That GPs do not have endless capacity

[memorial]

The number of threads slating GPs for not seeing or doing this or that is saddening.
They may say they don't blame "GPs" but that's very much how it feels.
There are less GPs doing far more work day on day. Secondary care is almost at a standstill and we are picking up a lot of that slack. Add the can't be too careful/rather safe than sorry, the aging multimorbid population and the deluge of mental health problems....
GPs are retiring and leaving in their droves, it is near impossible to recruit and locums are expensive and do much less.
Other HCP can help but a recent study has shown they don't actually reduce workload or pressure.
We are seeing many FTF but in order to manage the demand we do have to do some kind of triage.
Those of us left are working 14/15 hr days and yes I know other professionals do as well. But do you want to be the 50th contact of the day, the 200th prescription, the 100th blood result of a tired stressed doctor. Would you be happy their decision making is on point. Pilots who make safety critical decisions have enforced time and rest periods. GP are expected to provide immediate access for everyone but also not allowed to miss anything/make a mistake/be short....
I ask those who are demanding to be seen what they think the solution is? What is the priority?
I am ill after a week of seeing numerous ill kids strep or otherwise. I probably shouldn't be working tomorrow but we have one GP on well earned leave and one who has a family emergency. I can absolutely guarantee that we will have numerous complaints and abusive behaviour tomorrow. What do you suggest we do?

Or point missed entirely.

Repeat failures take time, time better spent on new patients ...waiting lists and times would not be so long if all repeat failures were removed.

Doctors run the business, so the buck stops there with regards to failures.

How much time did clairelip "waste" during her 8 trips?
Deal with your inefficiencies- then complain about the huge demand.

But don't blame people for expecting health care from health care professionals when they need it....its life or death for some.
I get that doctors are stressed....let me prescribe my own medication and I'd be happy to leave you alone. Insist on gate keeping health care, well, then I have no choice but to continue to bug you for treatment and to complain when I don't get it, when I need it.

patients are not the cause of your problems.

This 👏

Seriously? So people in the UK deserves GPs more than people in India? How about you train your own doctors, instead of taking them from other countries who invested in their training to look after their own people.

OP I was with you in the beginning but now I hope you're never my GP because you're just angry and bitter.

My GP surgery are always lovely and friendly but you come across as condescending and rude in this thread - even to people with the same insider view as you who have a different opinion.

We do have a GP shortage but nobody wants to see a GP who doesn't care.

Maybe you could consider how to fix your own internal processes to better accommodate you and your patients.

I think a lot of people on this thread need to read the below posts from an nhs psych reg on insta and realise how much pressure drs are currently under. Suicide rates for drs are estimated to be between 2-5 times higher than the general population with gps at a greater risk than other specialities (quoted from the BMA). As dr burner says ID RATHER HAVE A GOOD DR THAN A DEAD ONE

also - do you want doctors to not be registered with a professional body and not have a code of conduct, ethics, etc, they need to abide by?

Sure, but there's no reason why the BMA has to lobby for reduced training places. That's a choice that the BMA chose to make, and a very poor and stupid choice too, IMO.

Ordinary working people are already taxed to the hilt and pay is being eroded by inflation. Corporations need to start paying their fair share - Amazon for example still doesn't pay tax. Plus we need to stop wasting money on expensive and mostly pointless drugs - most flu and covid vaccines for healthy people etc. There's potentially also a debate to be had about access to some treatments which are cosmetic etc

Poking my head into the thread to say how much I appreciate the availability of telephone consults as a first stop, at least in some cases.....so much more convenient for me to fit in around my work than having to trudge to the clinic every time.

OP I'm so sorry that you and your colleagues are the subject of abuse, it's not right for you to be the targets

Sure, but there's no reason why the BMA has to lobby for reduced training places. That's a choice that the BMA chose to make, and a very poor and stupid choice too, IMO.

As someone has already explained, the BMA is campaigning for increased training places. What it is opposed to is increasing the number of medical school places without increasing the number of postgraduate training places, as this just produces medicine graduates who then aren't allowed to work as doctors.

Seconded.

Since covid, I've had two phone consultations lasting a couple of minutes each - situations resolved.

Third phone consultation led to a f2f later that morning with a referral to same-day x-ray unit, and blood tests the following day.

Fourth phone consult was feedback from x-ray/bloods and how to proceed from there.

I'm fed-up listening to the nonsense that 'GPs aren't seeing anyone' - they are seeing those who need to be seen.

Similar to those who whinge on about waiting XX hours at A&E. Medical priorities are seen much quicker than XX hours.

I amuse myself by knowing within my soul those who whinge about A&E wait times would be the first ones 'kicking off' 'being pushy' etc. when their husband was wheeled in with a cardiac arrest and told he had to wait XX hours before being seen because there was a backlog of snuffly noses and bunions to which attention had to be given because they'd been waiting longer!!

