Are GPs ever going to get better?

[KassandraOfSparta]

Just phoned my GP to try to get an appointment as I need to see/speak to a doctor. First appointment was a telephone consult in a fortnight.

My issue is indeed something which probably can be dealt with over the phone but if it hadn't been, wait for 2 weeks to speak to someone and then wait again to be seen in person? Is it any wonder people are going to A&E and queuing there instead?

(And before anyone pipes up, yes it is something which needs a GP. I sat through several repeats of the "if you have an issue with your eyes, see the optician. Pharmacists can help with minot ailments" message. Also to preempt the other common question, no online anything, just a webform to fill in for a repeat prescription).

Out of interest, how much is a private consulation with one of those online GP things and a private script? Starting to think things are not evern going to improve.

Its not just Doctors but all AHP's who are leaving in droves.

Its not possible to force people to stay x number of years but if it were, people wouldn't go into medicine or healthcare.

How about make UK practice more attractive with better wages, working conditions and job prospects?

As for those that say its not the Tories fault, look at their priorities? bigger bonuses for bankers to make London more attractive but no incentives to work in Healthcare.

Because it needs discussing. Don’t tell people to shut up. We pay NI and taxes and the public deserve an honest debate about what we can afford as a society. Perhaps it’s time to charge £10 a visit but then it’s the same people paying …. The people who can least afford it but are working for low salaries. The elderly would not pay yet we have an ageing population.

It is unlikely to get better for at least 5 years. They haven't been training enough doctors from the UK who want to remain in the UK and work as GPs. Also as GPs can't refuse to take extra patients and local areas have an obligation to give everyone a local GP if there is a shortage you get a domino effect of GPs leaving as every day there are more people wanting seen than you have time for. People are consulting their GP more frequently now as well and hospitals are passing more work like diabetes on to GPs. Also psychiatric services are almost non existent and "see your GP" is the default answer to everything.

Also I am in Scotland. This isn't a problem that can be solved by voting in a more left wing government. Waiting times for many hospital appointments are higher under the SNP than under the Tories. Free tuition in Scotland meant medical schools ( and other uni courses) reserved lots of medical school places for overseas students who paid high international fees and then vanished off elsewhere once qualified. The NHS is not seen as a good employer of doctors.

Its because you've gone to a cheaper run outfit.

The expensive ones dont need letters.

And its usually your insurance providers who want the letter to make sure they are paying out appropriately. So stop blaming the GP for your insurers rules.

I don't think it's the fault of GPs, just to add that.

I think GPs do a great job.

I think the system surrounding it is broken.
The actual health care people are amazing.

The hidden costs, and demands suck. That's the sacred cow that needs fixing.

I'm curious to know why they're gate keeping my access to a private specialist

My insurer has given up on GP referral letters because of the length of time they take - I haven’t been asked since well before Covid.

Well, yes! Of course it's partly at the Dr convenience - the patient is approaching them for a service! If you wanted to see a lawyer it would be at their convenience, if you want to buy a pair of shoes you go when the shop is open.

DP always tries multiple times to get hold of patients, with my GP you get the one phone call and if you miss it, you miss it.

I went for a blood test at my old Dr surgery and the nurse was all flustered as the Dr's had double booked patients...turned out they were doing private at the expense of their NHS patients

I see nobody's addressed this, Crumpleton, but that's hardly a surprise - the same happened when I mentioned that my previous GP spent telephone "consultations" touting for private work on NHS time

It's almost as if other GPs know perfectly well it's happening but would just prefer it wasn't mentioned ...

If you wanted to see a lawyer it would be at their convenience,

Yes but you would have an appointment so you would know what time it was at and could work round it.
I have never known a lawyer say come along to my office on Tuesday and be prepared to sit there all morning and I'll see you at some point! They would say come at 10am or whatever

If you wanted to see a lawyer it would be at their convenience

As a lawyer of 20 plus years, this is absolutely mendacious horse shit. Clients call the shots because they pay the bills. Piss them off and they go elsewhere.

If the money followed the patient (as it does in better healthcare systems), GP and other hcp attitudes would change overnight and you can bet your boots they’d find a way to talk to you that didn’t involve 4 hours of solitary confinement with a phone and/or a day off work just to discuss your troublesome hemorrhoids.

From 1st October GPS will be providing bookable appointments from 6:30-8pm weekday evenings and all day Saturday. This will be organised via the PCNs (so a group of GP practices) on a rotating basis. You will not be able to book to see a specific GP as it will be rotated as to who covers the hours. Other services be provided too.

