Why do so many people have issue with crap GPs in the UK?

[AgapanthusLove]

I know the NHS is much revered but as a non UK person I am baffled by the very regular threads about poor service from GPs.
Why are so many of them seemingly so bad at their jobs?
Why is it so difficult to access them if an appointment is needed?
It seems very weird to me. I think I would rather pay for a service that worked & I felt attended to than a 'free' service that didn't give a shit about me or anyone else
Are there not enough GPS? Are they not trained highly enough? Why does there not seem to be enough to go around?
Genuinely interested as I've never experienced anything like what I read about here

You only hear people’s complaints, not the many satisfied patients.
I’ve never had a problem getting an appointment.

There is a massive shortage of GPS. It is bloody hard work for relatively little money (until a partner type level). Huge stress & responsibility, crazy workload, abuse everyday and massively underfunded.
Oh and they actually work for private companies which are contracted to provide NHS services not actually work for the NHS itself so lose some of the employment benefits of the NHS machine.

I am foreign to the UK. I gave up on the NHS, only using private now all the way. I don't quite understand why British people hold the NHS sacrosanct, it looks not quite fit for purpose from my perspective, but up to them. Waiting 4 weeks for an appointment when you say clearly need antibiotics for ear infection is just bizarre.

Thankfully, private GPs are cheap and now available via an app.

(I do pay taxes, have been for 15 years, and a significant amount, before anyone jumps at me).

I expect that there are as many good GPs as there are bad ones, but it's the same with anything in life you only hear about the bad stuff because it's more interesting.

I’ve always had very good GPs and no issues getting appointments. Btw you don’t need a GP appointment for an ear infection, the practice nurse can handle that and get antibiotics signed off on quite easily.

There's lots of issues as to why some gps seemingly offer a poor service.
Ainly due to not enough gps and not enough funding

@forinborin

95% of ear infections dont need antibiotics and over use of antibiotics is causing huge issues

So add that to the list.

Unrealistic expectations of what the nhs should and can provide

I see it from two sides. Where I live our GP practice is fantastic, no problems getting an appointment. I live in a smallish market town.

Where I work as an NHS nurse practitioner 40 miles away from home (large city) my patients really really struggle. It's a combination of lack of GPs and too many patients. Many have retired in recent years and haven't been replaced. I don't think they are crap at their job just merely they cannot cope with the numbers. The community team I work in handle a lot of the overflow from this, also lower cat 999/111 calls. The biggest complaint is always lack of GP contact. Ringing at 8am to find you're 60th in the queue, what do you do? Many ring 111 or 999 so the pressure is put on other services.

Over the phone prescribing is dire too I have had to admit many patients to hospital that have reached out to their GP and been prescribed meds over the phone only for their complaint to escalate - it's a crisis.

There are not enough gps. In some areas this is worse than others. It seems to be a political decision to not train enough medical staff in general.

The bottom line their just isn't enough of them. Remember it's not 'free' is paid for like every other medical service we all pay for it somewhere.

How much do you pay? Last time I looked they were £50 ,that's prohibitive to many people.

The new triage system where the doctors ring you back was the beginning of it all being so hard to see a GP or a nurse and then Covid soon after made it even worse.

At our surgery we have the same number of GPs we always had and loads of brilliant nurses- getting through to see them is nigh on impossible! The whole system of making appts changed, you cold always get an appointment but it's terrible now.

It’s always an idea to explain the problem to the receptionist, but many won’t and think it’s none of their business. Yet the receptionist can point you in the right direction.
As an example, I’m thinking of getting HRT so I rang the surgery mid afternoon when they are not busy. I asked for their advice, explained what I wanted and was there a particular GP I was better seeing. She gave me an appointment for the menopause clinic there and then.
When I mentioned this on MN I was told I shouldn’t have to go to a clinic, I should able to see whoever I want. Why, they have a dedicated clinic and I’m happy with that.

