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

Eh... so if a private GP says "actually, you should have started it days ago, why on earth didn't you come earlier" and prescribes antibiotics, that is considered "buying what you want"? OK then. Should have waited in the queue like a good girl, what's sepsis after all, stiff upper lip and all that.

NHS at its conception was the most amazing ideology . Now it's misused broken and there are too many people for it to sustain itself. Waste in the nhs is massive. Bad management, dodgy deals, big payouts, corruption. And at the bottom of all that you have Dr's nurses and patients all muddling round in the shit .

Why are so many of them seemingly so bad at their jobs?

In fairness I have truly never had a GP in the UK who was bad at their job.

The problem is you can't access them, but if you can they are pretty good and you don't have to worry about costs piling up for tests etc.

@forinborin

We're you admitted to a private hospital with sepsis?

I work in a gp surgery , the doctors work their asses off. We currently have 2 doctors off because patients have come in with covid after saying they have lateral flowed when they really haven't. Last month we had 27 people call an ambulance for minor issues ( think small cuts and feeling tired ). It's hard work and we try our best for all the patients. The waiting times for hospital appts are the longest they have ever been, it's so hard seeing people struggle through until they finally get one.

I’ve lived in many different parts of the UK, some known for having very very good NHS services and some known for very very bad ones and I’ve honestly never experienced anything like what you describe. I’ve always been able to get appointments when it’s been necessary and have nothing but praise for the NHS staff who’ve helped me. I’m not saying there aren’t problems and some people do indeed seem to experience those long waits and issues, but it really isn’t the case that the entire NHS operates in that way.

I was bitten by a dog a couple of weeks ago, called 111 for advice and was at my local GP hub being seen by a fantastic nurse within an hour. Walked out having had a tetanus shot and with a prescription for antibiotics 15 minutes later. All for completely free. I think the NHS is an amazing thing!

My mum absolutely loves her GP. She gets a great service from them.

However she reads the Daily Fail slagging off GPs everyday so will come out with 'I don't understand why they aren't seeing people' on the same day as she has actually seen her lovely GP.

Or 'They need to see more people face to face' when I point out to her that we have just solved all her issues easily without her having to go into the surgery, as she would have done 4 years ago which avoided about 4 appointments but didn't mean the GP was twiddling their thumbs.

A particular favorite is 'You only get to see the nurse' - when she actually loves the nurse, who is highly skilled and solved her complex health problems.

I'll point this out to her, she'll agree for about a day. And then she and her mates will go back to moaning about how dreadful GPs are.

Reality: there are not enough GPs. Complexity of problems dealt with by GPs has rocketed due to an ageing population and work being pushed out of hospital. No new GPs are on the horizon. Public expectations are through the roof, GPs are actually seeing more patients than ever before.

Given how difficult it is to get an appointment with my GP, I have also decided private is the way to go, and use an app.

I find it difficult to comprehend those saying GPs are overworked and stretched to their limits, when I log into the app and have a choice of over 80 GPs with appointments from 7pm - midnight. Overworked and stretched to their limits on NHS pay, but have the energy to do additional hours when they want the extra money they get doing private work on the side.

@lady I agree that the NHS is broken :(

Not enough GPs. Tory government actually cut places for medical training (they have now been replaced). The pipeline for GPs is over a decade. GPs are lower paid than in other English speaking countries and have worse conditions, so there's emigration. Constantly high patient loads and demands lead to retirement or working "part time" (which is not 20 hours a week!) UK has been importing doctors to fill the gap, and lost some due to Brexit.

It's just not possible to provide a proper service with the numbers of patients GPs have to handle. Then add on the other demands--UK GPs are expected to do more than GPs in some other countries (rather than refer upwards), and they're expected to ration care.

Having dealt with doctors in a few countries I don't think UK GPs are any worse trained; that's not the issue.

OP. What is the name of the App for private GP appointments? Thanks

Well, there are a lot of people in the UK and everyone uses GPs, so even though mostly they're fine, that tiny percent of unsatisfactory encounters adds up to a lot when you multiply it by the millions of people!