@Deguster
Do you think GPs want patients to be hanging around all day waiting for a phone call? Do you really think we are that sadistic and out to inconvenience people?!
The reality, as we have so clearly seen in this and other threads, is that patients demand so much from us. Once we are on the phone to them, most don't care that they've gone over their 10 minute slot and are cutting into another person's time. Everyone wants more. So to offer an exact time slot then get stuck with Mrs Jones crying about her noisy neighbour and her dead cat for 25 mins means I would be late calling you back and then you would feel angry and hard done by and then the vicious cycle continues "I've waited 25 mins so you need to sort ALL 15 of my problems in this phonecall or I'll complain"
So it's much easier to allow for this by giving wider time ranges
Also haemorrhoids don't usually need a GP. Pharmacists can offer treatment. But yes please give your vital input as clearly you know the system well 🙄

To those sprouting the "if your not dedicated then leave the role there's hundreds waiting to replace you" rubbish
Also I work as a commissioner too. And we have HUGE pots of money. I mean HUGE! But even they are not enough to entice GPs or AHPs.
As one GP partner said, money is not the issue, it's finding bodies.
There is a saying amongst GPs that if you have an MRCGP (the qualification to be a GP) and a pulse then you'll get the job. That's how easy it is to walk into a job in most of the country. And yet no-one wants to. Adverts to unresponded to months and even years
The situation is utterly dire and the poor service will sadly continue. And as long as the misinforms continues and the media smear us, GP

@Tootiredtothinkstraight
My GP practice gives a bookable time-slot for telephone appointments just as they do for f2f. They've done this for at least 5 or 6 years now and it works quite well.
Yes they can be running late just the same as in person appointments but not by any more than about 20 mins

@Tootiredtothinkstraight So how does a bus driver or teacher get to speak to a GP in your practice? Wider time ranges “work better” for GP’s, not patients.

In your scenario, let Mrs Jones complain because she’s wrong, and an arsehole to boot. There is still no reason why a 10 minute appointment slot should be less possible on a phone cf. in person.

Interestingly, my DH’s NHS clinics require everyone to turn up at the same time and wait. His private clinics give everyone a fixed time (as does the private GP service I access through work). It really is barrel-scrapingly poor service for NHS patients, whichever way you slice the responsibility for that.

Also haemorrhoids don't usually need a GP. Pharmacists can offer treatment. But yes please give your vital input as clearly you know the system well 🙄

The over the counter stuff is rubbish and going by threads here.

You can’t use steroids long term so the stuff on script from a GP is very short term use

@Deguster

Did you answer my question?

Do you think many people book to see a lawyer to discuss their very minor inconveniences?

'If the money followed the pt gps attitudes would be different'

If the pt had to pay the money their attitudes would be different

@Topgub Absolutely, yes. Most people are not lawyers and may require professional advice to distinguish the serious from the trivial. That has been a hallmark of my 20+ years in the legal profession. Oh and yes, some are arseholes, because people. 🤷🏻‍♀️

As I said, I’m happy to pay (and do pay) for decent healthcare, but not for the shambolic sanctimony that seems to be the hallmark of NHS primary care. If others enjoy being treated as supplicants, let them crack on.

My GP, over the phone, advised a change of diet, worked a treat, you can buy over counter steroidal cream, if you explain to Pharmacist why you want it.

I like over the phone, of course doesn't work for everyone but Primary Care is shambolic in many cases because, we simply have not got enough GP's for an increasingly older population.

Thats a failure of Govt, so Cameron recognised the issue in 2015 and said he would get the UK another 5000 GP's, the Tories got not a single extra GP, focused on Brexit instead.

@Deguster

Well off people maybe.

Most people can't afford a lawyer even for serious matters

Just like most people can't afford private health care. Which for the most part provides the exact same service just quicker.

Except of course if its trauma or an emergency.

Its easy to be 'decent' when you have the resources. I'm not sure I'd count that as a selling point

Or have so much confidence in staff in one setting but not the other.

Knowing they were happy to sell out/rip off the taxpayer would put me right off as well.

@KassandraOfSparta I'm Scotland and the GP service is woeful. I don't think it is going to get any better as I think Covid was just the excuse they were looking for to change their responsibilities / see less patients / triage patients to other HCP. This all dates back to the terms of the new GP contract which I think was agreed in 2018 which the SNP oversaw.

I get so pissed off being passed from pillar to post these days and the constant fobbing off / condescending attitude from my GPs. DS has skin issues and it took me 3 phone calls to actually get a GP appointment as the receptionist kept fobbing me off to the pharmacist who had no idea what the issue was and kept telling me to get a GP appointment. I am seriously considering getting a private dermatology appointment. Re HRT I have just made a private appointment with a specialist and I couldn't get this until Jan!

Problem is compounded by fact that most GPs coming through system are women who then take time out to have families and then want to work part time. There's nothing wrong with this other than you need at least 2 qualified GPs to fill one FTE post now. Some of the GPs in my practice work 1 day a week! This is not recognised in the workforce plans, nor is training to be a GP incentivised - hence shortage.

@GelatoQueen

Nice bit of sexism there.

Yes, let's not have any female doctors.

They should all be at home with their kids full time anyway

Leave the working to the men who don't need to sweetheart kids anyway

🙄

And some solutions - GP services are so inefficient. If someone is ringing about a skin issue make a face to face appointment rather than having to have a phone appointment then a face to face. In my role the emphasis is on dealing with the issue at the time of presentation rather than putting in lots of additional steps to reach resolution.

If I am ringing about an ongoing issue, take a couple of minutes to read my notes so that I am not spending 5 minutes of my 10 minute slot recapping. Text people when their test results are in rather than telling everyone to ring after 3 so you get loads of calls which then need to be triaged. Especially when we need to ring multiple times to check if tests are back.

Open later one evening, tell people about the services you offer rather than assuming they know. Don't offer screening appointments(eg smears) at 8.30 and 9.00am only then complain women aren't taking up the appointments when anyone with half a brain would know that getting kids to school will affect a lot of people. I could go on, but won't ...