To ask if GPs are leaving NHS and why?

[CloudyYellow]

Seems like numbers are going down and it sounds like the job is unsustainable.

Training wise it’s the lack of post grad training places that’s the issue not the med school numbers - less GPs means less trainers so less training places so less GPs and so on. At some point it will hit a terminal decline and then we really are screwed

I have nothing against PAs or allied health professionals but those who don’t have their own professional registration and insurance-mainly PAs are therefore practicing using the “supervisory” doctors legal liability, registration and insurance. As a trainee GP the PA/allied health professional is often my “senior” on a shift and so we have the bizarre situation where I am legally/professionally/financially responsible for my supervisors choices. I’m not doing down PAs here I just want them to be responsible for their own actions just as I am for mine.

The hours are shit and not reflected in the ones payed or reported. Every consult with a patient creates an equal amount of time needed to do the paperwork and this isn’t factored into the day at all. Same for repeat prescription checking, checking blood results, reading and actioning letters, auditing all of the above, mandated written reflection, practice meetings. All of this takes up probably double the time actually spent offering appointments but the public just see it as the doctors being “closed” and think we’re lazy.

im part time - I’m paid 50% of the standard trainee salary because of this and I still work 36 hours a week over three days in the week and one weekend shift a month (I’m paid for 24) if I was full time I would easily be working 70+ hours mon-fri and the out of hours and being paid for 48

and I pay for my professional exams to be fully qualified GP out of my own pocket (these are £1000s) and my resuscitation and safeguarding training. I don’t get leave to study for the exams so do so in my annual leave. As a trainee GP (qualified dr) I get 20mins rather than ten per patient, a half day of zoom “training” a week on how to be a GP and usually have a named supervisor I can discuss cases with if I am stuck on what to do (but since were so busy we’re asked to only seek help if we really need to). People coming to see me get the same service as if it was a fully qualified GP.

we do at least get our insurance paid for now (we didn’t used to a few years ago)

I spend a lot of time wondering if it’s worth continuing

To the doctors who feel they are being bashed by the media and public... do you not understand why you are getting this bashing?! Do you believe because you earned title of 'Doctor' that this should result in automatic reverence?

The latest ignorance is the health secretary to say we need consultants working at weekends. Um, doesn’t the fool know we already do?
I thought the ‘#iminworkjeremy’ campaign taught some people something. Perhaps Jeremy Hunt could tell him about it.

when I was contacted to work 24 hours as NHS consultant, which was 3 x8 hour days, I would gladly have swapped to go to work Saturday at 9 and work until Sunday morning at 9. Of course, that’d be me free for the rest of the week. It sounds great.

if they want a consultant- delivered service ( which is what he is suggesting) rather than a consultant- led service, gonna need a whole lot more consultants.

if they are trying to train up and fill gaps with Allied health professionals and PAs, then of course they need to be part of the unsocial hours too. Currently they often are not ( certainly not where I worked, where AHP worked office hours).

I left for private practice- it is lovely and I’d recommend it to anyone.

An elderly relative who lives in a South Somerset market town told me that all the gps upped and left the local practice when it got taken over by a private consortium as some sort of trial. Whether this is 100% true or not I don’t know, but it’s scary. The terms and conditions offered to the gps must have been really poor for this to happen.

ButterflyLeg

have you not read the thread? What on earth are you on about? 🙄

Im married to a consultant and since Friday morning he's been home - 830 last night til 11 am this morning. hope to
see him around 7 pm. he's 62, and mentally and physically exhausted.
he has Monday as a rest day and then back in Tuesday.
he's paid well, but we would be better if financially if he retired tomorrow.
so i get the rage when some politician says the consultants aren't in at weekend s - one weekend. in 4 DH works all weekend to cover his acute speciality

Look up Symphony Healthcare.

Yes I have, and noticed a few posters moaning about lack of respect which is why I asked.

Here's you moaning about the 'bashing'

ButterflyLeg

really? Your response to this thread is that they should understand why they are getting a ‘bashing’?
and then some nonsense that they think their earned title means they think they should be ‘revered?’
do they deserve a ‘bashing’? What other people do you believe deserve a ‘bashing’?

there is something very wrong with you if that’s your response to the clear problems detailed by doctors on this thread. Something very wrong and nasty.

very nasty

Thought this had now been sorted? Was in news recently

Yes you really should look at why so many people are frustrated and disappointed in GPS that would be an obvious thing to do in my eyes if I was a GP and felt like the whole world was against me and my profession. Perhaps there something in it?

Did I say I personally think doctors deserve a bashing? No I didn't lol . You're making things up

You sound very silly and I doubt you actually are a qualified doctor of any sort

Telling me there's something wrong with me 🙄😂 gone on them give us a proper diagnosis, what's wrong me with doc?!

ButterflyLeg

you say that is me ‘moaning’ . Fool.

That is me answering the OPs question as to why GPS are leaving the NHS

Duh

🙄

Isn’t some of it about pension tax? The gov could alleviate that? We never talk about public sector pensions but it does seem to be a factor for consultants etc who probably have more than £1m in their pension due to their age. I can see being a GP could be a hellish job with the timescales and lack of follow on care facilities.

@Carriemac my dh is 61. Lawyer. He delivered five 11 hour days last week. I've done about 12 so far this weekend on top of five ten hour days last week. Why is it that medics and their families think they are the only ones who work hard?

