To ask if GPs are leaving NHS and why?

[CloudyYellow]

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

The A&E without consultant oversight, and no facility for emergency surgery or orthpaedic presence out of hours is Epsom Hospital.

Let's not forget that the person in charge of the NHS until quite recently was Sir Simon Stephens a former aide of Tony Blair. He ran the NHS as does his successor - not the Health Minister.

GPs and their associated bodies whatever they are now called, commission services. They have rather more power over commissioning than is disseminated and should be commissioning high quality services.

I am quite sure all local GPs heard horror stories about QEQM. What did they do about it from a commissioning perspective? I'd like to know that.

@Qazwsxefv I hear you and i can see how that is exhausting. Its the same in any public facing job. Not sure what the answer is....

@chopc
Thats what I was told when I looked into going back to work. If someone gave me the wrong information then that is on them, not on me.

There doesn’t seem to be a structured path for Drs to return to work, and that is a big loss.

That's frankly idiotic.

Nobody working front line in the health service has any control over the resources, staffing or funding they have to work with.

By logical extension everyone should be 'bashing' individual tory voters, since they're the ones ultimately responsible for the current shitshow.

GPS are independent of the nhs though so no they can't hide behind that.
I agree though we should bash tory voters though lol

@ButterflyLeg GPs are not independent but if the NHS. They are the primary care. Funding comes from government.

@ButterflyLeg im an ex GP. I don’t think I’m owed any reverence at all. However there is a big difference between a member of the public with a valid clinical complaint, which of course is important to be raised and we can learn from, compared to angry members of the public venting their frustration at me for no reason/ no fault of my own just because they are angry because life is difficult!

I actually left after a maternity leave as I didn’t want to go back. I’d had 3 complaints recently none of which were my fault and I’d done absolutely nothing wrong. People are just angry at the system. Angry at waiting times, at delayed hospital appointments, at restrictions to services etc. I was a
salaried GP so had no control
over how the practice was run. But that doesn’t matter, you are guilty until proven innocent and have to apologise and grovel. One of them I hadn’t even met/ spoken to/ had anything to do with! They made up complete lies and I still had to apologise that they felt that way even tho it was all made up!

@RosesAndHellebores

most gps are busy working in their individual practices not sitting on ccg boards
most gp said they didnt want to be the commissioners of the service - im trained to recognise signs and symptoms, make a diagnosis and discuss and implement treatment not in how to run a complex expensive health system. sure i could advise on what my patients need but business management i dont know anything about, and i recognise as a skilled profession for which one needs training. GPs said they couldn't do this and guess what they cant, and if i was to you know retrain in management (which i might be rubbish at since my training was about how to feel someone's tummy to see if their spleen is big and stuff like that) then there would be one less doctor actually seeing patients

icbs as i understand them are not made up of GPs sitting around comissioning services - they have lots of "local stakeholders" what they actually do or know i have noidea

@Cinnabomb I understand. I agree.
See this problem GPS have with misplaced anger from the public for things like waiting times etc etc isn't unique to them

Guess what, the receptionist in your gp practice she gets shit too.
The flight is delayed, the cabin crew get abused even though it is in no way their fault.
It's part and parcel of dealing with the public. Its unfortunate, it shouldn't happen but it does.

GPs are independent as in most (not all) surgeries are independent business contracted to provide nhs services. However the contact they have with the nhs to provide these services is pretty prescriptive so they can’t just do what they like. It’s sort of like each hospital trust is contracted - you wouldn’t say they are independent of the nhs. What is does mean is that when you see a GP partner they are business owner of that surgery as well as being the doctor rather than an employee of a big organisation like a hospital consultant is.

So surely these GPS partners are perfectly placed to address all these issues and renegotiate apparently impossible nhs contracts then?!

