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

It seems very weird to me. I think I would rather pay for a service that worked

Except many people would be paying for a service that didn’t work. A service where the choices GPS were making was in the hands of insurance payouts (who employ drs to specifically find reasons not to pay out)

plus many people just couldn’t afford the £1200 per month plus insurance premiums for a family so they simply wouldn’t be covered.

The NHS needs fixing not getting rid of. Or the are so many people going to be completely screwed.

plus many people just couldn’t afford the £1200 per month plus insurance premiums for a family so they simply wouldn’t be covered.

Exactly, 11% of US citizens have no health insurance and have no health coverage at all (state or federal ie Medicaid, Medicare). That’s around 45 million people. Of course wait times are shorter when millions are literally being denied healthcare.

@alanabennett

You can never be asked to pay more than 200 per month plus 7k excess? For the whole family?

Regardless of diagnosis or use?

It doesn’t help that, bafflingly some medicine that used to be OTC in the UK is now prescription only; Happinose - I now order from Amazon (no idea why this is no longer available) and Naproxen. Fortunately, Naproxen can be bought for a couple
of dollars OTC in the US.

While other meds have vanished or are regularly OOS. I suffer from migraines and it was impossible to get Migraleve for almost a year, Tyrozets are discontinued as they had 0.01% of an antibiotic.

Not saying you're lying but you need to request an emergency appointment with things like that. Phone at the right time and say you've got an infection and the pain is getting worse. Had an infection last year, all dealt with on the day I phoned with a short telephone call. And no my doctors surgery isn't the best it does get complaints.

@alanabennett most people cannot afford £5k, even on a payment plan.

I don't, I don't have any trouble getting an appointment and I'm very happy with the treatment I have had. I can see any of the several GPS at my surgery and they are all excellent.

@SecretVictoria OT but migraleve is just paracetamol and codeine (1000/12 iirc) which is available everywhere and one of the colours also contains an anti-emetic.

You can also buy sumatriptan OTC in Boots with a little card thing - very handy (although the 100mg is always OOS).

Ironic that they discontinued Tyrozets when you can buy amoxycillin OTC in most countries.

My GP's only offer telephone triage. You can't have a face to face appointment until you've been spoken to over the phone. There's a 3-4 week wait for a routine telephone appointment.

The only trouble is, they can't give you an appointment time or even a small time period like between 3-4pm. You have to pick morning or afternoon, then you can be called anytime between 9am-12pm or 1pm-5pm.

I work in a job where I can't always take a personal phone call. If I'm working with a client, I can't interrupt their appointment and start talking about my medical health on the phone. The customer would be annoyed if I did that. Work would be ok with me arranging my day around an hour window if I was waiting for a call. They won't let me have no appointments for half a day though.

It means every time I need a GP appointment, I have to take a half day unpaid leave from work and sit in the house waiting for the call.

Added to that, I live in a poor mobile signal area. They insist on ringing on my mobile phone, even though I've specified that I must be phoned on my landline. I had an appointment two weeks ago which came through on my mobile and the call dropped mid-consultation. When I rang the surgery back, I was told I'd missed my slot, so I have another appointment (and another unpaid half day) booked for next week.

I did complain but the practice manager told me doctors are busy people. I'm a busy person as well as I also work full time but they don't seem to understand that.

Talking of private businesses supplying services to the NHS, the 'Push Doctor' service is a mixed bag also.

I've read the reviews - very varied. The main criticism seems to be the Push Doctor GP not being there for the appointment. After this happened to me I contacted my GP surgery because I didn't want this putting down on my records as a 'Did Not Attend' on my part. It was the Push Doctor GP who didn't attend. I also suggested to my GP practice that they didn't pay.

The admin person said I was the third person that day who had complained that this had happened.

My GP surgery has now employed two locums who seem very good, who possibly cost a lot through an agency. But perhaps my GP surgery shouldn't have expanded to 'serve' 12,500 patients on 3.5 FTE GPs in the first place.

Yeah, I really don’t understand why they can’t give you a specific time for a telephone appointment, just like a rl one.

Many people can’t be available to take a call about personal medical stuff for a whole day, as happens here. If you can get through the 8.30 flood of calls

At our surgery you can't book ahead for a doctor to call AT ALL. There isn't even a queuing system on the phone. You have to ring at 8am on a fastest fingers first basis - usually in excess of 80 times before you get the 4 minute covid message and then hopefully through to a receptionist. Ring after this time you have no hope of a call back. You get told the doctor will ring - they try once and it can be ANY time at all during the day. When I rang with a very unwell, severely immunocompromised son at 10:15 am they refused point blank to see him. He ended up in urgent care at the hospital 2 days later (Sunday) and being prescribed antibiotics, antifungals, and painkillers. They refused point blank to see my 10 month old with a fever of unknown location - she ended up admitted to hospital through urgent care - god knows what would have happened if I'd left it - I'm just glad I'm an experienced parent. As a practise they don't do blood tests or anything other than imms and routine appointment stuff. I rang once asking for an emergency call for my baby to be told they didn't have a doctor on site.

