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??

No one is up in arms like this about hospital waiting times, why not? Because they are part of the government and that’s being glossed over by attacking primary care (the media, driven by government) who have chronically under funded and mismanaged health and social care money so badly, now patients can’t even access basic services. Gp’s are mismanaging their money, they can’t afford to, they have to pay their staff and rent and mortgages on their buildings. A hospital goes bankrupt, will be bailed out, a GP practice would just fold

That’s not actually the NICE guidelines
https://www.nice.org.uk/guidance/ng109/chapter/recommendations

https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/diagnosis/assessment/

they will dip but it’s not always necessary if it’s ‘non complicated’ under 65 and not pregnant

I think it's a good move for some types of gp contact. Things needed to change. It did my head in that for years I was made to go to a gp appointment every 6m just to get a repeat prescription for the pill. No they said. They couldn't possibly do it over the phone as they needed to check my blood pressure. Now simple repeats like this are much easier to organise. For people who are well and managing chronic ordinary medication it is a better system. And getting antibiotics straightaway from a phone appointment is way better if you actually have a uti - compared with dragging yourself to a surgery.

My hard of hearing gran had a physio appointment over the phone the other day. I walked in to her shouting ‘you want me to do what with the brush?’ She was meant to be stretching her arms with the stick of a brush but she has got one of the little ones from the dustpan and brush it was chaos. She’s ended up having to pay private (which she can’t really afford).

In our surgery, if you have uti symptoms you drop a sample off at reception with a form describing your symptoms. The nurse or GP then tests it, if positive then a prescription is sent to the chemist.

I had to do this last week, got a 5 day course of Macrobid 100mg which works really well for me.

When our DS14 is ill our practice will always see them the same day. For adults it's triage then face to face if needed.

I feel very sorry for the pressure GPs are under.

Our surgery doesn't do phone consultation/triage. If you're not one of the first on the phone you do not get an appointment.
I've been asked, by letter, to make an appointment regarding my blood pressure (had machine at home for 3 days). I repeatedly called but was always too late , caller 17 etc. I had my mam at the same surgery for an appointment and spoke to the receptionist ,explained the doc wanted to see me but I couldn't get an appointment 'you have to phone on morning ' (for 2 days later). I said I have been . 'Well I can't give you an appointment you need to keep trying and if you have trouble pop down and let us know!'. I pointed out that I was having trouble and I was there now letting them know. 'you need to try in the morning'. I told them if the doc wanted to see me then make me an appointment and I'll turn up (as all my nurse appointments are made). Absolute disgrace. I am so worried about what will show up in the near future due to people not being seen.

My doctor's surgery is doing anything to avoid seeing patients face to face, instead you have to sit beside the phone waiting for a telephone appointment where they can ring anything between 8.30am - 6.00pm, they can't even say can you call between 3.00pm - 4.00pm. I had to ring 111 earlier this year because I was in agony with a pain in my jaw, got sent to OOH, the doctor there left me stood in the freezing cold outside until he finally let me in & then refused to come within 2 metres of me & diagnosed toothache. He also wanted to send me to A & E because my blood oxygen levels were 1 below what they should have been, I rang A & E & got told waiting times were 12 hours+, I didn't bother, turned out I had TMJ after going to the dentist & getting referred for a scan. The NHS is broken, my surgery has 9 part time GP's, 7 of them male despite having a patient demographic of 55% female patients, you can wait 3 months to see or speak to a female GP.

My 3 yo was prescribed antibiotics over the phone which looked like an ear infection. I had to search on Google to find the symptoms and watch YouTube videos as he was crying in pain so much but telling me his mouth and chin hurts and not telling me his ears hurt and he doesn't have the comprehension yet to describe exactly what's wrong or make any connection. Anyway, he was given antibiotics and only now his back to his old self again but it did worry me that my gp simply didn't see him in person to confirm whether it was definitely an ear infection and even take it further to push for a referral for ent or hearing test as there is also language delay.

Don’t wait to be asked. Buy a sample tube from the pharmacy, take a sample and drop it, labelled, into the surgery. IME, they will routinely dip anything that comes over the counter, and send it to the pan and contact you if it dips positive.

If you're symptoms don't resolve then I'd expect a GP to see you face to face.

Well yes but they should have seen her face to face to start with.
But this is a nonsense - the symptoms aren't necessarily a UTI or anything, and could be very serious. Plus what about the fact that we're not meant to prescribed antibiotics unless they are actually indicated?!

I agree OP, it's a complete nonsense for anything other than a discussion about existing conditions or test results or prescriptions, where the patient is happy to discuss over the phone, for a very few very simple problems or known repeat problems where the symptoms are exactly the same, where it is completely obvious what the problem is and the patient is happy to discuss over the phone, and that's about it.

And a lot of GPs and other healthcare professionals, including senior ones, agree with you. My GP told me earlier in the pandemic that phone clinics take her longer, due to not being able to see the patient being such an impediment to communication and working out what is wrong. She's a very thorough and good GP though.

I was diagnosed over the phone recently . After 4 days of antibiotics I was blue lighted into hospital with sepsis!!! At the same time I had a rash which the gp over the phone decided was scabbies 🤮 …. Hospital just laughed at that . I was in there for weeks and I do feel if I had seen the gp I would not have become so very ill

I recommend following this up ASAP and don't take no for an answer:

ent or hearing test as there is also language delay

There could be ear/hearing problems which haven't caused pain or infection yet, other than this time, or that are completely separate to whatever infection it seemed to be this time. The language delay should be under review anyway.