Also at my local A&E there is no consultant oversight over the weekend, no orthopaedic oversight for all the broken bones and no emergency surgery facility.

That is one example of mismanagement and leeching costs. An 80 year old with a broke hip is taken to a hospital that can't help her. Triage, bunged on a trolley, not very well cared for pending transfer to the hospital that was 3m rather than 2.5m from her home. The mismanagement and stupidity in the system knows no bounds and the people in it want the public's sympathy.

The NHS needs to sort it's nonsense out if it wants any sympathy from me.

Lapland
You aren't a doctor - that is clear. I suspect you may also go by the username passport123 also.
Your a very bored individual with loads of time on your hands. But there is no way you are a doctor. You sound like a child

DH earned the title of doctor through many years of study and horrendous hours of work. He never expected to be revered but to be respected for the job he does. DH got told he had locked himself away during lockdown - NO - he worked seeing patients face to face, working on a Covid ward and working with church leaders so that patients could understand the benefits of the vaccine.
i rarely saw him for weeks on end. I am so glad he has left but sorry for his old patients as DH’s practice closed down as the other GP’s left to work in other countries or return to their own country and no other GP’s applied to take on the practice - 10,000 patients to then be allocated to other already overwhelmed practices

I’ve seen your posts before - a regular NHS basher but knows nothing about it - never worked in the NHS and has a cushy office job as a pen pusher!

Doctors should be respected for their work for as long as they are doing a good job. Same as a cleaner, bus driver, scientist or any other person doing any other job.

Having worked closely with doctors, I have observed that most doctors feel they should be respected unreservedly and can not abide being challenged or questioned. And as most folks know that kind of attitude is daft at best and downright dangerous more often than not

@ButterflyLeg

depends what it’s about

bashing because your doctor has missed something they shouldn’t of/made a mistake with your medication or worse been racially/sexually or similar inappropriate =justified and I understand the anger. We’re not all perfect. Doctors can be arsewipes just like any other person can be and should be called out on it and penalised.

However Sometimes errors are due to systemic failings such as overwork and poor it and control systems and these should be fixed (more expensive so not done) rather than hanging the individual dr (cheaper and so more often done) -see the Hadiza bower-gaba case - much easier to convict one doctor for manslaughter than admit your whole hospital system was unsafe and negligent

bashing of GPs for something they cannot control or when the bash is better directed as the health secretary does get your back up. I know It’s shit for patients right now. There are not enough doctors to provide a decent service and people in the system have been saying this for years. Moaning at the doctors that are still left who are trying to keep things going with ever increasing demand but less resource really dosent help.

common non deserved moans I hear:

1. Waiting times for GP appointments (this is because there are not enough GPs so there are not enough appointments)

2. Waiting times for hospital appointments and scans/tests (this is the hospitals problem and also due to their not being enough of them)

1. The care they received in hospital(also the hospitals problem)

4. Waiting times for ambulances (ambulance trusts problem and not enough of them)

1. Delays in letters/results or not being able to see what the hospital wrote down (due to the nhs shit it system, governments problem)

6.fancy drug not being funded on the nhs (nice/prescribing committees problem) 7.waiting times for counselling or total lack of counselling or other psychological therapies (mental health trusts problem/funding ) 8.previously available drug disappearing (brexit/global supply issue) 9.GP only having 10mins to see you (funding) 10.massive wait on the phones to talk to GP (can sometimes be individual surgery related but often due to too much demand for not enough apts caused by the surgery having too many patients for its number of doctors because they are not allowed to cap lists and other surgeries have folded, and sometimes due to an actual physical lack of phone lines at rural surgeries - as in no more lines at the exchange available and these are the places where internet lines are less available) 11.lack of care package for themselves or relative (social cares problem/funding) 12.Gp refusing to fill out insurance form/marathon form/gym form in an nhs apt (nhs doesn’t pay for these services - health secs problem) 13.Gp not prescribing benzos for phobias (BNF/mrha says we can’t anymore - regulators problem)

none of these can be fixed by the individual GP. Most are stuff our union/professional body are campaigning for improvement in. Please direct anger at the health sec and the big wigs.

@Parker231 I remember your posts. My GP practice was better in lock down than before. But for many people their experience was far worse. My dd's MH team is still only available digitally. Many affiliated services are still only available digitally with far too many admin staff wfh. I am aware of one hospital consultant tearing her hair out because everything is taking twice as long to get done. It is unacceptable.

Also my DH undertook years of study and gruelling hours to earn his title. He had to wait until he was 55 to get it.

@RosesAndHellebores different jobs have different pressures.

I don't think your husband can kill someone quickly if they don't redirect them to A&E if needed, or slowly if they don't do send them for the right tests on time or chase consultants for advice.

@RosesAndHellebores
28 day prescribing is a mandate from on high about saving the nhs money. Obviously months don’t have 28 days And some meds still come in 30s. The computer system cannot work it out. Meds get out of sync on the the repeats. It’s hell for GPs and takes up so much time but we can’t get out of it - again direct anger at health sec!

I am not shocked that working full time means working more than 35hrs/week. That would be weird. I am shocked that working 40+hrs a week is considered part time just because I am only in the surgery for three days a week.

No indeed @RedWingBoots but he has other significant responsibilities and a wrong decision could end up in someone dying.