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?

The BMA is a doctors union and has no power over medical school places or foundation posts. That would be the government. Please direct your anger in the right direction.

@Qazwsxefv

The standard secondary care contract requires the history issue the first months meds if the meds should be started within a month.

Having worked in hospital medicine the reasons why prescriptions aren’t being issued in outpatient clinic are usually:

1. Encouraged to do hospital pharmacy scrips - cheaper for hospital, hated by patients because they have to come to hospital to gets meds if it was phone and/or wait for hours at hospital pharmacy
2. No system for electronic issue of fp10s in hospital so patients have to come and get the fp10 which they don’t like if it was a phone consult
3. No fp10 pads anywhere as there all locked up as there more expensive
4. Complete non understanding that the letter they are dictating will take 10 days to type and 10 days to check and then sent to GP where it will join the several hundreds being revived that day and might get read a week later….
5. Hospital dr dosent think it’s urgent patient gets meds that month but patient does

So in conclusion

1. Hospital is trying to save money by doing hospital scrips
2. Hospital has not developed/paid for a computer system to do electronic prescriptions
3. Patients loose out

And the GP who has paid for a clever computer system and does issue expensive fp10 and isn’t being paid for this initial prescription gets blamed for this show

I wish consultants could issue prescriptions. At the trust I work at they are not allowed to, unless urgent, even from hospital pharmacy. So things like antibiotics and medication in palliative care. There are some drugs that are hospital prescription only like TB medications. For a new routine drug a letter is sent to the GP, there is a piece of paper as well patients can drop into surgery as letters can take a week. This is the CCGs arrangement with the trust, I’m sure my consultants would rather give out scripts. It would save me a lot of phone calls!

@Crawfishspots

For a new routine drug a letter is sent to the GP, there is a piece of paper as well patients can drop into surgery as letters can take a week.

Not all consultants do that. My OH's oncologist literally never writes to the gp nor gives any kind of letter. OH is just told to contact the GP and ask for x,y or z. Then there's the delay as the GP either has to contact the consultant for test results etc or does the same tests again to get their own results.

Different trusts must have different procedures.

I tend to find 111 gets things done much quicker. They can do scripts etc.

That's just beyond rubbish. At my surgery you get a call back that day, or the next if you call late in the day and its not an emergency. If you need to be seen face to face you get an appointment within a couple of days. When my daughter was poorly she was in the surgery with a Dr in 2 hours! We have econsult too.

It's a busy, oversubscribed practice and also covers a deprived area.

After refusing to wait until 10 May a GP called today and talked over the meds with me and issued the script.

46 Days 😳 Wow that is quick compared to here 😳😳

I've lived in Africa and it was better there. Honestly.

The NHS is broken and rather useless.

[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]
The systemic problem is that there aren't enough GPs. GP numbers are falling. Patients numbers are growing. The number of patients per GP has increased by 33% in under a decade. On top of that, falls in hospital activity have increased workload massively (27%) over the last 2 years, as more and more is left to GPs. And we have run a hugely successful vaccine campaign. And most of us have at least 20% of staff off at any one time at the moment, due to Covid.

GPs are handing back contracts and bailing out to become locums all over the country because the job is just undoable . The GPs who stay have to take on more and more work, and still get it in the neck from know-alls like you, who think they are lazy wasters. If the job's so fucking easy, why are GPs resigning in droves?

At my own practice, each WTE GP has over 3000 patients. Each patient consults their GP 5.5 times per year on average (plus 3 consultations with the practice nurse), so that's 367 appointments per GP per week (allowing for annual leave and bank holidays). And patient consultations are only about half of what we do - there's home visits, prescriptions, blood results, referrals, safeguarding reports, PCN meetings, MDTs and fuck knows what else on top. As well as 367 appointments. Tell me again how we're fucking lazy. And, no, we can't recruit more GPs because no one wants to become a GP. And a big part of the reason is twats like you, who blame GPs for the fact that there aren't enough of us.

You don't become a GP to give patients poor service. GPs hate the way we are having to work. But our only way out is to resign. Thanks to people like you, that's what more and more of us are choosing.

@Cocomelonsundae, 'The NHS is broken and rather useless.'
This with bells on. The way patients are treated nowadays is shocking and shouldn't happen.

@MrsKebble

The GP has been told which meds to issue by the consultant.

Then you don't need an appointment. GP should go this s we hen they read the letter

@orangemelon

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.

It is such a shockingly bad state of affairs - I don’t know how we have anyone prepared to be a GP, and patients are frustrated and worried - No one’s wins like this, The pressure over the whole NHS is shocking and GP’s are at the coal face as the gateway to other services which can’t meet demand … I despair and wonder how this will all implode ….

@Crawfishspots that’s a very odd CCG set up. Hopefully it will go away when the CCGs go soon.

You say unless urgent though. No urgent is about a month (2 weeks is urgent) So under that set up the OP should have been issued a prescription by the consultant if she needs the meds in less than two weeks.
I do wonder if it’s in part that the consultants are “discouraged” from issuing prescriptions by system issues rather than “not being allowed” the trust can very easily purchase fp10 forms from HM stationary office just like GPs can, any prescriber can. the key word here is “purchase”. If a hospital dosent issue an FP10 because they don’t want to pay the fee to get an fp10 and pass it on to the GP then they are just passing on the cost. It’s money saving for the hospital and the GPnis getting the blame

Also 700 medical students without jobs.

We need more doctors the country said. The government said we we train more doctors. The BMA said don’t train more doctors than you have first year doctor jobs please. The BMA have been vilified for limiting doctor training numbers - you see that trotted out all the time on threads like this.

So the government increased medical school places and boasted about increasing doctor numbers BUT didn’t increase first year newly qualified (pre reg) doctor numbers….so this year we have 800 newly qualified doctors who can’t complete a pre reg year and so can’t become gmc registered doctors…what a bloody waste of money time and effort.

And we’re still short of doctors

In case that dosent make sense come august we will still have doctor shortages all over but have 700-800 newly qualified doctors unemployed

(Newly qualified/pre reg doctors need to work in a supervised practice setting for their first year (Foundation year one) to gain full gmc registration and become fully registered doctors) and the number of these posts has not been increased to match the increase in student numbers.

So the government gets to claim it increased the amount of doctors without actually increasing the number of actual doctors

Just because a consultant requests meds, doesn't mean a GP has to prescribe them. Therfore they can't just prescribe them. I got refused medications from my GP which were requested by a consultant. That said a 46 day wait is insane.

And no they dint have to prescribe them. I made a formal complaint and fought this outcome for months. Its down to the surgery not the consultant at the end of the day.

The person who prescribes the medication (as signs the prescription electronically or in ink) is the person responsible in law. There is no “I was following instructions” defence. So if a GP (or a junior doctors) doesn’t feel competent to prescribe the medication on a consultants instructions the correct legal and ethical position is not to prescribe it.

Not saying i agree with the above but that’s the legal position