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?

My GP is a bit of an odd case I suspect as it's linked to a work site which is empty for many months of the year. In those months I used to be able to walk in any day and get an appt (and obviously less availability during the busy season) Not anymore. I now get a phone call back the day after. Maybe there is some huge reason but it's hard to work out what it is.

It would help if the government upped the number of student medical school places. They've redcued them by 10% this year. Unbelievable.
My DS and everyone else is jumping through ridiculous hoops to try to become a doctor. God knows why he is bothering when he could walk into any other degree course without any issue at all.
And he will leave with c 80k debt and be treated like shit and paid a pittance for years. He is exactly the right sort of person to be a doctor. But the odds on him being accepted are very very slim.

YANBU In the past year (Oct to Oct) there has been a drop of 389 GPs (in addition to 3000+ vacancies the government identified lat year), each GP nationally (England) has 2260 patients on their list, so over 800k patients are now without a GP (with the 3000 vacancies it's more like 8 million ....I'll say that again 8million people in England do not have a GP).

General practice is in total freefall, GPs are handing back contracts and walking away from the profession, producing an unstoppable downward spiral.

Training a GP takes 10 years post A levels so there is no quick fix even if we trebled the number of students in Medical School we wouldn't see the impact for many years.

My job is in a gp surgery. Times are tough I know. But 200 scripts? That takes 20 mins max assuming 50 x 4 per shift. No gp I ever worked with looked at them either. That's someone else's job (prescription clerk etc)

plus all my gps work part time all earning 100k approx. So i am sorry. But also not sorry. Sorry.

No, because the most vulnerable people/lowest earners are going to be unable to get GP appointments. They're already the ones who get shit on with prescription payments or lack of sick pay etc.

Fine people who don't attend. Don't charge people upfront.

I spent three months in a Welsh hospital this summer, it was an eye-opening experience. The NHS is so badly run it's unbelievable. That is why they have no money. They also have a significant percentage of staff (5% ish) who should be sacked the old saying of you have to kill someone to get sacked and even the they would give you a second chance is very true. Since coming out I've had nothing but problems with my own doctors surgery, even trying to get the prescription that the hospital sent me out with refilled took 8 trips back and forth, they also never apologize when they mess things up. They have a large sigh about the receptionist about not tolerating abuse, I feel like making one for the patient's saying we will not tolerate incompetence

Very hard not to take it personally when I am having staff in tears and keeping daily. When we have daily vicious complaints and abuse. When you read the posts on here.
I have an incredibly thick skin but I am burnt out and stressed but I know if I leave my practice will likely close.

Why would it take 5/8 years to have more GPs? Loads of doctors in other countries (India most obvious example) could come and work in the UK in the next 6 months!

There is a lot of non-EU immigration into the NHS. I don't understand why that's not increasing the number of GPS too.

Is it Government not funding the GP demand? Is it practices not wanting to recruit from abroad? Is there a visa/immigration issue? Some sort of regulatory barrier?

Point proven.

Examples - visited A&E, had a serious wound. A&E was bursting at the seams, moved to urgent care. X-rayed, seen by orthopaedics and stitched up within 2 hours. But lots of very busy staff.

Went back for fracture clinic two weeks later. 5 members of staff, I was the only patient. Frazzled doctor (I’m assuming) came in from A&E asking if the fracture clinic staff could see a man who’d been waiting in A&E 13 hours with his fingernail (or something to that effect) Doctor was just desperately trying to get that man help. Response from relaxed, clearly not rushed fracture clinic staff was “Sorry got to follow procedure, can’t help” the doctor was clearly asking for a hand.

Used 111 for out of hours twice now. I’ve been sent to a local emergency care set up at a leisure centre. Twice I’ve walked straight in, been the only one there, been seen immediately and left (Still the only one there). Receptionist and doctor there. Receptionist always ready for a chat and tells me it’s always quiet. Honestly so much easier than the GP. Appeared under utilised. GP is rammed always.

You have to be registered as a GP with the GMC and on the performers list. It's not that easy just to come. Even if they wanted to which they don't.

