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?

Of course. I can do 25 tel appts in a half day and see 30% FTF. I could do maybe half - 2/3 of that FTF. Of course neither work load is safe or sustainable and no other countries have GPs who do this volume of work.

The advantage is that many more consultations can take place as many don’t need a f2f appointment. GP’s have never been closed but now there are more people wanting more appointments with less GP’s.

Point proven. I guess you've seen their appt system and know for a fact they aren't seeing anyone FTF. You are the problem

I did actually

What is so bad is it shows no sign of changing. How are the government addressing it?

l was talking to a neuro diversity nurse about my DD’s 3 year wait for ASD therapy. She told me that they can’t get therapists no matter how often they advertise, and this is in a big city. They all went back to Europe apparently.

Two points with this; I have a moral problem recruiting medical staff from developing countries, it almost feels imperialistic.

Secondly as we are now seeing International Medical Graduates who come to the UK to train as a GP are completing their training and returning home, entirely reasonable and some might say expected, but not the government who thought by training these graduates they could solve the GP recruitment problem.

I had a ridiculous situation recently. I got a phone call from a receptionist to advise me of a FTF with my named GP in 2 weeks. I hadn’t booked one, didn’t need one and she couldn’t explain what it was for. I wasn’t allowed to cancel it but after repeatedly asking it was changed to a phone call. All she’d tell me was it was “a routine face to face appointment with my GP”. I tried not to guffaw given the problems I had trying to get a GP to see my very ill child twice over the last couple of years.

I got the call and it was asking if I needed to be referred to a clinic. I said I’d been under it and discharged weeks back following a call with a different GP (that I’d waited weeks for at the time) and we ended the call.

That sort of utter batshittery is what’s taking precious time away from sick people in distress needing the expertise of highly trained doctors.

You ask what patients want GPs to do. I’d like to know what to want us to do.

I can guarantee next time I or my child actually needs a GP they won’t be there and we’ll back to urgent care via 111, which at least takes hours or days not weeks on end.

Why are more people suddenly wanting appointments though? We’ve been ‘unlocked’ for 18 months. Surely the oral of the demand must have passed?

The issue is newly qualified Drs don’t want to be GPS, it’s seen as the boring choice, those who choose it are often mocked (light heartedly but still it shows the sentiment)

It needs to be incentivised more so than it is now.

The fact is a lot of gp work is taken up by acopic patients, who cannot handle a simple cold without a visit to the doctor to "get it checked", this also goes for parents who take their kid every time they have a temp.
The combination of acopic patients + ageing population with more complex long term health problems + fewer GPS + sense of entitlement exhibited by so many people (as evidenced on this thread) is causing doctors to walk for the sake of their sanity.
On this thread you can sense the vitriol towards healthcare professionals. Something needs to change, I agree OP.

I work for a GP practice. We have two sites - one with 12000 patients and one with 2500. I am currently based at the smaller one.

We do mainly book on the day appts (which I know infuriate people as they have to ring at 8am to be seen that day and they can't get through) but we do do quite a few advance booking appointments.

In November, 52 of those pre booked appointments - the patients just didn't turn up! Didn't cancel. It didn't' snow when we would expect some people to DNA.

And then people complain that we have no appointments and blame the surgery!

I'm not, nor have I ever been (well v rarely) dissatisfied with the individual treatment I get. The system my surgery uses seems the most efficient under the circumstances. It's the bloody circumstances you and your patients have to suffer that I strongly, strongly dislike and blame.

would a relaxation on the rules of overseas doctors help more quickly? By that , I don't mean a lowering of standards, I mean encouragement +through general salary increase or whatever) to come here temporarily. This would/ May cause the country they normally live in problems, I guess. But what else are we able to do in the short (5 to 8years) until we can grow our own?

Oh,and we should reinstate the bursary for nurses at university.

YANBU , however as far as our GP is concerned they just haven’t moved on since Covid , the main aim seems to be keeping people out of the surgery , it’s impossible to get a face to face appt , and actually quite difficult to get a phone call they seem to like text . It’s all on the day appts , you cannot book a few weeks ahead even for a phone appt so unless you are free all day to answer a call there is no point in trying to book one .

