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?

With respect OP, you’re only engaging with negativity. The majority of posters have been respectful but those comments are ignored by yourself. No wonder you feel hard done by if you are blind to kindness around you. Just an observation, I understand you have your reasons. But we are ALL in the same sinking boat, very often with way less in the bank and many times with much, much longer working hours. Yes the situation is dire, I completely agree. But you seem determined to make this is a negative thread rather than an informative one.

Apologies for the lack of clarity, that comment was aimed specifically at those demonstrating a sense of entitlement... Not those rightly asking why the system is under strain.

People saying "its not like it was pre covid" no, its not, that's because in those 3 years many people have become more unwell and demand has increased hugely (because of passage of time, because mental distress has sky rocketed, because of delayed diagnoses from the pandemic, because chronic illnesses have deteriorated due to reduced annual checks, because of long covid) and the number of staff working in healthcare has decreased (because some died, some left, some retired, some are unwell). The numbers simply don't add up any more and so damage limitation means fewer docs are trying to see more patients in less time. The pandemic forced people to use e-consulting and telephone consultations, which take less time meaning resources can be spread thinner... and it is not perfect but unfortunately damage limitation is the best we can hope for.
The general public have expectations which cannot be met by the resources available. This is not the fault of doctors, it is the fault of years of chronic underfunding.

I'm not blaming GPS for the state that it's all in, but (in my world at least - I'm a public sector employee, not a doctor) it's become a sort of heresy to criticise any doctors or nurses. Ever.

It's obvious how tired and stressed some of them are, but I don't think they should be beyond reproach.

Personally, as a patient, I recently received really shoddy, uncaring and dangerous care from a GP - one who I had previously respected and had actually asked specifically for. I think it's important to be able to criticise where needed, but if anyone even dares to make suggestions to the GPs when we work with them they get (sometimes quite literally) shouted down.

It's a complex problem 😔

GPs need to wake up and smell the coffee, yes you did an amazing job during covid and thank you very much, but now get back to normal and see your patients face to face that's what they want, and it's what they deserve.

@memorial what do you actually want us to do? What would make a difference?
I know that my surgery is doing lots of th things other people on this thread and others describe.

I also know several GPs personally. Lovely people. Multiple private jobs on the side of the 6 sessions a week they do in GP practice (are partners) Nice cars, nice houses, six figure earnings, kids in private school. They earn big money doing locum work for the stuff they are not contracted to do, because the NHS is so ridiculously inefficient.

NHS is not free, we pay NI, maybe not enough, but that's not on us.

It's all fucked

.

**

It feels impossible tho. I cannot get an appointment with my surgery. Please can you ask those 100 patients how they do?
I cant pre book a non urgent appointment. So I have to call at 8am. I get a voice message saying the system is too busy to even put me in a queue. And it hangs up on me. I try again and again and again. And never get through our get through after all appointments for the day are gone. I don't need an appointment that day....
I try to book on line. There are no slots
I try e consult and no one gets back to me.
If by some miracle I get through I have to wait for a phone call to see if I am worthy of an appointment. That call can be any time in the next 2 days. If I miss the call because maybe I am at work or driving or in the shower I have to start again.
So yes it literally is impossible.
Unless you are one of these mythical people who seem to know what to do.
I don't blame GPs I blame the system.
I am not sure why you started this thread as you are only replying to those who are critical and not those who are just genuinely baffled.

3 days working 14 hours a day = a full time job. Even though you may think it part time. If appts finish at 6, don’t forget admin goes on way way after.

”why can’t GPs go back to face to face after covid” they have - because demand has skyrocketed and there are less GPs there are more people clamouring for the few appts. The system has been slowly collapsing for years but pushed over the edge by covid. Hundreds of people phone a day for an appt; the only way to see the ones that need to be seen face to face from the other few hundred is telelphone triage. If you give the first 25 people who call an appt then they may not all need one and more people will go without and the situation would be even worse.

Great source...

I can't remember the last time I saw my GP, having to phone at 8 am for an appointment and usually being 60 odd in a queue means it's impossible to get in! For those of us that work, we can't always be on the phone for a same day appointment. Our surgery also runs the urgent care centre and are quite happy to signpost you there because they get paid more from the NHS to see you there than at the the surgery! It's about time GP's were under the NHS rather than private companies, you're over paid for the service you provide.

There are 161 GPs earning over £200k and yet a GP on this thread had the audacity to say that none of them earn over £100k!

@Ravageur I'm a GP, I know you're talking about signing off repeats. I just said on Emis web I can't do 200 in 20 minutes, which system do you use? Also you didn't answer my other question, where can I find these jobs that pay 100k for part time work?

1 - I never said I was a gp
2 - there are 10's of thousands of GPs in the country. I said you wouldn't find evidence that most earn 100k. 161 out of tens of thousands is a drop in the ocean

In other countries you can go directly to a specialist though. I've lived in the US, where you can book your own gynaecology appointment with a doctor of your choosing, you own rheumatology appointment, your own heart specialist. Here we need a referral and we get pot luck. What the hell happens if you need one and your visits are limited? More people will pile into A&E. Many older people have multiple health conditions and need to see their GP regularly. If you limit their appointments you are just going to get people with more conditions which need treatment at a later date, to the detriment to the NHS and the patient. Surely you know this. What this country needs to do is make more services self referral and action on the referral in a more timely manner.

@tocas - thanks for the reply. Makes sense. I’d heard explanations before that drew on some of that, but they never seemed to fully explain how it all happened so quickly as yours does.

where can I find these jobs that pay 100k for part time work?
That's easy, you get out of the city and go into a partnership that also has a pharmacy.

You have to wonder why 1) we would lie about what we earn 2) why you wouldn't expect a highly trained professional to earn a decent income and 3) if its so easy and well paid we aren't awash with bright young doctors desperate to be GPs? Eh?
You do understand that GP partners pay both employer and employee pension contributions so they have paid heavily for their pensions which are no longer as good as they once were. But if you had paid 1/3 of your income into a pension pot from age 24 then you too would have a decent pension...have you?

GP’s have never stopped seeing patients f2f but there are more people wanting an appointment than there are appointments available- more patients but less GP’s (my DH is one who has now left).

What are your suggestions on improving the number of GP’s so more patients can have appointments?

With absolute pleasure. Everyone who insists on an orthopaedic referral for their sore knee (but doesn't want to lose weight or do physio) can self refer with absolute pleasure. Of course the waits might go from I dunno 2 years to 10 but I would be super happy with this model of care. Likewise just about every speciality I can think off. I would be more than happy to just see the strep kids

That is infuriating!! As if GPs aren't stretched enough, I didn't realise so many people did this

I’m sorry you’re having such a shit time OP. I hope venting has helped.

Actually my profit share was just over 100k. Minus pension payments of 35k. That's 65k taxable income. For at least a 40 hr week but with all the management stuff closer to 50k. Is that too much for you?

It'd only work right across the board and that would never happen. Any exemptions would leave the situation worse for those left paying

This would be funny if it wasn’t so concerning that someone actually thinks an article about 2 doctors on 500k means most earn 100k plus

Most UCC are funded completely separately to GP funding. The individual GPs who work there may be getting paid more per hour because they are locums/salarieds but you are essentially talking rubbish.

Most newly qualified doctors don't want to be GPs.

Isn't that one of the most significant issues?