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??

There aren't enough to cover reasonable hours yet you think they should work 24/7? Logic has left the building. You can only work with what's available, sadly its impossible to magic more gps out of thin air.

@Muchtoomuchtodo

generally what would be urgent for a same day call back is;

-small children who are not themselves, have a rash, temp, not eating, drinking
-ditto for older people as above
-district nurse requests (depending on urgency, perhaps for an infection)
-end of life patients who need medications or help
-ambulance reports/A&E discharges for something that needs urgent follow up
-paramedics who are in someone’s home and need to speak to a GP
-chest pain
-breathing problems (asthma exacerbation, COPD, infection
-acute infections like UTI, cellulitis, anything that could be sepsis related
-mental health crisis
-urgent investigation results called over from radiology or pathology
-acute D&V

I’m probably missing one or two.

depending on where you live will indicate what your daily list looks like. If you live in an area with an older population your list might be dominated with these requests every single day. Depending on the set up of the practice they usually hold back a certain number of routine appointments per day but once those are gone, it’s all down to the duty doctor. We have had a lot of work on our hands stopping all the prescription requests going on this list each day, as it’s urgent to the patient but really not urgent.

@Sidge @Florenz
Gp’s have so much hidden work no one sees.
Our area provides as much as it is able to, with what space and staff they have

111 are contracted, and paid, to cover the out of hours. This is manned by… GP’s and nurses who also work in practices! But 111 can’t cope either. I worked in general practice in 2000’s and GP’s on a rota would work a Saturday morning and then be on call out over the weekend. Unpaid. Now we have 111 doing this job, and providers are paid handsomely to do so. They are also overwhelmed and often will just send people to A&E or back to their GP. 111 was meant to be a better solution. Blame the government.

Maybe we should all be using pharmacies more if the GPs are overwhelmed?
Many have consulting rooms and they can deal with a lot of minor ailments with over the counter products.

Sometimes the problem is people not managing their own needs so putting in late prescriptions, calling the Gp about hospital appointments (instead of calling the hospital or they can’t get through so call GP), not going to the pharmacy for minor ailments (people who get free prescriptions don’t want to pay for meds)

Apart from we haven't enough Pharmacist's either.

Ah... I am SO glad I am making firm plans to get the hell out of general practice.. I am giving up my 'cushy over paid job' for a minimum wage job (£9.59/ hr) that might not stress me to the edge of hell and back working 14 hour days spinning multiple plates... in this case lives ...simultaneously, hoping it doesn't all come crashing down.. but that's fine... yes the service is shit, yes people aren't getting the care they need. But constantly abusing the people trying their damndest to deliver in a broken service is only going to make it worse as they like me, walk away and they are in droves... I have done this job for 20 years... I can't do it anymore. And the abuse is a major factor. People sneer and jeer and don't want to listen. I'm not explaining any more. I'm out of it as soon as I possibly can. I used to feel guilty about leaving as I am a good compassionate dedicated doctor, but there is just too much vitriol and complete lack of understanding if what is really happing out there now. I genuinely hope those of you that hurl abuse DO get the care you need as everyone should ... but honestly I doubt it, as every snide poorly understood insult you throw is another straw that with break the camel's back.

Yanbu OP. How long will gp’s be allowed to hide away in their surgeries using covid as an excuse.
It’s really concerning!

Again, this sentence makes no sense. They are in the place they always were. Where else are they meant to be? You need to accept that things have changed in healthcare because of Covid and that’s not something that can be undone now. It has changed nationwide, for the worse. There is no going back to pre-covid and everyone who thinks they can is sadly delusional and rose tinted fantasising about a service they were already complaining about pre-covid for long waits and not being able to get through on the phone. The system is broken.

I assume this genuine?

We have an aging population, many didn't go to see their GP's during LD, though personally not sure how much this has affected Primary care now, i ve 2 GP friends and neither think this is the biggest issue but that may well not be the case everywhere.

According to them both, the biggest problems is so many are leaving/part time and Brexit, we voted to tell EU nationals you are not wanted here and in January 2021 Brexit came into force.

Hiding away in their surgeries?

That is where they work you muppet.

Oh when they’re not out staffing Covid vaccination clinics and doing home and hospice visits anyway.

Covid has changed the planet. We had to adapt and modify our working practices and we are still adapting and modifying. Of course we had to restrict access - if your GP gets Covid and is off work for 10 days or more that’s about 2500 patients with no GP. Their GP colleagues are picking up the slack. Oh hang on they’re getting Covid too. Now they’re off, as are admin staff, nurses, phlebotomists, receptionists. We had to protect those vulnerable patients who HAD to come into the surgery - for their pre-chemo bloods, their baby imms, their wound care, their urgent assessments.

