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?

Completely agree. We need to go the way of European countries with a system of insurance rather than free at point of delivery. With private top ups allowed and encouraged. But NHS is such a sacred cow that no one will have the guts to rip it apart and start from a clean slate.
Oh, and there is no lack of GPs - there lack of NHS GPs. Plenty of services have proliferated in recent years and seeing a private GP on the same or next day is not an issue. Something is broken and throwing money at a broken system won’t fix it.

I don't mind normally but I've been saying something is wrong with my DD for weeks she had to go to a&e last night and have a chest x-ray and was prescribed antibiotics the GP didn't examine her properly didn't do chest auscultation or peak flow. He just said she's normally healthy and it's viral. I also knew I had an infection after a LLETZ procedure , I was dismissed I had to beg for vaginal swabs and yes it turns out I did have an infection. I'm a HCP so have some medical knowledge if they are like that with me what are they like with the general public? It's the dismissive attitude in primary care which is really disheartening. I'm wondering how many are being failed and dying because of it.

I'm a terrible pushy patient because being quiet gets you nowhere.

The Tories want it to fail. I'm not in the medical profession myself but have several family members who are and they have been saying for years that they and their colleagues feel as though this is a deliberate attempt to sabotage the NHS so that they can justify bringing in private contracts. And we all know who will benefit from that! It's so sad that people don't realise the impact of the decisions they make at the ballot box.

They need to change the way gps operate. Any gap should be able to see any patient.

Since signing up to my local I can’t get an appointment for love nor money. Previously when I was in the area as ‘visiting’ I could always get an appointment somewhere same day.

I don’t know if this is because they are paid differently or if being free meant I could call around. But there are appointments. Just not where we need them seemingly.

90% of diabetes is now managed in primary care likewise numerous other chronic conditions prev managed in sec care. This is part of the problem.

The fact that gps get less than an hours training for some mentsl hralrh conditions angers me.the way those conditions are treated is down to the system and the god themselves.
We have a major adult mental health crisis and I don't think it's got for purpose on how to treat them.this is something god fail time and time again on.

I’ll be honest. I am an assistant manager in a GP practice. I’ve seen a lot in my 20 years in the same Surgery.
I think a big issue is GP contracts. I’m my humble opinion there are a lot of ‘box ticking’ exercises to meet quotas and get extra money. I am sick to the back teeth of phoning patients and trying to get them to have their Covid/flu/pneumonia and shingles jabs in order to make money for our partners.
I believe patient care is slipping and you see the same names calling for telephone appointments, day in day out. The people who need to be seen are falling through the cracks as it’s seems to be whomever shouts loudest, gets seen.
Admin staff are being asked to triage patients on barely over minimum wage and take abuse daily.
GP partners work hard but they are well paid, it’s the elderly/infirm or timid patients I feel for as well as the front line staff.

Fat fingers sorry for typos before someone eats me!

That has been my experience as well.

There may be some flaws with Medicare, as with all systems, but my experience of healthcare in Australia has only ever been positive.

Ha autocorrect changed gp to god!

Get out of the practice, whether you have to be bought out, close it or whatever.

Then get employed as a private GP.

This country is fucked. No fixing it as it won't be admitted. The public draw bloody rainbows and the government just pretend it isn't happening.

On the other hand, there are plenty of intelligent 18 year olds who have just got 4 A stars at A level and been told to fuck off by all the medical schools they applied to. I know one working in a min wage job whilst she reapplies for next year! I know it takes ages to train them. But at least in 8yrs time, we would have more docs - if we actually bothered to train the ones who are desperate to be trained! In the meantime, we need to bribe experienced docs in from abroad.

A spectacular waste of my (new GP surgery) time is insisting I come in F2F before they’ll dispense my meds.

The ones that are done under Shared Care with CMHT, who I’m also having long term therapy with and have a CPN. Every CMHT appointment other than therapy is over the phone. Every 12 weeks with Psych, every 4 weeks with CPN.

There is literally fuck all the GP can do for me other than dispense my meds in a timely fashion with the correct doses/amounts on.

In the last 5 months, I’ve seen 5 different GPs. So there’s no continuity of care anyway, they also have no power to change my meds. I get grilled each time and frankly I’m not willing to discuss my issues, the first two times I tried, the judgey attitude of “why are you taking these” (because a Psych prescribed them?) unless they fancy block booking me an afternoon. And even then they’d get the Spark Notes version.

I have to run the gauntlet of calling at 8am (whilst I’m commuting) for a same day appointment (pre bookable doesn’t exist here, not even when the GPs are insisting on seeing me). 50+ calls every morning, for 10 days - I have to start trying to get an app 2 weeks before it’s actually due and even then, I haven’t managed it.

Result? I’ve been without my meds every month, for anywhere between 3-10 days. They have horrific withdrawal effects due to a short half life. It’s dangerous. This immediately impacts my ability to function and has had a snowball effect, to the point I’m now signed off work as I had the Crisis Team out last week.

Not once in 3.5 years of being under CMHT/previous GP have I ever gone even a day without my meds. It’s been constant here.

And no, the pharmacy can’t give me a few because they’re controlled drugs. Receptionists don’t seem to grasp that.

CMHT are pissed off as they’ve now had to start writing (as in hand writing) my scripts and posting them to the pharmacy as of this month.

And their SM is constantly wanging on about “have patience” “we are short staffed”.