I’m not hugely sympathetic. GP’s run a business. They have far too many people for two few GP’s. This crisis could have been foreseen. Whilst other community services run in an integrated way GP’s have always wanted to continue a model which means they earn more to a patients detriment. In my view GPs should be part of a multidisciplinary community team and not a separate business. If the model was different than the staffing issues would have been addressed in a better way.

@memorial I hate how the Tories have broken our public service system - we all rely on each other and need each other healthy to be a productive workforce.

I’m a teacher and at breaking point too. I’m in pain each day (have a chronic condition) yet I can’t access a GP appointment as I need a telephone consultation before a FTF and as it is either “AM” or “PM” I have missed calls as not allowed to have my phone out in class (obviously, safeguarding issue). This means I am not the best teacher I could be, and my students get a rough deal. My family also don’t have the best of me either.

The system is utterly broken now and we’re seeing the consequences. Instead of being angry at public sector workers, we should remember this when we vote.

One thing that’s troubling me - if there is a lack of GP’s why do private GP’s have such capacity? If GP’s are overworked and overstretched and chained to their desks how are they fitting private clinics in too?

I know it pays better etc, but where do they actually come from if each GP is doing all the tasks OP describes?

What I’m saying is there must be some untapped capacity if they’re able to do this - so is the issue pay? Is it because private work pays better? Or they get more patient time? There must be some GP’s ready and able to work if there are private appointments to be had.

I think it's because more GPs have gone private?

Or they do other things. One of my neighbours is a GP for 1 day a week (whatever the minimum is to keep practicing) the rest of the time she does Botox & fillers work because that pays really well apparently.

What happens if you block them and then they're later found out to actually be in need of medical attention?

And where do you draw the line on self inflicted injuries? I managed to fall in 2017 and still have vertigo from injuring my head.

OP - can I ask roughly what % of your F2F are no shows? When I worked in the NHS (clinical not admin) I was astounded by the number of people who took the service for granted and wouldn't even bother to cancel appointments that could have gone to someone else.

@memorial

Not a single country has our model of care where you can demand to be seen by your GP for absolutely no up front cost as often as many times as you want for anything. If I tell you some patients have as many as 3 calls a week and 1 a month is a common occurrence.
No other country provides access to a GP on end 24/7.
I agree it needs an overhaul. I'd get rid of OOH for a start. And limit the number of "free" contacts.

I'm in France. In the big towns, ooh is run on a rota basis by surgeries (SOS Medicins) who do home visits and have 2 appt only clinics staffed 24/24. Low income families pay 0 upfront, the rest pay at the visits and are reimbursed. A cardiologist friend charges full whack (non reimbursed) for no shows - have never been entirely sure how she does this, but am convinced it's the way to go. At one point where I worked in the NHS, no shows were 1/3

See I think that’s the problem. Clerical staff are seen as less than or dispensable.
Of course I understand that profit margins are tight and partners are squeezed, but at the end of the day, I don’t take a break as I’m trying to fill clinics to bring in money for the Practice. I’m totally dedicated and loyal and yet, financially I’m under appreciated.

I don't think they would be allowed to because you're basically giving someone a hefty amount of drugs in one go that could be used for suicide, to sell etc.

@Adviceneeded200 Sorry I didn't read the night bags part properly. Been awake all night so my eyes are glazed lol

I probably have one phone call a month. All genuine. I have lots of health issues.

Is it a crime!

@memorial , I remember the days of the family GP when they used to do house visits routinely, when we could get a same day appointment and half of that would be spent chatting about an upcoming holiday and would we mind bringing them a hagiss back and here's where to get it. We are still in the practise, the GPs are retired and elderly and we still reminisce about them.

So I'm wondering what has changed from this unhurried sort of appointment where trust was built and you felt you knew who your GP was and that they knew the family.

Are people sicker? Are they more anxious in general and more likely to rush to the GP for very little? Are the GPs having to serve more people?

I was thinking how we used to have more of a village for when it came to childhood ailments and the child would be taken to granny for their opinion and maybe a bit of balance. Are we missing that trust in ourselves now? Have we lost all the old cures - some of which were helpful and supportive and some merely helped us feel we were doing something? Do we rush to the GP more readily because we can't trust that if we implement waitful watching there'll be help there if things get worse?

How will that work cor those with life limitlimiting conditions or disabled people on a low income? But not receiving means tested benefits?

Bring in a £15 fee for a GP visit, to be paid upfront and you lose it if you fail to attend or are late. Reduce NI accordingly

That would cost more to set up than it would to redeem any money.

There is a second thing needing challenging here; teachers not being able to take calls or have the office take them in such incidences. It’s not fair that teachers cannot answer a call regarding their health when it is the only way to access care. There is no safeguarding issue having a phone out in a classroom. It isn’t ideal but on balance with an ill teacher, it is fine.