Honestly some people need to engage their brain before posting. Read the informative posts on here from those working in primary care and THINK about their replies. If GP work is so cushy and they’re doing so little why are they leaving in droves, and so hard to recruit and retain? Surely they’d be lining up to sit around all day drinking tea and playing solitaire on their computers.

They have milked Covid for all they can, now that they can see this is wearing paper thing they have to think of other excuses.

Some of them have already been trotted out here:

GPS retiring (Yes, their over inflated salaries does allow them to retire early)
Refugees needing longer appointments because of translation problems!!
Not enough GPS being trained.
Any old shite they can think of!

All bollocks and all just trotted out because saying "because of Covid" is no longer acceptable.

All those-most GPS or related to GPs-saying they are working longer than ever is totally untrue. If it were true why are there so many stories of laziness filling this thread.

A&E overwhelmed because the lazy, and often incompetent ,GP tells patients to go there.

WE can't see a doctor-the waiting rooms are practically empty, so obviously they're not overworked actually seeing anyone. Repeating that they are working so hard doesn't make it true in the face of people's experience which proves the exact opposite.

These things are imagined, they're true and most of us have experience of it.

They may be in their surgeries-playing with their balls, watching Bargain Hunt, drinking tea and squeezing in a few telephone calls but they are not working.

They're a disgrace and very few are now defending them,

From a user point of view I only see a gp when I really need to, so all of my conversations end up with me describing the symptoms over the phone, to be told I need to be seen and I think that was a waste of time as I now have to go and explain it all again.
I guess the assumption is this is the case for many people, so from our end it looks quite inefficient.
For the GPS on here, are these kind of phone appointments the minority?
Im not slagging you off I’m just trying to understand how it’s more efficient.

I expect those same GPS expect
their children to be taught in a classroom,
expect to see a dentist,
expect the supermarkets to be open,
expect jails to be staffed,
expect courts to sit,
expect to get their hair cut,
expect driving tests
expect to eat out,
expect pharmacist to be open

Fill in a 100 hundred others.

Every fucker doing their job except doctors, who are happy for hospitals to do their job for them.

They're part time-pay the fuckers part time-even that will,b e above average salary!

Your symptoms don’t sound anything like a UTI to me and I’m not a doctor! I’d be calling them back to explain that the symptoms aren’t going away at all and that you really don’t think it’s a UTI. If you had obvious UTI symptoms like urinating constantly, burning sensation when urinating, even blood in urine then I’d understand but bloating and abdominal pain? Crazy. They should be checking you out in person now, it’s been going on for some time.

@AnonIsUsuallyAWoman You are exactly why GPs and other healthcare staff are leaving in their 1000s.

My DD turned up 15mins late for a home visit because her previous patient had the temerity to have another stroke.... she got a mouthful from the client and her husband.... called lazy, hiding behind Covid, sitting around drinking tea... watching TV.... remind you of what you are accusing GP's of?

Can I ask what GPs would like to happen? As gatekeepers of pretty much all healthcare apart from very basic medication which is available to buy over the counter, they are going to be overstretched so what system would work for them.

A couple of examples from personal experience. A got a tick bite whilst on holiday with relatives in the US. As it was a Lyme disease hotspot antibiotics are recommended. No need for a doctors appointment though, I walked into a drug store and got them from the pharmacist.

Forgot my HRT on a recent trip to Spain. No problem, picked up some patches from the chemist.

Both if these would have needed a GP appointment over here. Why are other countries do different?

I can answer some questions

there are more prescribing restrictions in the U.K. and this is due to laws and safety. Things are loosening up (chemical termination pills sent by post, more meds OTC). These laws and guidelines are down to the government. The US has a higher rate of prescription drug abuse, so I wouldn’t compare it to the U.K. it’s harder to get things OTC for a reason.

Barely any reasons given in this thread have anything to do with ‘hiding from covid’.

All workers age and retire at some point.

I don’t even know what to say about the translation of longer appointments for vulnerable refugees or asylum seekers. What do you want me to say?