It’s hard to have patience when you’re in withdrawal from GABA medications/have no beta blockers/no antipsychotics so you aren’t sleeping/shaking/sweating/brain zaps/HR of over 150/etc. I don’t take them for fucking fun.

Tories cut off ovdr 30% of our medical professionals that came from other countries.

Based on my purely anecdotal evidence I think in a few years we are going to have a surge in GPS but a lack of doctors in secondary care, or at least in my area.

I work as a nurse in an emergency portal for the NHS and 90% of junior doctors don’t want to do speciality training and want to do GP training. GP training appeals to them because of the work life balance, lack of stress compared to other specialities they are interest in, shorter training period and not having to fight for competitive roles. They also speak highly of their GP placements despite there being a lot of demand on the service.

GP shouldn't be asking you about your psychiatric medications if you are under CMHT. It's not their speciality so they should just butt out.

I think it’s all coming from the selling off of the NHS over the years.
Our surgery (bought by a multi-practice business), has bought in a private company’s system from Sweden called ‘Doctorin’ (oh the irony - indoctrination), to get everyone doing everything through an app!!
I refuse to do it.

My private medical data is not being put online - protected or otherwise! A private company is NOT the NHS and their aim is to turn a high profit which surely then cannot be in the public interest 🤔 .

I also don’t want my hospital records being held by the private company ‘Doctor Doctor’ but the hospital made a massive deal out of it when I asked them to remove from the system.

To improve the GP system, I think we need many more but smaller practices. More choice of where we go and less focus on private profits!

In our market town there are about 4 or 5 doctors rotating for 7000 people!
It’s crazy! And the majority of those appointments are not Face to Face! You are not allowed to book an appointment to see a GP without having a phone call first. If they employed an extra receptionist, they could easily triage between GP’s, nurses and HCA’s without the need to phone call you back.

@Peedoffo I told the last one to “stay in his fucking lane” - I can’t remember the last time I spoke to anyone that way, but I’d had 10 days of withdrawal at this point, and he was talking at me like I was a junkie. No. I have CPTSD and ADHD. I have been functioning at a very high level for the last few years precisely because I have the correct combination of medications, which I take at the same time of morning and night every day. I have a routine. I have therapy.

They’ve got a very strongly worded complaint coming their way, which my friend who is a GP in another county is helping me write.

Friend a GP has been off with covid for the third time. Saw her today she looks so ill but will be in work tomorrow. It's bloody awful.

Friend needs a hip operation waiting list three years. Her mum offered to pay private for her. Waiting list is now 18 months. The private sector here is now faltering

Poor you, OP. I think doctors have had such a shit time of it, even more since the pandemic. Plus, lots of bullshit and spin put about by Tories, here and elsewhere, to justify privatisation of parts. So demoralising.

I'd be so disappointed if my wonderful assistant PM wrote this. Surely you know the money made is used to pay wages and bills and its only what's left over is for the partners.
Interestingly I have just done a reference for DD uni accommodation and had to provide 3 years tax returns. My profit share hasn't gone up at all in 3 years. That's because any increased income has gone on increased bills and above recommended staff increases. Perhaps you need a different job eh.

This was what it was like last time the Tories were in power. I remember it distinctly because of a family member who was waiting over 18 months for a hip replacement. Labour improved the NHS but it has been run down again with austerity, which we are back in again.

I can’t get my gp to phone me back despite booking a phone appointment online on Thursday and Friday. I am choking on and vomiting mucus from what I suspect is a chest infection and everything is moving up and down like I’m at sea which suggests an inner ear problem. Something major needs to be done even if just to allow people to speak to GPs where the GP can then decide how serious it is.

Thanks for your hard work. I know there is a massive shortage, there is a massive shortage in most professions.
I really think we should all be taking more responsibility for our health and wellbeing. We eat junk, we don’t exercise, then we blame it all on the tories, the doctors and everyone else. We all need to take some responsibility for ourselves. We can’t blame everything on others.

I don't think most people are frustrated at individual GPs but at the system. The NHS is costing itself more money by making it so difficult for patients to access GP services. Many early diagnoses will be missed and then end up costing more. The lack of GPs is entirely down to the government of course but there are things that GP practices could manage better, notably the appontments system.

At my practice, if you can't endlessly redial for an hour or more at 8.30 you are stuffed as you will have missed all the appointments. There is no facility for making an advance appointment, eg for an ongoing condition or something that is a nagging worry rather than an emergency. Every single person has to call at 8.30, which just makes it impossible to get through. Genuinely sick people are missing treatment or being forced to go to A&E because they lost the fastest finger first battle.

DH and I are teachers. At 8.45 we are in front of classes of pupils. If we can't get through in the first 15 minutes (highly unlikely as our practice only allows 15 in the queue then cuts you off and tells you to try later) then we can't stay on the phone. Finally got an appointment after nearly three weeks of trying to follow up an ultrasound scan for DC. Turns out an urgent referral had been missed which would have been picked up much sooner if we had only been able to get an appointment. There must be a fairer way so that appointments are not only available to those who have the luxury of continuous access to a phone.

The last few GPs I've seen for my DC's ongoing and hard-to-diagnose condition have been fabulous and really gone out of their way to help. It's just the difficulty of getting to see one.

Its not just the GPs, the whole system is weird to me. British GPs are doing far more more than GPs in /at least some/ other countries. Lots of what they do would be done by a specilist doctor elsewhere plus there can be separate GPs for adults and children.