To think that is a miracle that gp's can suddenly diagnose and treat patients over the phone?

[thewinchesters]

For the past 5 days I've had abdominal pain, bloating, and a couple of other symptoms. I spoke to my gp over the phone who diagnosed me with a uti and sent antibiotics to the pharmacy.

They're not making any difference so far (day 3) and the pain and bloating is getting worse.

For the sake of a simple urine test, or even just a quick appointment where the gp checks my actual body, I don't understand how we're at the point of now just guessing and hoping for the best!

Why haven't they resumed normal service??

GP offers pain relief/physio, none of it helps.

This does not happen, because the patient cannot access a GP. If they are able to wait an hour on the phone at 8am (and don't get cut off) they may be offered a call from the practice nurse between 3pm and 4pm. The call may in fact come at 11am or 5pm or not at all. If the patient can't get to it in time they will receive a message saying "Sorry I was unable to reach you. If you still want to talk to someone, call tomorrow at 8am." And repeat.

I genuinely don't think people understand how bad the situation is. Patients are not complaining about nothing. If it were possible to talk to a GP or be referred for Physio (ha!) the complaints would go away.

I think the gaslighting of patients on here by some hcp’s is astonishing and really concerning.

The amount of times people who have had awful experiences with gp services whether it’s accessing them in the first lace, and poor or plain wrong diagnosis when they finally get through the surgery door is downright scary!

Also, there is absolutely no doubt that gp’s are trying to palm off patients to pharmacies and A&E.
I have heard my own pharmacy complain about this!

Yes, they do complain about it. I have said on here at least 3 times, this is a concerted effort by the government to drive GP’s out of business. The government is putting out into the media blaming of GP’s business models whilst simultaneously making the business models not viable. They cannot just stop contracting them, because they need the workforce and service. So they are driving the workforce into a corner of fewer options and despair.

They don’t want to contract independently they want to centralise services, pay them a pay rate on Agenda for Change, manage all their hours and services. but they cannot reform primary care as they don’t own it

The idea in principal is attractive for a lot of reasons, but in doing this, instead of supporting the business models for the good of the patients, they are destroying it for a long term goal. And we are all the collateral damage

I am not terrifyingly stupid...ta very much.

However, doctors on this thread telling lies, puffing up their own importance and expecting us to believe as one said-probably not the brightest spark in the box-that refugees who can't speak English is one of the reasons why they don't see as many patients- have a vested interest in calling critics stupid.

Nice bit of trying to wind up Middle England...our time is taken up by refugees.

Purleese...I know all the excuses are now scraping the barrel but wt f!

I find the attitude of how dare I compare a hairdresser to GP quite telling because of course there is no-one as important as a GP.

I believe they are leaving early and I know why. It's because they've been overpaid for years and can well afford to.

Walk into any doctor's surgery this afternoon and see how many are in the waiting room. The majority of the those who are will be there to see a nurse.

No matter how much bluster-the simple truth is this: Covid has now worn threadbare as an excuse and they are having to come up with a mixture of excuses and bleating about how hard they work when nearly everyone in the country can see that they just don't want to get back to seeing patients.

Shame.

Most primary care networks can contract physios on the ARR scheme and you can ask your practice if they do so and have appointments. I believe there is a… shortage of physios

my point was, if you need a knee replacement, your GP cannot help you apart from giving pain relief. It is absolutely shit, a broken system that is destroying the trust in doctor patient relationship. GP’s do not actually want that, why would they?

The situation is awful. From all angles. Not just primary care. There are over 6 million people waiting to see a consultant. This was 4.4 million before pandemic. In 2015 this was 3.3 million. Since 2015 the NHS has been buckling in on its self slowly. You just can see it more now

this is a concerted effort by the government to drive GP’s out of business.

Interesting point about GP surgeries being businesses. This is actually one source of the problems in my area.

The local large GP practice is owned by a group of GP partners, each of whom has an enormous number of patients registered to them. It is a long-standing practice, and the older GPs haven't been seen in the flesh for years. The younger partners used to work full time but now work very part time. Almost all appointments (mainly telephone) are carried out by registrar level locums who are perfectly good but transient and not especially well paid, and by nursing staff. In effect, the business is owned by a team which is paid to provide primary care and chooses to pay agency staff to do this instead of doing it themselves. I would love to see how the finances break down.

