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?

@HappyHolidai well yes of course increasing GP number is the solution but we are already more than 40,000 short with more leaving by the month. It’s a simplistic view that doesn’t consider the training requirements nor the pressures. Tbh I wouldn’t touch the job with a barge pole reading some of the stuff I have online. The stress isn’t worth the money, it’s a thankless role.

www.independent.co.uk/news/uk/home-news/nhs-doctors-brexit-vote-jobs-b2234460.html

Our village has the same number of residents and the same GPs as before Covid, yet they are still doing phone appointments and not providing the same service. Understandable that people aren't happy.
Elsewhere two members of my family have been referred to hospital consultants on the basis of phone appointments and without actually being examined - which seems crazy to me.

I am so sorry to hear about the awful
complaints. That is unacceptable as GPs are brilliant and provide such an essential service. Of course, like with anything, things can go wrong but to experience abuse is terrible and the patients should be pulled up and asked to leave the surgery. I am so sorry that you are struggling. Please do look after yourself, there are so many patients who are so appreciative of what you do but don’t make yourself ill trying to make others happy. A stricter triage may be necessary at times of severe staff crisis such as only seeing real emergencies and direct everyone else to call the next day, call 111 or go to a walk in centre if available etc. as a retired nurse I am so proud of the amazing GPs, you guys (and girls!) are the absolute best!

I can not fault my GP and the care myself and family have received over the last few years.
however, that can’t be said for others and dh (who is registered as a different surgery to me) has had endless problems with his. I don’t blame the gps though. In our area, over the last 20years they have double the number of houses, endless building new estates. They all come with a new primary school, they are also building new secondary schools. However they have not built a single new doctors surgery and it’s just up to the current ones to keep taking on more and more patients.
I can see why they are struggling. The system needs an overhall

GPs in this country have always been awful. That's the reality.

The whole system needs improving with more and better trained doctors. and also an end to these dreadful receptionists who seem to think they are doctors....

I have the opportunity to see how GPs work in other EU country and the UK really has a third world GP system compare to places like France.

Yes, this kind of thing is a real problem. I’m asthmatic and left my inhaler behind when I went away for a few days. Doctor won’t do a repeat prescription over the phone and the online system will only send it to the GP dispensary so I bought a new inhaler from an online pharmacy, just to get me through the holiday. Only time I’ve ever done anything like this, asthma long standing and well controlled. Yet I got texted by the GP saying that I needed to make an appointment to discuss my condition in light of this purchase of an additional inhaler. I ignored this, because it is plainly a waste of everyone’s time. And I hear about this kind of thing all the time. I’m not blaming individual GPs — no doubt there’s a centralised policy driving this stuff — but it clearly places yet another burden on an overstretched system.

I think there are things that could be done but it's probably only tweaking around the edges eg charging a nominal amount for GP appointments. Also making it easier to get repeat prescriptions - my mother has said she has needed repeat prescriptions twice recently (not for anything controlled like Tramadol, one was for eye drops) and they have refused the prescription, saying the doctor needs to speak to her. But then they say there's a 11 day wait for a telephone appointment. That is just silly and the height of inefficiency - yes it might be better to talk to the patient, but then it needs to be done that day!

But that is just tweaking and still not ideal. And it won't magic up new GPs (but more money might magic up more specialised admin support, though probably at the cost of lack of staff in other sectors).

I don't think the NHS is underfunded but it isn't funded in the right places and obviously the lack of staff is the most significant problem.

I’ve sent a link to this thread to my OH who works in a vets. They’ve passed it round the vets and vet nurses there.

They say thank you OP, they really needed cheering up and you’ve managed to make them laugh.

I think to an extent, but the problem was massive even before covid and Brexit. But before covid I could book an appointment online (and cancel one). They turned that off during covid and haven't turned it back on. Same goes for the private dentist. You have to call or go in person.

Completely agree with you.

I hate the assumption that we are all slating GPs and other health care workers.

Based on your detailed experience of how many British GP practices? That is absolutely not describing my excellent GP practice, or indeed the several GP practices I have been registered with previously over my adult life (I’m 63). In addition, I have worked as a Clinical Psychologist over more than 30 years and have liaised with thousands of GP practices over that time. Only a very tiny minority have been poor (less than the fingers of one hand out of thousands). Your comments are totally without foundation.