It was all working fine before Covid now it's just endless excuses, GPs need to stop complaining and get back to doing their job probably for their patients.

Yup... I get it which is why I am a totally broken GP getting out to work in a minimum wage job that I'm hoping won't kill me... anyone that thinks thats an exaggeration... its not..if I don't keel over physically, my declining mental health will do it. I have done the job for 20 years +. I no longer feel safe doing it and I am done with taking the abuse and shit that goes with it. I work part time... I earn far far far less than the 100k stated by someone upthread as do my full time colleagues. My day is 7am - 9pm... no breaks, never less than 4 things on the go, most of which could have serious adverse consequences if I drop a ball... even simply signing off a prescription if I mis read it, don't check it against the notes etc.. the demand is a tidal wave over us on one side and the lack of support from secondary care is like looking over a cliff I'm being pushed towards on the other.. if I refer as someone needs specialist care.. and that's not available for 1yr + , I am magically supposed to provide that care while waiting... only I'm not a specialist... I haven't trained for 8 years in something that represents 1/20 of the stuff I see, but it's my fault if I can't do it.... I'm done... I'm sorry...

I am always extremely apologetic and thankful on the occasions I have had genuine cause for taking up a doctor’s appointment. I’m sorry you are on the receiving end of abuse from people who don’t understand not to spite the person who is trying to help you. I feel that since Covid, people have become very short tempered and rude. There are endless reasons for this, the country is well and truly at its knees. But there are many people like myself who truly just want the NHS fixed, who will literally try everything they can to avoid taking up their time. But it’s not working how it is now, due to reasons entirely out of your control. FWIW I want you to know you are not alone. Teachers are also working around the clock as they can now be reached at all hours of the day. My husband is an HGV driver, working 16 hours a day, sometimes delivering 6 tonnes of goods with a hernia. He can barely walk up the stairs some evenings and after a 7 hour “break” has to get up and do it all over again. Family members who work in post offices and local corner shops are reporting daily abuse by agitated customers who are sick to death of the state of the country. This is everywhere. It’s absolutely sickening and we are all holding on for dear life, many choosing whether to eat or heat their homes. It’s a shitty, shitty existence.

Thank you for your hard work. Thank you to everyone who is working their asses off right now just to stay afloat.

Well at least you are earning £100,000 and have a massive pension, which you would never get in the private sector. Stop complaining and get on with your job.

And this is one of the main reasons I'm done... stupidity and a complete lack of any understanding of the shit storm the NHS is in...

You're telling people not to blame GPs for falling standards of care (completely fair - the fault is underfunding etc), but then you're blaming patients instead?

No I'm not... and never have done..

We’ve found the daily mail reader

You're not being unreasonable really but the fact is that it is near impossible to see a GP face to face nowadays and I'm sorry you can't blame people for being angry about that. All the same GPs are still at my practice that were there before Covid and yet you cannot see them face to face at all. That is hard to understand

I can sympathise with the burn out and the constant fielding of angry clients. I work in education. Schools are a shitshow at the moment. Social care and CAMHS are also on their knees. So I honestly do get it.

But I still don’t understand why since the pandemic GPs aren’t seeing people face to face. Is it wholly an ‘efficiency’ thing, that you can see more patients?

My GP practice used to be heaving. I went in to drop off a sample last week and I was the only person there. I can only get telephone appointments and they feel rushed and aren’t adequate for a lot of health issues.

How did it all get so bad, so quickly?

It's actually very frightening to live at the moment. I have stopped using health care completely. I should have discussed HRT with my GP but I haven't because I can't face trying to.
Similarly my DS needs help with his severe acne but again we haven't even tried. Because both matters seem very trivial in the scheme of things.
But they aren't really because our mental health suffers.
And my other DS has had mental health issues for years and we have just given up trying to get him.help. so we muddle on as best we can.
And i truly dont understand how people get 3 calls a week etc. It must be their full time job to call the surgery I don't have the emotional strength to even try.