Its becoming increasingly difficult to access primary care, it’s worrying. I have medication that they only let me order 4 weeks worth at a time. Due to taking this I need my bloods checking every 12 weeks. Tried to get blood appointment last month. Firstly couldn’t get through on phone so went direct to the surgery after work. The receptionist said we are no longer doing bloods at the surgery due to lack of staff. No appointment at the walk in centre that week. None the week after and none the week after that. It was only when I said well how am I supposed to order my medication if I can’t get the blood test done (the GP frequently rejects the request if too close to the bloods needing doing) she pulled some strings and managed to find me an appointment. I was in the surgery 45 minutes between queuing and sorting one simple blood test.

No matter how much bluster-the simple truth is this: Covid has now worn threadbare as an excuse and they are having to come up with a mixture of excuses and bleating about how hard they work when nearly everyone in the country can see that they just don't want to get back to seeing patients.

Even more GP's have left the profession, retired or gone abroad, since Covid, the facts are there, in many parts of the country, there are now far patients per GP than in 2019, a backlog of treatment and an aging population.

I can only speak as i find but our GP practice does a mixture of phone, video and F2F appointments, even during the height of LD, i saw a GP twice in the first LD.

Get a phone call, describe symptoms etc, told to come in.... on other occasions, been pointed to OTC medication, which worked, it is also possible to self refer for Physio - no need to see a GP.

We had a shortage of GPs pre 2019, which is why Cameron promised 5000 additional GP's... he failed to do this, add in Brexit and its easy to see why we have so many problems in primary care.

Your dislike of GP's will only see more leave.

Okay but which of the scenarios do you think is the most likely:

There's a plethora of GPs in every practice and they just can't be arsed. They phone a few people to fob them off but otherwise sit twiddling their thumbs for the rest of their working day.

The government has slowly but surely been making things more unmanageable for them which has led to many leaving and a lot of vacancies. This means each surgery is stretched to the max and cannot deliver the care the doctors want and are instead constantly fighting fires and trying to speak with as many people as possible. In this scenario yes some doctors are crap as after all they are only human, but many are working their hardest.

Well in your scenario they wouldn't even be breaking even- so I suspect their finances wouldn't look too good broken down.

All of the GPS at our practice work part time, yet we hear of GPS retiring early because they have maxed out paying into their pension plan. I’m really struggling to understand it.

Struggling to understand what? That it's a job and not a vocation people do out of the kindness of their hearts? If you could afford to work part time or retire would you? If they weren't GPs they could earn more elsewhere so I reckon saying if that's the case pay them less so they'll work more hours and for longer isn't going to be a huge success.

Their model sounds terrible if it’s a profit sharing business. Most GP’s are now women, who often have children. Are those women completely excluded from working part time as they are a GP? People work part time for all kinds of reasons. Usually this is why a GP surgery would have multiple doctors, like a job share. In a good model like Tescos, this means more staff working lots of different hours. If Tesco can’t recruit staff, the other staff have to work harder but you can’t make a salaried Gp or a registrar work more than their contracted hour

I am not sure why GP’s are excluded when in all other walks of life part time work is acceptable if it suits you and your family

not all Gp’s are partners. Many are employees

It all depends on the gp I think. Since lockdown our gp clinic has improved IMO because of better triage, either online or through the receptionist. Less people physically seeing the dr when a trip to the pharmacy is all that's needed.
I've filled out an econsult form a few times for different things and have been very pleased with the service. Once I didn't need to see gp and they gave me a prescription. The other times involved in person appointments and referrals to relevant departments. This is actually a lot better that the lottery of trying to get through on the phone for an appointment. With econsult they call you back the same or next day.
As I say, it's a lot to do with the individual gp. The one I'm seeing just now is fantastic. Very thorough, very clear and doesn't feel like he's rushing me out the room. Last appointment was 20-25mins long!

In a good model like Tescos, this means more staff working lots of different hours. If Tesco can’t recruit staff, the other staff have to work harder but you can’t make a salaried Gp or a registrar work more than their contracted hour

Have you had any experience of working part time for Tescos on a zero hours contract; and Right Hours Right Place?

