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.

We have a national shortage of GPs.

Ageing population means more complex medical needs, mainly being managed by GPs so we need more not less.
Many GPs are part-time or planning early retirement.

Complete failure by the authorities to plan ahead for this. It takes YEARS to train a fully qualified GP, they can't be magicked up in a couple of years!

Is working 60-70 hours a week routinely as a doctor safe? As a junior doctor, I fairly frequently did 80-hour weeks and felt barely able to get myself home at the end. I'm not sure people should want to be treated by an exhausted doctor!

Ultimately, no one is beholden to work in the NHS. In other professions, people can choose to move for better hours / better pay etc. Medicine should be the same. No one is saying GPs have to earn 6 figure salaries (I would jump ship and leave the 6 figure salary behind well before I was working a routine 60-70 hour week!). However, not enough GPs can be recruited. The options, as far as I see, are either to:

1. Increase pay to recruit more GPs
2. Improve conditions to recruit more GPs

Trying to increase GP availability by reducing pay/increasing hours just isn't going to work. GPs will jump ship and fair enough. As people on Mumsnet are keen to point out, doctors are not heroes (and rightly so!). Medicine is just another job and the usual forces of the market apply.

As an aside, people love to compare medicine to corporate city jobs. If a city banking firm couldn't employ enough bankers, would it fix this by slashing the bankers' pay and telling them they had to work longer hours?

Yes, this. I'm either on the phone for my job, or nowhere near my desk/phone, so I can't answer. My GPs receptionist said 'surely if you tell them it's important you can answer', so I asked her what she would do if her GP was calling her mobile right at the moment she was speaking to me. She admitted she wouldn't be able to answer.

I can only have a telephone appointment on a day off. A full day's annual leave to speak to a GP for five minutes, if that. I basically don't bother with the GP now, if I needed one I'd go private.

Generally they spread it across the week so the session numbers are equal every day
session numbers are based on factors like your patient cohort numbers, your building capacity etc. a session is an AM or a Pm. If you need to have 50 sessions a week you have to schedule your staff to cover those, so combined all of their working day patterns will cover the 50 sessions.

If you have 5 GP’s all doing 10 sessions, 70+ hour weeks they are even harder to cover during sickness or leave you are actually better to have more people doing 3 days (6 sessions) than less people doing 8-10. I don’t know any GP’s who do 10 sessions, absolute madness no one could do this. They would burn out. I worked in primary care in late 90’s and they shared on calls and evenings and they didn’t work as many hours as some of the ‘part time’ GP’s do now because people only called them out if they were literally dying or had a very sick child. Nowadays people call 111 for constipated tummy aches

I'm so sorry.

It's easy for people to gesture to other careers where long hours are the norm, forgetting (other than the fact that it isn't okay there either) a GP can quite easily kill someone, accidentally or overtly. It's one of the most exhausting jobs there is. You have to see SO many patients each day, in ten minutes (including moving to and from the waiting room), put them at ease, assess, diagnose, formulate a treatment plan, treat or refer, answer questions and get them out. Again, and again, and again. Regardless of the fact that appointment four of the day might be a suicidal man you have to stay with while ringing the crisis team, or appointment thirty nine might be the woman who is so lonely she simply will not stop talking and other than physically pushing her out of the room you just can't get rid of her. Then there's the patients arguing for antibiotics for a virus, the ones who don't have the vocabulary to explain their problems or who are too shy to discuss it and throw valuable info at you as they're halfway out of the door...

It's like sifting through haystacks all day, knowing that if you miss the needle someone could die. Is that stomach pain gas, an ectopic pregnancy, bowel cancer, IBS, a tumour, what? Is that headache stress, migraine, dehydration, a brain tumour, what? And so it goes. Even truckers have working time limits because we recognise driving while exhausted is dangerous. But apparently diagnosing and treating sick human beings while exhausted is fine and you should actually do more because other professions do just as many hours, don't you know? Never mind that the lawyers and those in finance aren't going to get sued for missing cancer or misdiagnosing.

Don't ever let ignorance from people who haven't done the job let you believe that you're not doing a brilliant job and your absolute best, which is the most you can do. Thank you for everything you've done, and wherever your career takes you I really hope you find some peace and happiness.

I did it a few years ago. Spend a bit of time seeing patients, and have a variety of other work, all generally within the medical field, that fills the rest of my week. Would have burnt out by now if I hadn't made the change and probably have left the NHS.

I know this wouldn't directly help GPs but I have recently decided I'd love to retrain and join the NHS.

Can I? No. Whys that I hear you ask? Well the local huge hospital doesn't support the training or educational placements.

But there's a shortage of trained medics there, its on black alert and ambulances are queuing up outside.

But the hospital doesn't training or education 🙈 so intelligent people of all ages are moving away or choosing to do other things (like me, I've given up on trying to train in the NHS!)