@perenniallymessy I think fines for missed appointments would be a good start. If they fined £20 for each missed NHS appointment that would be £300,000,000 (three hundred million pounds!) per year that could go back into the service.

I can understand not being able to give an exact time, some calls might be quicker than others but even a window, "you're number 20 in the list you'll get a call between 10.45 and 11.45

Of course, people couldn't possibly be thinking with their own brains and posting their own thoughts on a social media site now could they?

That would be lovely if it actually happened. Friend needed blood test recently to confirm a condition before medication would be offered. Was sent home and told to book a test online at the local hospital . Waiting time for blood test - two weeks.
There is a practice nurse, friend asked if blood could be taken at the surgery. No.

The statistics on 'missed appointments' and 'Did Not Attends' (DNAs) are bollocks.

They include:

Telephone appointments where the patient did not receive a telephone call at all (surgery's mistake);

Telephone appointments where the patient was unavailable for the call because the GP called outside the allocated timeslot;

Telephone appointments where the patient was unavoidably unavailable for short time within the 4 to 5-hour window in which the GP attempted to ring twice within 5 minutes, and where the patient was unable to be reconnected via Reception, even where the unavailability was due to the medical condition they needed to appointment for;

Push Doctor appointments sub-contracted on behalf of the GP practice where the Push Doctor GP didn't show up.

@BattenbergdowntheHatches I know but even the pharmacist admitted that the pink Migraleve ‘did the trick’ for most people. I went to one pharmacy and they gave me paracetamol & codeine and an anti-sickness tablet that melted on the gum. That got me through.

I have sumatriptan on my prescription now (100g) and am on amitriptyline as a preventative and I’ve never (fingers crossed) had trouble getting those.

Yes - not the whole family, though. Me and my children. My husband has a separate health plan with his (self) employment.

it's not a system without problems - porters are correct in that there's a huge number of uninsured, who essentially get emergency care and little else. But I'm not sure the effect of that is really much different from non-treatment due to waiting lists, etc. Each is a barrier to treatment.

also it's often the case (as always) that it's the middle that get squeezed. Very low income, children, veterans and seniors (65 and over) are covered by state/federal plans.

i think to sum it up I'd say the barrier to healthcare in the US is money just as the barrier in the UK is structural failings e.g. waiting lists, "postcode lottery", etc.

I had a receptionist moan at me because of this. I've got things I need to be getting on with! I don't want to be hanging around all day if I don't get a call until 3-4pm.

I find it easier (because it' easier to put into words) to do an e consult now. One of the questions is when are you not available for a call. Makes it slightly easier.

GPs don't have any way of tracking their mistakes unless they happen to see the same patient twice and pick it up. There's no bench marking that picks up a GP who fails to consider something or behaves appallingly unless it is recorded, reaches the level of a complaint to the practice manager (who will close ranks) or the GMC (would need to be a huge mistake and the process of weighted in their favour). So the GP who told me I was infertile while I was bf did not have any learning experience when I got pregnant. I could go in and speak to them myself but in IME there is no real interest.

@alanabennett

How much does your oh pay?

It won't be her OH, it'll be the company as a part of her benefits package.

The real cost will be several thousand dollars, of which the company pays a high percentage (the better the benefits package, the less the employee pays) and the employee pays very little.

The coverage will be linked to her job, so if she quits she can keep that coverage but pay full cost, and only for a max of 18 months.

So sure, good if you can get it and you don't need to leave your job or get fired.

That said, I live in the country and my particular surgery is a dream. You call at 8.30 and book an appointment for that day. There is a pharmacy attached. You see the same GP each time. I was referred for physio last month and it turned out there is a physiotherapist right there in the back room. I was offered an appointment for that morning. Needed further advice later that day and got it. Needed an appointment the following morning and did the whole thing again. The difference in experiences (postcode lottery) is unbelievable. I wasn't on death's door either.

But I used livi many times before the country move.

Just realise I misunderstood the question and voted YANBU in error.

I think most GPs - as individual service providers - are great. I think GP surgeries often offer a crap service, but even then I would caveat that with an acknowledgement that they are often chronically under resourced.

So...

GPs = not crap
The state of primary care in many part of the UK = crap