Telephone triage is the most effective way to deal with the volumes required, and it's up to you as a patient to be clear about your symptoms and take some responsibility for your own health.

Well, no it's not actually. While it is a good idea to try to be organised, clear, and take an interest in one's own healthcare as much as one is personally able to (and I certainly do), people have different levels of what they can realistically achieve with regard to this, and it can vary in one patient due to other factors. The whole system, and the health of the nation, is a mess partly because the early-pandemic measures instigated for GPs have been allowed to go on far too long.

Access to decent healthcare should NOT be dependent on how expert the patient (or their parent, carer, partner etc.) is in describing their problem in a short phone call perhaps with someone who doesn't know them at all, and hasn't necessarily read anything you've told them when booking the appointment or even your most recent notes test results or hospital results, about either complex or subtle symptoms. Which means the appointment gets off immediately to a stressful start and becomes pressurised and difficult. A duty doctor rings a relative of mine quite often and asks "what do you want to talk to me about" when the appointment was instigated at the GP Practice end, not theirs, and the GP Practice is meant to be responsible to overall co-ordination of their quite complex care. Most GPs are very hardworking (some are not) but they also need to Get Organised!

It seems to me that you need to be quite well, highly educated, very organised, forthright with the hide of a rhino, sometimes versed in the law, (and with a bit of luck), to access consistently good healthcare in the NHS, more often than not. No wonder we have quite appalling health inequality in this country!

i honestly think people will die from this sort of ill management.

I am sure they have already and I am sure they will continue to do so.

it's a lot to do with the individual gp

Very true.

And government, NHS management, and GPs as a body of professionals need to do their utmost to end the unacceptable level of inequality in timely appropriate access to GOOD GP-led services. Guidelines issued by government and professional bodies need teeth, ie, you do this to the absolute best of your ability and resources, not you do this if you feel like it and shrug if the patients aren't front and centre of your policies, and if you don't, well nothing will happen.

(people who get free prescriptions don’t want to pay for meds)

And this is wrong how?

And government, NHS management, and GPs as a body of professionals need to do their utmost to end the unacceptable level of inequality in timely appropriate access to GOOD GP-led services. Guidelines issued by government and professional bodies need teeth, ie, you do this to the absolute best of your ability and resources

How would you this without ensuring GPs left? how would this get GPs to work in less well off areas of the country and most importantly, get more GPs into practice?

700 EU GPs left the UK up to March 2021, after the referendum 4 in 10 said they would leave.

What’s happening with access to healthcare is frightening for most of us. That
doesn’t mean it’s GPs’ fault. Healthcare staff on this thread, I hope you know that there are many of us who appreciate what you do, while finding the current system frustrating/terrifying .

Our practice is overall pretty good.... But the demographic of older female population and also lots of GPs working part time and I've largely given up trying to see a female GP.

Another example. The montelukast that I managed to get for my dc on Monday is (as predicted) working a treat. The nurse said it was a one off prescription (confirmed by the pharmacy when I collected it) so as it’s working so well I rang the GP surgery this morning to ask if it could be one of dc’s repeat medications.

I could not be told this over the phone. I had to contact them via their website which I’ve done. Now I’ve had a text saying that it is a repeat medication and to contact the pharmacy. So I’ve contacted them (through WhatsApp as that’s their preferred method for non urgent enquiries) and await an answer.

I fully expect to be told that it’s not on dc’s list of repeat medication since that’s what I’ve already been told twice and will have to contact the GP surgery again to go through the whole rigmarole. However I can’t reply to the text that the surgery sent me so that will have to be on the phone. Monday morning will probably be emergencies only again……. It’s exhausting and time consuming for everyone involved.

Go to the chemist first.

I had to look at the NPA website on another matter, and came across this article

www.inpharmacy.co.uk/2022/02/07/npa-argues-funding-uplift-locum-rates-go-through-roof?utm_source=bibblio

Apparently, Ernst Young did a study of independent community pharmacies and found they will be in a deficit of £497 million by 2024, and this will be unsustainable. Pharmacies are not the answer to a shortage of GPs, unless the NHS is willing to pay them more to give that advice!