the consultant's the expert and knows what you need, and supplies a letter so the GP (who isn't an expert in that field) knows what's required and writes the prescription. It feels like NHS bureaucracy / inefficiency wasting everybody's time.