@ roses Epsom - so answer 1 and 2 I think. Not enough doctors to staff both sites properly. Planned closure/alagmiantion resisted by locals. How any of that is the fault of the doctors who currently work there I am not sure…..(I’m no expert it’s not my patch)

@ButterflyLeg no individual negations allowed, it’s a take it or leave it offer (plus buy in to additional services to offer such as flu vaccines and phlebotomy). Government changes and imposes terms unilaterally. Only tools are strikes (public always think it’s about money and don’t support) or hand back contracts- which lots of practices are doing - hence lots of surgeries shutting - and so the reason for this thread

When health professionals, Doctors, AHP,Nurses, post about frontline,stress and demands of job we are routinely closed down or derided. It becomes like bingo
You are already overpaid, other people get paid tu’ppence. Be grateful ✅
You knew what you were signing up for✅
Your terms & conditions and pension are splendid. Pipe down✅
It is a vocation✅
Cannnot stand criticism you all have massive egos✅
Remember the Francis Report✅
I was in hospital once and the staff loll about eating chocolate & gossiping✅
GP are useless, they do not care✅

@Qazwsxefv I think it was 2 and 3.

No offence personally but a partner at my practice was until recently chair of the local CCG.

All I want is to be treated with respect, and referred to optimal services. The idiotic paperwork and culture of excuses is mind-blowing. It has got worse imo but for as long as local trusts spearhead equality and diversity and throw shedloads of money at it whilst allowing 95% of patients to be afforded not a lot of respect it irks. My Trust/GP didn't have the resources to refer me for for further investigations, based on an incorrect radiology diagnosis. It got sorted because I paid for the diagnosis and was able to access optimal care. Had I not got it sorted chances are I'd have had to stop working three years earlier than planned. It cost me £1200 privately and I am.paying £2500 for a drug not available on the NHS. So for not spending probably £5k the NHS risked losing significantly more tax.

The system is utterly broken and I think it would be helpful if those within it looked at the reasons why it is failing, poor management and waste, that would be the same regardless of which colour was in government. And yet the failings are persistently used to whip the government which does not match the left leaning ideologies of those working in it.

Indeed - massive political shit-show ATM with MP Chris Grayling leading the resistance to the closure of Epsom's A&E Dept - the new £500,000 Sutton Hospital is one of Boris Johnson's were building '40 new hospitals'

I’m a Director in a global accounting firm - a specialist in corporate finance. 1st class Economics degree and qualified accountant. Was able to transfer from the London office to the same role in the Quebec and Montreal offices when DH and I moved to Canada earlier this year.

@RedRosesPinkLilies

madeinheene.hee.nhs.uk/general_practice/Continuing-Practice/The-National-GP-Induction-Refresher-Scheme

I did this after being abroad for several years. Not sure who advised you and this info is readily available so not sure how you don't have access to the correct information

Oh thank you@Parker231 another pen pusher then .

@HelensToenail I believe Chris Grayling now supports the new hospital at Sutton. I just hope they won't lift and shift the Epsom staff to it. Notwithstanding SWELOC which ought to stay.

AFAIAC Epsom is it is currently structured needs to close ASAP. It also has, I believe, the highest number of unexpected deaths in the country. I don't understand why Grayling has supported it so ardently.

There is a parallel with the closure of the old QMUH at Roehampton that the local great and good brayed to save whilst at the same time ensuring they were referred to the brand spanking new hospital on the Fulham Road.

What QMUH now provides is pretty good. Something similar at Epsom would be great. Also the loudest voices supporting Epsom are I believe the local Labour Party, such as it is.

The old QMUH was falling apart but the people there were good. Similarly at St Helier. Epsom is something else from top to bottom despite looking lovely and sparkling clean.

mumda

its most certainly a real tax bill, and for consultants of my era can comprise the majority of their take home pay. The government of course could intervene but may well want to have senior doctors reduce hours/ retire from nhs. We’re mostly all then doing private work instead.

Thanks everyone really interesting but also worrying.

They are technically private businesses, but ones that can't set their own prices, fees, staff pay or materials costs, so in essence completely bound by the terms the NHS set, and the requirements of the local population.

@chopc
Thanks. I clicked that link - for people already trained in GP, and the pathway for return relates to Drs in England.

@FixTheBone and @Qazwsxefv
Thank you, I didn't realise that

Genuine question, assuming you are both GP's- is there a solution? What is it?!

The government can change the legislation around the annual allowance. What it can't do is to change the regulations of the pension fund. The NHS Pension regs are draconian compared to my pension fund, the LGPS. When I have exceeded my annual allowance, my pension fund will pay the excess and make an actuarial reduction over (20 I think) a specified number of years. For every 7k exceeded my monthly pension payment is reduced by £50. That option isn't available in the NHS pension fund.