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??

We have already answered that. The demand has risen to now be higher than a practice can cope with. COVID is a red herring in some ways. Gp’s were instructed to change to telephone triage in the pandemic to try to protect healthcare services from an internal outbreak. Staff are now getting sick with COVID at a rapid rate.

The reason many surgeries have stayed there with telephone appts is because of the knock on effect from underfunded secondary, community and social care and realising they can see more patients per day this way. The government is pressuring them constantly to do more and more. The system is at breaking point

They can recruit from Europe it just takes longer and the paperwork is awful

The government needs to offer incentives to nursing and medical students. They need to accept more overseas medics. They need to pay more. We need more GPS.

They ARE doing face to face. The calls are on top of their normal F2F appointments.

There was a GP on Sky just now, he said we now face a choice "Spend more and fund healthcare properly OR go down the USA route"

He suggested this is a choice, not just for MPs but voters too.... meanwhile, Tax cuts seem to be MPs priority.

I believe it was the Govt who suggested GPs are lazy and told them to "get back to work"

Many did so and now work in Canada, Australia and NZ.

Discussion elsewhere suggested booking an appointment with a private GP.
That private GP is also a part time NHS GP.

That's their decision to privatise themselves but to be part time NHS would increase their private work.

If we have to ration GP and NHS care then we need to have a serious discussion about it.
But we need honest stats on how many GP are part tiowith sidelines

My GP website advertises the vitamins one of the doctors markets.

Sorry, what do you mean? I am a doctor in my local hospital. What's your point?

The people posting the system is broken and dangerous are not wrong. GP’s will agree with you. It’s now a no win situation.

The blame is being placed on primary care as they are independent contractors and the Tory Gov has set the focus on them as a deflection from their decision to cut funding and numbers of new doctors in training, and the media have been spreading misinformation about GP’s salaries and laziness. It is not true. People from inside are telling this story, why would we lie? It isn’t the easy career, easy money lifestyle it is a career that almost all GP’s burn out from eventually, it takes a huge toll on their mental health and family life. Many end up working way past retirement out of guilt for their colleagues and genuine desire to help people.

I’ve also used the analogy it’s like 10,000 people trying to leave a gig through 1 fire exit

I know a lot of GP’s and I don’t know a single one who works privately as a GP apart from one who does cosmetic injections in their own time. Most GP’s who want extra work, work for 111, out of hours type services. Working as a private Gp is another set of issues you need to have staff, premises etc

I don’t understand WHY there are not enough GPS or locums! Is it because fewer GPS are being trained? Pay? What is the reason?

I actually feel sorry for the GPs at my surgery. When I first registered 7 years ago there were 6 GPs working a mix of part and full time. A full time nurse practitioner and practice nurse. Now there is less than half of that and a new 700+ house estate has been built nearby with no additional medical provision obviously.

What does really annoy me though is the 8am scramble to get a same day call back when there is no phone queuing system, no e-consult and no advance booking at all. After about 8.10 the phone is unanswered until the following day. If by some miracle you do get through then you can be called anytime between 9.00 and 6.00 which is a nuisance because you can’t plan your day.

One thing I have noticed is that GPS don’t read notes or patient history at all anymore. Which is concerning. Also they don’t seem to diagnose, just refer.

Yes, ok so they got old and retired

since 2015 there has been no growth in GP numbers, yet the population has risen

we have the least doctors per patient in Europe apart from Poland

the worst of the vacancies are nursing, so GP’s and other HCP’s are having to fill the gaps

You need doctor trainers for training doctors, and there aren’t enough doctors. It’s hard to get into medical school, it costs thousands and takes 10+ years to be fully qualified. My friend is a doctor (not GP) and it’s taken her 5 years to pass her final exam and cost her an eye watering amount of money trying. She was on her last chance when she finally passed, as it’s so hard

It’s always been a tough training and takes a long time. So something has changed. Less applicants because the job is so stressful? Poor pay? Or funding isn’t available. The govt needs to look at the reasons in detail.

Mine too. I’m in Wales, don’t know if that is relevant.

Yes it’s stressful, its expensive and it’s not an attractive career like it used to be.

30 years ago you could build up your own profitable business ready for retirement, now you are £100,000 in debt of student loans, burnt out, get abuse all day and miss your kids. I don’t know why people would want to do it

I've been GP bothering for 3 weeks now with weird symptoms. I didn't even get the phone call I was promised. I carried on going into work.
Then at the weekend I collapsed unconscious and was taken into a and e with a blood pressure of 220/150. Luckily I got urgent treatment before I had a stroke but it was a close one.
Now I'm off work for 4 weeks.

Let's look at an example of a universally underfunded service... CAMHS... for those who don't know this is child and adolescent mental health services.
Now think of the number of children and young adults who are more anxious and troubled than ever following the lockdowns etc. Now think of the GPs, who by the way are not the correct service, nor are they adequately trained to deal with this. That is only one example of how GPs are trying to look after people while they await to access appropriate services etc. They are dealing with so much more than people can even think.

Yes I think that GPs are being expected to deal with health issues that are beyond their expertise (ditto gynae, the menopause, women's health issues in general. And I would guess that mental health issue appointments last longer than the average appointment. A relative is a nursing practitioner and they are going back to working in a hospital (non patient facing role) because they are sick of the abuse and threats of being sued by patients at the GP surgery.