My hard of hearing gran had a physio appointment over the phone the other day.

She has a legal right to Reasonable Adjustments (Equality Act 2010) and also look up the NHS Accessible Information Standard which has been in force since 2016.

She should be getting ALL appointments face-to-face, extra time allowed for appointments, information in whatever format she finds most useful, and professional communication support and/or advocacy if she wants it (don't be fobbed off that it's not covered if she doesn't use BSL, there is a separate code for non-BSL support and it very much is available, at least in theory). She should also be allowed someone with her (eg you) at any/all times she needs it, especially if a professional is not attending but even if they are, notwithstanding any 'rules' leftover from the pandemic, because 'carers' who are needed for communication or other support are allowed and should be welcomed (and many Trusts have policies around this), including outside 'normal visiting hours' if she's an inpatient. The AIS also covers how she contacts the GP, hospital etc. and how they contact her. For example, being able to email or write or drop in about appointments etc., rather than being "required" to phone.

There are advocacy organisations (specifically for D/deaf people, many of which cover those who become HoH later in life too, or general advocacy such as via CAB) who can help you to help her. Stand your ground, keep quoting the relevant laws and processes, use PALS to help you make complaints where needed, and tell them rather than ask them for what is needed as though they are doing you a favour, they're not, it's the law. (Unfortunately in the NHS you seem to have to be very forthright and stand your ground on many of these issues.) If she would like to, she can make you and/or another family member a point of contact who is allowed to discuss all or specified things with GP, hospital etc. on her behalf, but it is very important that she only does this for things she wants to, because she has a right to privacy and can use professionaly help rather than family help.

PM me if you want to discuss further.

@EarPlugAfficionado , except I have never had to wait longer than three days for an-in person appointment and have always been seen the same day for anything more serious. Obviously I have health insurance.

I’m floored by the paltry provision in the UK when it comes to seeing a GP, in person, in a timely manner. It wasn’t like that at all when I grew up in the NW, and it wasn’t like that when I lived in a busy part of London twenty years ago.

I meant "at UTI or anything that needs antibiotics" earlier.

Same with surgeries around here. Hasn't gone back to precovid face to face appointments. It puts a lot of responsibility on the patients to verbalise their problems accurately and other things may be missed.

One DS has been having treatment for acne for several months from his gp that has not been in the same room as him. Off our own backs we sent photos in of original problem and updates - was not asked for. And when my (stupid) 82 yo DF fell off a ladder a few weeks ago and probably broke a few ribs (at least), we desperately wanted someone to just SEE him to reduce his and our anxiety and accurately diagnose him. He was a bit all over the place (probably shock?) and in agony. Everything was done over the phone including prescribing some very strong painkillers. We had several days of extreme anxiety that we and he could have done without. I'm sure the people at the end of the phone are doing an excellent job, but feel this situation generally is not good enough.

@MrsEthelMorningtonCrescent

👏👏

The answer is we can't diagnose safely over the phone which is why I am seeing all my patients face to face now.

I am shocked by this thread.

I don't live in UK (anymore) and luckily go to the GP twice a year at the most.

However, we still have the old-fashioned walk in surgery every weekday morning.
8 - 8.30, register with the receptionist and take a seat. It could take till about 10 a.m. but you will be seen.

I needed specialist treatment this time and got an appointment within 3 weeks.

I feel for all of you going through what you have written about.

Best practice? Are you joking? Best practice is to test the urine first, then examination of the abdomen by palpation. COVID was the best thing that ever happened to them.

Yes @Iflyaway was OK (around here) before covid, but not now.

My parents are in their 80's and seeing a gp is nigh on impossible

I took DS out of school for a specialist hospital appointment several miles away (not available at the 2 closest hospitals) only to be told when we got there that it had been cancelled but we hadn't been informed and no-one was available to see him that day. They were apologetic and gave me a number to call. The number is supposed to be open 8-5 (I think) but couldn't get through at 11 - just a message saying lines closed ring tomorrow. Rang next morning and was waiting for 45 minutes to get through. It is frustrating.

Every surgery and hospital has signs up saying violent or abusive behaviour will not be tolerated (which I heartily agree with), but if you constantly frustrate people don't be completely surprised that some of them may kick off - not an excuse but an expectation

Yes, they would - you pee and they put a strip in which confirms or otherwise the existence of an UTI

The reason the demand on GP services is quite simple... during Covid a lot of elective procedures, surgeries and cancer screening/treatments were delayed and cancelled.
These patients were still ill.. where did they go to? Yes, their GP. Where are they likely still going to now for symptom management and other referrals? Yes, their GP.
I am a doctor in ED and it is the same there. We are all suffering the hangover of a mass of untreated and uninvestigated/unscreened patients now presenting sicker than ever.
I can tell you that the GPs aren't sitting drinking tea all day..

As someone who works full time I find phone triage quite useful as I don't have to physically go somewhere to have an appointment. However, it depends on what the issue is of course. Medication review? Phone. Rash? F2f. I've been seen by a gp if my symptoms are 'physical' for lack of a better word. Absolutely needed.