Some areas have less than one gp per 2500 people, simple maths tells you why that fails even if we assume a third of the people never see the gp, third see the GP once, and a third see the GP twice. My maths makes that 24 hrs a week already filled (assuming half hour appts, I'm aware that most places run on 10 min appt but accounting for referral times, documentation etc). That doesn't include any form of annual leave,mandatory training, general things needed to keep the surgery going. It doesn't include things like the huge number of meetings, patients that have much more than 2 appts a year, referrals that are lengthy e.g. phone calls to children services, safeguarding meetings

It's a vicious cycle where being a gp is stressful due to being understaffed, thus for more gps leave

Gps are private businesses contracted to the nhs. While the nhs has some control gps have a lot of freedom, so like any small provider they vary, some are fantastic while some are crap. Fwiw I think the nhs is currently broken.

The whole health service is pretty rubbish and not fit for purpose imo.

But it’s venerated and any attempt to reform it will be met with screeching.

OP I dont think you realise that what it would cost to simply "pay yourself" for access to a private equivalent of a GP is beyond the reach of many.

Often the people who are the heaviest service users are the poorest and most vulnerable who can least afford to pay (which is why the state set up the NHS in the first place).

People have a sense of ownership of anything collectively funded, so it's frustrating to feel like a huge amount is paid by the state for something that doesnt seem to provide the service people expect.

It probably depends where you are in the country. I have to fight for an appointment in my area.

Unrealistic expectations of what the nhs should and can provide
Eh... if getting antibiotics for a bacterial infection causing fever and intense pain in the first world country is "unrealistic expectations"... I rest my case.

As an ex trainee medic I strongly believe the current medical training is not fit for who we are now. I strongly believe the medical model is limited and actually harmful in many aspects. I think training also generates many doctors who are unable to practice reflexively in terms of actually communicating with patients empathetically. Getting into medicine has become increasingly harder for those less financially able which is making this situation worse, especially considering the widening poverty gap - put simply, many doctors just cannot relate and hence can be judgemental impacting the provision of care. I also think mental illness is still heavily stigmatized in the medical profession. Mental illness impacts so many illnesses across the board, without tackling this head on, will always leave people feeling unheard and angry. I entered the medical profession thinking it was something completely different to what I saw and experienced. I am now retraining to be a psychotherapist. At the start of my psychotherapy training I realised just how awful I was at listening - I had to undo (and continue to be actively aware of it) year's of indoctrination which completely blocked any sense of what it is to make a human connection with people at their most vulnerable.

Our GP is constantly telling patients to go to A&E as they cannot see them. And then you go to A&E to be told you shouldn't be there and should have been seen by a GP.

The constant passing from pillar to post will inevitably cost people their lives.

My previous surgery merged with another and it was only then it was much harder to get an appointment.

I changed GP surgeries and with one, I was told it was a 3 week wait. Only to be told by the GP there's nothing wrong. (Had a slightly abnormal blood test) 3 weeks of worrying over what turned out to be nothing.

@forinborin

It can be. Most of the time antibiotics aren't necessary.

The whole point of having a gp is to diagnose and treat. They are challenged in being able to meet demand due lack of staff and funding and unrealistic expectations

If you want to skip that process and just buy what you want, that's fine.

£38 for an appointment. I think quite affordable for most people, many won't think twice spending that on a takeaway or booze. Just that there's no tradition at all here to spend on healthcare (I don't mean it in a demeaning way, I think it is genuinely considered as an extravagance by many people, even well off ones).

Im fortunate that our GP surgery locally is excellent. Has a dermatologist that has really helped me, also a menopause doctor who has also really helped me. I have zero complaints.

The GPs I’ve seen have on the whole, been excellent. Getting an appointment has been challenging since covid however, and some of the rules are ridiculous. You can’t talk about more than one issue even if they are inter-related and you can’t make double appointments. Not the GPs fault.

the government screwed over GPs many times, new rules, new quotas, new contracts. Many have left the profession and not enough have joined. It’s hard work with long hours and the pay isn’t as high as it should be (and is in other countries).

the government have long known a crisis was coming with experienced GPs retiring early and not enough new ones coming in. They promised 10000 new GPs by 2025 and have done nothing to make it happen, whilst pushing tuition fees up and scrapping bursaries for nurses.

GPs are not to blame for any of this mess.