A lot of the public these days behave like arseholes and think because 'they've paid in' (they are unlikely to have paid enough over their lifetime to cover what they've cost the NHS) they can treat HCPS how they like. Plus they take no responsibility for their own health and expect the NHS (taxpayers) to pick up the pieces. I think the UK's entire GDP could be poured into the NHS and it still wouldn't be enough.

I'm amazed (but glad) that so many young people still want to be doctors, I wouldn't do it for 10 x the money.

Key differences in Switzerland, where they seem to have a top class health service, is: a) people pay more money - they accept that a high class service doesn't come cheap, b) they have a very high number of nurses from other countries - under free movement between Switzerland and the EU. We used to have nurses from the EU (and doctors too) and threw that away with Brexit.

• The US system is a disaster and costs vastly more than a decently funded NHS would cost. Imagine knowing that one bad illness or accident could ruin you and your family, even if you are (very expensively) insured.

It’s always been a tough training and takes a long time. So something has changed. Less applicants because the job is so stressful? Poor pay? Or funding isn’t available. The govt needs to look at the reasons in detail

This situation didn't suddenly happen by accident, its by design.
Austerity assured the NHS was given just a 1% increase per year in real terms extra funding, AHP's were then charged 50k to train, cuts in primary care funding, Boris knew what ending FOM meant but still supported it.

Expecting the Govt (and the electorate) that caused this to fix the reasons is not going to happen.

I live in another country, but we have a very similar set of problems. They are trying to fill the doctor shortage problem by hooking people up with these online doctors to tide them over, but it's not really working. It doesn't increase capacity much at all and the care is just much more limited. And there is a lot of infrastructure that goes into this, things like tech support for the people having the appointments which is stupid in it's own way.

What really chaps my hide though is that when we were under the new covid regime, I know there were doctors in our system who were quietly trying to warn that this would happen, that there would be thee huge backlogs, problems wth more advanced cancers, mental health issues, and they would all come to roost eventually. And some of these doctors were fairly high up.

Every one of them was sidelined, some removed from their positions in the health authority, because they thought that in the end the bad effects of almost shutting down the health system for anything not covid were going to be catastrophic in their own right.

The voices which might have moderated some of the decisions were shut down both by the health authorities and political authorities, all with the media making it easy for them by not asking questions or keeping an eye on what was happening. And I think something very similar was going on in the UK, and also in the US.

So many governments seem to think this is the solution, recruit doctors or nurses from other places. It's stupid, it does nothing to deal with the underlying problem. Which is nothing new. There is no inherent reason Europe should be able to produce enough doctors for themselves and the UK, while the UK can't produce enought even for themselves.

The public needs to be really clear about the kind of pressure they need to put on. Not bemoaning that it is now harder to recruit from elsewhere and og those evild Brexiers, but that their own production of doctors and other HCP is not adequate and needs to be stepped up.

People expect a lot more interventions than they used to. And more complex ones as well.

There are more people. They live longer and in those extra 10 years they need a lot of care, often more than the whole of the rest of their lives.

Doctors also typically work less than they used to, so can't carry as high a patient load and have the same service. This is partly due to changes in the workforce. In some areas of medicine women are now the majority, and typically they don't work as many hours over their career. And then while in the old days a lot of male doctors worked pretty crazy hours, that was with a wife at home holding down the fort. In a way that salary represented two workers, one of whom was very specialized and trained, the other of whom allowed that person to dedicate more time to work. Now that it's more common for both parents to work, that's not sustainable for many families. And also not always financially sustainable in terms of maintaining the same lifestyle now that two incomes are normative.

Don't forget it now costs more than £9k a year to go to medical school. That's £45000 plus maintenance (say £25,000) - £70,000 just to finish a medical degree.

And most can't work on the side to fund themselves due to shifts in hospitals.

When my siblings trained (grad 2016) it was £2k a year - £12000 + maintenance.

That's a massive jump and yet GPS aren't paid more than 7 years ago by much.

So what's the incentive for young people to become doctors? Nurses get paid even less.

My dh has not been able to get a GP appointment at all this year. He has needed appointments for 3 separate issues, one of which was a suspected cancerous mole. On 2 occasions he has been told no appointments available go to A&E if it is serious. Is it any wonder that A&E departments are overwhelmed when this is what people are being told. Obviously, we wouldn’t do this and he ended up going to a private GP and then funded private dermatology appointment and subsequent treatment for removal of mole.

He has been trying to get an appointment this week for what we think is a suspected hernia. He has had a hernia previously which was repaired and he has pain in the same place. He needs a face to face appointment to be examined but we can’t even get through on the phone. We have been trying since last Friday to get through on the phone. This morning he was no 38 in the telephone queue at 8AM, 40 minutes later he was cut off. Rang back but was put back in a queue and was no 70 something. Gave up and booked private face to face GP appointment for tomorrow.

I have just drafted a letter of complaint to the surgery and will be copying in our MP as it is ridiculous that after paying 10’s of thousands in tax and NI we have to resort to paying out for private appointments. We are lucky that we can afford it but what about those that can’t.

My husband has an issue at the moment. The doctor asked him to take two samples into the surgery to be sent off for analysis. He phoned after a week to find out the results. The receptionists told him it could take two weeks. He phoned back in two weeks. The receptionist told him the samples had been lost. No apology, just couldn't be bothered.