Being unable to access healthcare which other countries just take for granted, means people have every right to complain. Unless the NHS is reformed, not by flinging even more money at it, but changing it to be like European systems it will continue to fail and people will continue to complain.

I don’t blame my GP for the lack of appointments but I do blame the surgery for their bloody awful system meaning you can redial in excess of 200 times each morning and not get through. Then they stop answering the phone after 8.10am when all the appointments have gone.

I have a really good GP practice and have had good care throughout the pandemic and after. However, my gp practice is at breaking point. From what I can gather from them there is a lot of unnecessary paperwork that takes time plus, of course, all the patients not getting timely secondary care and the issue with social care as well. More funding to employ more staff would undoubtedly help but also allowing practices to recruit via immigration to facilitate the needs of the NHS (given how long it takes to train GPs.) I can't praise my GPs enough. It might be more difficult to get through to them and appointments sparser but emergency care has been superb and I've always managed to get the help I need (I have several long term conditions.)

So the UK's doctors are putting a barrier in the way of overseas doctors coming to cover the gap in GP numbers while the UK increases its trainee numbers?

I'm actually shocked. Perhaps when you have recovered from your illness you can start working from the inside on this?

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.

My GP seem to be behaving as if we are still in lockdown, you have to have an e consultation before you're allowed a face to face visit, it's pathetic.

Both the general public and health care workers need to be allowed to complain.

Otherwise, as happened to dm, the patient will be blamed for not coming in earlier when a simpler solution could have been sought. Gps are struggling and patient are struggling. Don't blame the patient but the system.

@Ravageur Do you have any vacancies at your practice, I'm tempted to apply? I've never seen anyone pay full time salaried GPs 100k let alone part time, it sounds like I'm working in the wrong practice. Also which computer system do you have that enables you to do 200 scripts in 20 minutes?? We have Emis web which definitely does not let us do that.

Totally agree it isn't the GPS fault and they shouldn't be penalised for it. But I do have a question if anyone knows the answer.. why are GPS still seeing less patients face to face? Is it because of precaution with COVID still?

I've needed a couple of appointments over the last 6 months or so and they have been over the phone. Doesn't bother me but I definitely know that pre covid any appointments at my GP surgery were in person. I was a bit disappointed as I needed an appointment for something that was physically on my body and I was told to take a picture and send it over. I was given medication which to be fair worked great so no complaints. But honestly at the time I was scared that no professionals had actually seen the problem in person so nobody could be sure what it was.

Are GPs able to get through more patient appointments when they are not face to face but over the phone? If so then I have no problem with it, but just curious more than anything as to why things haven't returned to "normal" systems.

@HappyHolidai these countries (which are considerably poorer than ours and have much greater health care staff deficits) have invested in training these staff. It is highly unethical to poach them from other, lower income countries.

Used 111 for out of hours twice now. I’ve been sent to a local emergency care set up at a leisure centre. Twice I’ve walked straight in, been the only one there, been seen immediately and left (Still the only one there). Receptionist and doctor there. Receptionist always ready for a chat and tells me it’s always quiet. Honestly so much easier than the GP. Appeared under utilised. GP is rammed always

l used 111 about 7 weeks ago. It was an emergency. ‘Adoctor will call back within 2 hours’ 12 hours later the doctor called and made me an emergency appointment at the local walk in.

Get to walk in which is heaving at 10.00 am in the morning. Wait hour and half to see my emergency booked appointment.

Not everywhere is the same.

Doctors? Are you joking? Government!
And FWIW I have been working on the inside for over 20 years both inside health boards and GP unions. As have many of my colleagues.
I'm sure it won't surprise you that government policy wins every time.

No fair point. I find my local emergency care much easier to access than the GP. It’s almost worth waiting until the weekend to be seen.

you didn’t answer another PP when they asked what you’d actually like us to do, just continued going on about increased demand, and how secondary care has stalled so primary is having to pick up the slack - seems to me that people are resorting to rocking up at A&E and blocking it all up precisely BECAUSE they can’t access primary care.

Sounds like you resent the public for getting ill and having the audacity to want medical care when that happens.