There is a GP shortage though - at least 3 unfilled vacancies in our small market town (in the SE so quite an expensive place to live). And if you say, "well train more" - you'll need more lecturers and facilities - talking a decade or more to turn it around naturally.

I would listen to politicians who want to investigate moving to a system like Germany, the Netherlands, or Norway has. Or France ...given that any French people I know, if they get seriously ill, they promptly go home for treatment! It seems batshit that any thoughts of changes to how healthcare is organised in the UK is shot down as wanting to move to the patchy coverage and risky billing system of the US (that said, I do agree we always should be watchful of politicians and their financial interests).

I've been asking my GP for help with my non-toilet trained 5yr8m old since he turned 4. They don't want to know. Can't get an incontinence service referral with the GP doing it. Can't get a GP appointment as he isn't unwell.

I think the NHS are amazing for life or death scenarios. They were amazing when same child had sepsis as a newborn. For more low level, not going to kill you but severely impacting quality of life stuff they have utterly fallen apart.

The GPs aren't doing private work on the side FFS.

These are GPs who have decided that NHS work is exhausting and miserable and they can earn a nice living with grateful, far less complex patients, with longer and safe appointments doing private online GP.

So effectively they are GPs who are lost to the NHS.

Currently my GP surgery phase system message goes something like this…

A/B call 999
C/D go to A&E
head or eyes see an optician
mouth see the dentist
E/F see a pharmacist
G/H make an appointment with the nurse
I/J self refer to the physio
K/L go to minor injuries
M/N put a wet paper towel on it…

im not even sure what scenario is left when I might get to speak to GP and even then it’s still only a telephone appointment first.

my worry is that the above approach leave us only ever treating ‘symptoms’ without anyone ever looking at the whole picture and potentially joining some dots

No, I got an antibiotic prescription from a private GP for it not to happen. Instead of waiting for ~4 weeks, or trying my luck every morning with cancellations as advised.

Is your point that an ear infection is not a worthy enough condition to see a doctor? Because it is self resolving for 95% of people without treatment, and booo to the other 5% weaklings?

We are experiencing the Covid-19 medical hangover. Some GPs have retired, some are off sick but the workload has increased as a lot of complaints that were left unaddressed over the past two years still need fixing. On top of that, as a nation we are aging. We would need more GP's, just to keep up - as it is, they are swamped.

For those who are interested, here is a handy breakdown of what is spent on the NHS and where, by the King's Fund.

There are some dreadful GPs out there, because there are some bad people in every profession, but there are far more fundamentally good GPs who are far too overstretched to provide an acceptable service, and surgeries where they literally can't get GPs to work. DF's surgery hasn't had a permanent GP for five years.

Also some GP practices like my local one which are doing great work. And some who would be OK but are hampered by terrible admin.

*phone not phase

Same here. I am baffled as to why the GP holds the power of all referrals. In my country you pick up the phone and call whichever specialist you need to see. You can use the gp to diagnose but other than that you can go directly to whoever you need.

Yes similar to ours. I don't actually know anyone local who has been seen by the GP in a long time, it's been a long standing topic of discussion in the community. Quite a few letters of concern/complaint have been submitted.

Our doctors office appears to be simply a telephone line signposting to every other service within the nhs.

We have been repeatedly told in my area not to contact GPs. 🤷🏻‍♀️

@forinborin

No. Its just an example of how sometimes we rush to treat things that don't always need treatment.

You're happy with the service you received so all good.

I mean everyone, by advertising and messages on social media, not just me 😃

I think the whole GP model is unsustainable, to be honest. When I was a kid, you had one GP, and they were very familiar with their patients. Now, you see a different person every time, and they only have the notes in the system to go by. Appointment times are also very short, because of the numbers of people registered to each practice. Referrals are few and far between, because of the pressures on the system, so people just keep going back to their GPs, and so it continues. Even when referrals are made, the waiting times are horrendous. The GPs bear the brunt of the pressure, as they are the gatekeepers to non-existent services, and then A&E get the rest, when untreated issues escalate and need more urgent attention. The problems are everywhere, but it's the main points of contact where you see it the most.