*Greenfairydust · Today 12:27
GPs in this country have always been awful. That's the reality.

The whole system needs improving with more and better trained doctors. and also an end to these dreadful receptionists who seem to think they are doctors....

I have the opportunity to see how GPs work in other EU country and the UK really has a third world GP system compare to places like France*

My GP’d and receptionists are amazing. Just fantastic.

I don’t understand your post. Could you explain?

GPs vary so much (like the rest of the population). I've had extremely uncaring and dangerous health care from some and life saving, holistic care from others. I got fantastic care from one today (who called back twice because I couldn't pick up - because in a 12 hour window there are going to be some times that are dangerous or inappropriate to take a call), gave me exactly what I needed and said I need another appointment in 3 weeks. I had just about given up expecting any care from them when I really needed it but it has honestly restored my faith a bit.

Problem is it's all so variable, even the same GP can be great one day and then burnt out and ineffective another. It also varies wildly across the country.

@KatieB55 if the phone apt your relatives had indicated a need for a secondary care referral why use up an appointment with a GP for no reason? There are so many presentations that warrant a referral that you can pick up on a history alone - it would imo be poor practice to make a patient come to the GP surgery for an examination so delaying the hospital referral that’s needed rather than get on and make the refferal and get the patient where they need to be

I live in Liverpool and my GP practice is excellent for the current situation we are in. I send an online form and am contacted either the same day or the next, and they always see my toddler face to face. We also have multiple walk in centres where the wait time is only 2-3 hours, which is reasonable considering they are always heaving. However, I understand this is not the case everywhere. People are misdirecting their anger at overworked GPs and nurses and it's not surprising that they are all leaving - but people are also suffering and don't realise it's the fault of our government. The whole system needs a reform.

The best GP visit ever was one I had in France. Kind, listened to symptoms, asked how I was feeling psychologically being far from home. Asked what support I had and advised on nutrition. I had a chest infection. If all GP’s in this country were like them the UK would be a lot more healthy. I felt so much better after the visit.

I would love to have a walk in centre! My city has A&E, but no minor injuries unit or GP walk in centre. I think that’s part of the problem.. when people can’t get a GP appointment they jump to going to accident and emergency as there are no other options in between.

Our surgery put out a statement yes on FB on Mon they were swamped with people wanting throat swabs. They're short staffed due to covid. So please be patient

How long is a normal standard GP appointment allowed to last?
10 or 15 mins?

I just never know when I am taking too long or not using enough time.
Just very awkward ending.
I also dislike how the chairs are placed, with the desks to the side.

Our surgery put out a statement yes on FB on Mon they were swamped with people wanting throat swabs. They're short staffed due to covid. So please be patient

Some pharmacies are also having severe difficulty obtaining penicillin or amoxicillin because there's been a big jump in the number of prescriptions. Presumably some GPs are prescribing antibiotics to children with normal wintertime respiratory & throat infections at the request of anxious parents "just in case".

Presumably some GPs are prescribing antibiotics to children with normal wintertime respiratory & throat infections at the request of anxious parents "just in case".

Just in case parents assault them? Given how many parents don't consider the bigger picture or consider anyone beyond their won brats, it wouldn't surprise me.

The myopic view demanding antibiotics like sweets will backfire massively further down the line when people actually need them due them losing their potency as a result of overuse.

But, hey-ho, so long as pushy parents can brag they 'pushed' because their brats are more precious than other peoples brats .... 🙄

Society is entirely fucked. Decades of wilful dumbing-down has brought us here.

I’m in Sheffield.

The one walk in centre is heaving all the time. 6 hours waiting time. The one A and E dept is the same.

Havent been to the one minor injuries unit lately but that’s always swamped too.

l cannot conceive of a walk in centre with 2-3 hours waiting time.

All understanding I had for GPs was lost when one diagnosed DD with UTI at the age of 2 after checking literally just her throat and ears. We brought her in after 3 days of very high fever and a cough. No urine tests were ran when that diagnosis was set. And it was not a UTI.