Our local NHS (its a county wide black hole!) doesn't even offer that new social prescribing recruitment programme! So that'll add to the horrendous backlog at the GP's.

Sorry for all my typos, I am typing with a broken hand

I've given up with our GP unless it's one of my existing conditions, which they need to be aware of, and deal with.

For other stuff, we use a private face-to-face GP, who charges £95 plus the cost of any prescriptions/tests etc.

We shouldn't have to, but that's the NHS nowadays.🙄

It is not safe for any doctor to work 70+ hours a week, hospital or GP. It should not be normalised. If you are talking about lawyers working 70+ hours a week, this also should not be normalised but it is because they literally charge by the hour for their work, it’s a competitive industry, there isn’t a lawyer shortage causing long hours, lawyers are not saving your life or dealing with your health. I know someone in finance who works crazy hours, he does this to get rich. No one is forcing him. He wants the money and doesn’t like missing chances to make money. It’s not the same

Lawyers don’t get paid by the hour, unless they are salaried. They just have billable hour targets. There is also a lot of non billable work that needs doing in just the same way as every other profession. Lawyers also face burnout and negligence claims for errors made when exhausted and overworked. It’s not a race to the bottom.

*non salaried partners!

The time needed to train people is not cost effective. I once costed up how much it costs to have a GP trainee for a year and it was mind blowing. Thousands. And you do not get back the appointments from the trainee to get anywhere near your costing in lost clinical time and they only reimburse you a few thousand to do it

Agree with this.

My surgery is great - you ring at 8 and I have always managed to get a same-day appointment, phone or in person depending on the issue. They always see children in person too.

My parents' surgery is awful and like the OP describes though

Well then, the problem will never change then. Will it?

Is seems to vary hugely. I got an appointment in person at the gp (non urgent in a week). Referral and in to breast clinic within a week after gp . I believe others are not having the same situation the question is why is there a difference rather than when will they get better as my gp have always been OK.

The NHS is entirely set up as primary care ‘front door’, so you need it to get any referral for almost anything specialist with very few exceptions

Perhaps this is the problem. I have private cover. I have a problem. I phone up, speak to someone, and am immediately referred. Why does there have to be a front door. As pp's have said, that isn't how it works elsewhere. People take charge of their own health. They have a skin problem, go to a dermatologist. Their children have an issue, straight to a paediatrician. Annual health checks, no problem. Our system is basically not fit for purpose and it needs to change.

How much does your private healthcare cost?

Everyone does have the same option as you.

They too can get private healthcare and do the same- except they cant, can they?

It still will be.

@Menora It's relevant because GP's expect their salaries to be comparable to those of other private sector professionals (lawyers, accountants, etc) despite the fact that:

• they are paid by the taxpayer rather than on the amount of profit they generate for a business
• their pension contributions are worth tens of thousands a year and the NHS pension remains insanely generous relative to just about anything else (including public sector alternatives)
• not all of them would be capable of earning private sector salaries beyond the dreams of avarice - most lawyers earn between £50 to £60k, it's the tiny handful at the top that skew the picture
• the professionals with whom they want salaries compared rarely have a PT option so it's FT or quit

I am a lawyer no longer in PP. I have never been paid by the hour - my hourly charge out rate bore no relation to what I took home. It really does seem that GP's want to cherry pick when comparing salaries - ignoring the fact that they are extremely well paid relative to just about everyone else, and the fact that people's complaints about poor service and lack of care are valid and not just "GP-bashing".

For full disclosure, I am a lawyer and DH is a hospital consultant. At no point in our professional careers have I earned more than him. He receives extra pay for overtime - I never have. The length of training is the same. At about 10PQE I had to leave PP for a lesser role to make family stuff work. My hours are still about 50% longer than his.

The assumption by NHS doctors that we are coining it in because I don't work for the tightwad NHS and/or am in The Law gets wearing after 15 years - many senior NHS staff and contractors honestly do not know they are born.

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've had real trouble getting a GP appointment recently. One of those call on the day places, can't book ahead. So do you take the day off work in case you're fortunate enough to secure an appointment?

I eventually got an appointment and it was cancelled due to staff shortage. I had to pay to go private. I feel angry on behalf of people who don't have that option, and it's not the best financial time for me currently, but comparatively I'm fortunate.

It's shocking what's happening with access to NHS dentists too.

Saying 'change the government' may be too simple, but you have to start somewhere. Nothing about Truss' leadership campaign has suggested she has any interest in resolving the issue.

Mine at great. No phone appointments anymore as standard they’re all face to face, usually same day (I’ve only had to make an app for my child but DP needed one for his back and got seen same day). Dentists on the other hand are the real worry for me. I can’t even get me 1 yo seen privately (which I can’t afford but willing to go without meals for)

@Deguster

Howuch do you think doctors should be paid?

Do you think your oh is over paid?