@AnonIsUsuallyAWoman
I’m afraid that actual real life statistics show that there has not been an increase in GP’s since 2015. would you like some links?

unfortunately you have named a few things in that list that are a strange comparison. Getting your hair cut ? Compared to health? Since when was a hairdresser comparable to a GP 🤣🤣Where have you been the last 2 years. Courts didn’t sit. They have huge backlogs. There is a passport backlog. Airports aren’t coping. You can’t name a load of luxuries like ‘eating out’ many people cannot even afford to do that and no one expects that they can! Schools are over subscribed in many areas and classes are huge. Children with SEN aren’t getting the help they need. There are threats of food shortages and fuel is astronomical

@Blimeyherewegoagain
surgeries need to be assessing their triage practice. Some conditions should not be a phone call. That’s why receptionists ask you, which people also complain about, to try to put you in the best type of appointment. It is not consistent across the board that triage is always as effective, resulting in 2 appointments. I am aware of this so we try to reduce it by putting people in the right type of appointment. A lot of practices are struggling with getting the balance right. DNA’s have always crippled General practice so no one wants that either.

You are quite frankly, terrifyingly stupid...and utterly utterly wrong but hey if you shout loud enough and swear that will make you right and everyone will beleive you and not the people that genuinely know what is going on. Thankfully it won't be my problem any more as this part-time fucker who works way more than full time hours while caring for my disabled child ( how DARE I not be full time ) .. is out...

Ps...who do you think is trying to look after the patients who are sick... desperately need hospital care but are waiting 12 months for an outpatient appointment therefore high needing levels from GP's.... its not the hospitals we are are apparently dumping all our work on....

Ps...who do you think is trying to look after the patients who are sick...

I think nobody is looking after them, to be completely honest. Until they have an episode and end up in A&E.

I have been trying to think how to word this

it seems there is a new pandemic of blame. Everyone knows someone who says they couldn’t see their GP so ended up in A&E. People do die, and it isn’t possible to save every single person who gets sick. We will see in the years to come the impact of under funding in the whole NHS and it is understandable people are afraid. You should be. Your government is making terrible decisions with your health.

HCP are not gods or miracle workers. If you feel you were treated negligently and came to harm that was avoidable, please raise it to NHS England, PALS or the ombudsman. Get a solicitor. Spreading lies and misinformation about GP’s playing golf might make you feel good but all it is doing is driving more HCP out of the NHS. They are also victims of the underfunding

If you are so sick you need admission to a hospital, the GP is not the right place for you to go. They can’t see inside your body or treat something that needs surgery or invasive therapy. GP’s are not emergency care providers and they are not specialists giving diagnosis of cancer or broken bones. They are there to treat with medication or advice what they are able to - within their level of competency, signpost, refer on to specialists, order investigations and coordinate your care of long term conditions, provide babies with immunisations, monitor your medications and liaise with specialists about your care. They can prevent deterioration into a more serious illness, but there are limits. Sometimes conditions are not straight forward, they don’t resolve when you want them to. People also get sick at inconvenient times that interferes with their life.

You get 10 mins with a GP either by phone or appointment. Make it count. You also need to self manage your own healthcare where you are able to. Go to the chemist first. Use A&E if you need to but not because you have heard there is no point calling your GP. Call 111 out of hours. Join your patient participation group at your surgery and be a useful participant in making change. Think carefully about how you want to vote in 2024. Listen to those people who are screaming at you that the system is broken and can’t cope.

This is often the case. Patient presents to GP. Gets a referral to a specialist. The 18 week wait has been almost abolished. Patient waits on list for months/years. GP has a limitation of what they can offer in this interim period. GP offers pain relief/physio, none of it helps. Patient remains in pain/ill/unhappy. GP writes another referral asking for urgent appointment. Hospital can’t facilitate it
what else can they do?

@TheYearOfSmallThings

i waited 3 years to have a hysterectomy and my GP had to look after me this whole time. They couldn’t take my womb out. So they had to just give me medication that didn’t work. It was so frustrating. I did once go to A&E with a haemorrhage. They also couldn’t take my womb out so they just treated me with drugs. I had to wait. I was sick for 3 years with anaemia. I eventually got my surgery and I am now better. It was awful, and I suffered but I don’t know who I would blame. My womb? I didn’t have cancer so I wasn’t an emergency. I didn’t have private health care so I had to wait

Maybe we should all be using pharmacies more if the GPs are overwhelmed?
Many have consulting rooms and they can deal with a lot of minor ailments with over the counter products.

GPs can refer patients to a pharmacist. Then the pharmacy gets £14 from the NHS, and background notes from the GP. However, usually GPs just tell patients to go to the pharmacy. The pharmacy don’t get paid for their time, have no background and can’t arrange staffing to ensure a pharmacist is there, when the patient walks in at random - while GPs are complaining about being expected to work for nothing; and how they can’t magic appointments up, because they don’t have the staff! Patients also expect the pharmacy to be a minor injuries unit or alternative to an ambulance.

The problem with your idea is that you are just shunting all the GPs problems onto pharmacies; and the staff get the abuse because of the shortcomings in the GP system, when it’s nothing to do with them!