State of the NHS & GPs

[ChocMarshmallows]

AIBU to worry about the state of the NHS and accessing GPs

It used to be hard to get through to the surgery, with long cues on the phone to get an appointment.

But now .... What kind of new hell is this?

We are no longer allowed to phone the surgery and have to book appointments online. The online portal opens at 8am and shuts within a couple of minutes until the next day.

If u r lucky enough to get a GP appointment after the triage, they r no help, won't prescribe anything because it's all too costly, and won't do any tests for the same reason

My son (age 11) hasn't been to the GP since he was about 5. Finally got him an appointment as he's really ill and we've had various probs over the year which are concerning me. Asked for a blood test because of these problems, and told 'we don't do them anymore unless X, y, z' and although he's really poorly and hasn't had antibiotics for years, he can't have them now because 'we don't give them anymore'.

What is the point of GPs now if you can't access them and they do nothing.

Don't get me started on A&E - a friends waited 18 HOURS to be seen last week

My mum died 2 years ago in an NHS hospital, pretty sure lack of staff, no consistent care, a too long wait time for operation (too late she died before it could happen) contributed.

It's scary and I want this government out NOW before it becomes a case of 'only those rich enough can access health care and expect to live a long healthy life'.

That's really awful for you. It seems like no consistency, I know I am very lucky but my surgery are always contactable and I have always managed to get at least a telephone appt on the same day when I ring them. Maybe because I live in a small town? I think it really depends where you are and how it's run, I think the whole system needs a lot more cohesion and probably a total overhaul. I think brexit really hasn't helped the a&e situation especially as it really does seem like there's been an exodus of staff. Hope your son gets better soon x

Completely agree with the sentiment of getting the current government out now and really hoping the next are better, but improvements are going to take several years to see from when changes are made (increasing qualified staffing numbers/reducing experienced staff from wanting to move abroad...).

In terms of antibiotics however it's not a money thing. We now have antibiotic stewardship so they are more likely to only be prescribed when they will be of benefit. For example less than 36% of patients presenting with a two week history of cough, bringing up gunky sputum, fever, feel short of breath and unwell, breathing quickly, high heart rate, crackly chest when you listen to it with a steth; will actually have a pneumonia that would be benefitted by antibiotics (i've just written a paper on this for my masters). Considering that most examinations will be normal findings/normal sounding chest etc then the chance of antibiotics being a benefit drops significantly.

Prescribing at a surgery has little to do with cost, it doesn't cost the GP/surgery a penny to prescribe so that's not a consideration at all. There is however a pressure to prescribe non-branded medications (which will work the same as it's the same drug just a different package etc) but that's it.

In terms of asking for blood tests, it's not a case of ask and they will be given, they're only undertaken if they're required to rule in/out a specific diagnosis. If in the consultation it doesn't sound like a chronic condition and there's no suspicion of an underlying disease then general blood tests are unlikely to help, the results won't have a context, it really needs to be something like "i'm concerned this could be a thyroid problem, therefore I'm going to order x tests to screen for this". If the doctor wasn't at all concerned about a thyroid problem for the history and exam, but now the randomly selected blood tests come back with slightly abnormal results (compared against a standard for the population) then you may end up now undertaking a whole load of unnecessary treatments/medications which all have side effects, chasing this slight abnormal to textbook result. When actually it could just a normal level for that patient, or a fluctuation that would have corrected itself and nothing to do with their recent illness.

Put in a complaint to the Practice Manager. Ours has gone to online only but the forms can be put in all day long and they triage you and get you in ASAP after that.

I've been seen same day, next day or within the week as necessary.

YABU to start yet another thread about this. It's not all surgeries.

As with all these threads, it is so dependent on how your own GP sets up their services. Some are terrible, some are good. Honestly, the last few weeks DH and I have both needed GP access, and referrals and they have been efficient and timely. Also requesting same day emergency prescriptions, phoned late morning, picked up them that day. So much so, we were in fact, amazed, at the good service we got. My brother also recently diagnosed with prostate cancer, following routine blood test, excellent and quick care. All NHS.

Me and DC have still been able to get a same day appointment as and when required.

Some surgeries are definitely better than others. Can you move to a different one?

It’s important to recognise that this is your experience of your surgery. Mine is very different, I’m in Wales in case that matters.

our surgery open their lines at 8 and have a call back function so you hold, your place in the queue without having to wait on the phone. I always get called back within the hour and we go from there. On the last 2 occasions I have seen a Dr or a nurse in the same day, had whatever was needed prescribed and a form for a blood test issued. The pharmacy dispensed the items within 15 minutes and I could book to have the bloods taken at a convenient time for me at our local hospital.

I can reorder medication online and pick it up from the 24 machine on the side of my nominated pharmacy.

can you look to change surgeries @ChocMarshmallows

I also haven't seen these issues. I had been seeing my gp every 6 weeks due to headaches. Changed my meds and did blood test.

Is it possible to change your gp?

You're conflating two separate issues.

The GP will have refused your requested tests and antibiotics because you've read something online and those tests and antibiotics aren't actually indicated. Not because they are too expensive.

What condition did you think your son has? What tests?

What @SleepyRich says is bang on.

sorry you’ve had a troublesome time and that your sons poorly but abx will only be px if indicated and blood tests only requested if needed, they can’t just “do a catch all” in a blood test the dr would have to select what tests they want run on the sample.

Similar to my surgery in London for adults.

However for children you have to phone up for them if they need an appointment to see someone. If they need a vaccination you can send a message from the online form.

You can also make it very clear that you don't want a face-to-face appointment e.g. if I want a referral, or you actually need one if you need to be examined.

Ive just received a letter from my GP surgery saying g the doctors there have resigned from their NHS contract. The reason? Only 2 GP's left when there used to be 6.they have tried and couldn't recruit any more GP's. Very sad so now who knows where all the patients will have to go to access a GP.

A huge reason why GPs are retiring or leaving is because of patients like OP and the myriad other posts like this.

A GP is a highly trained professional (5/6 years medical school + 5 years postgraduate training). They are not a McDonald's. You go for a medical assessment, not to order tests and medications off a menu.

We had routine bloods and blood pressure check a few days ago. Within a few hours I had a text to say my cholesterol is really high. I rang the surgery first thing next morning for a phone consultation. The earliest one is over 3 weeks away.
Our doctors are fab, but this situation is crazy.
I know they are overworked etc, but it's scary
I'm glad some people are having good experiences, but seems unfair it being so hit and miss.

Can you move surgeries?

What’s wrong with him? I can’t really decide whether you’re BU about that one, more detail needed.

I think it depends where you live. We have no problem seeing GP. I recently had my midwife appointment and saw information note that in January people missed 55 GP appointments and 67 nurse appointments, patients should take blame too for blocking the queues. You can't clone doctors and nurses.

Not my experience at all. Once in January and one this month, I have emailed my surgery, explained the issue, been called back and been seen same afternoon.

It's much easier to see my gp now. No fighting to get through on the phone, just email in, explain the issue and ask for an appt. They call me back.

I go to my gp about once a decade so twice in four weeks is unheard of for me. But dealt with quickly & politely.

Considering we hardly ever use the GP, I think this is a bit unfair! DC hasn't seen the gp in nearly 6 yrs. That's why I thought he would be a bit more attentive. I asked for blood tests because DS has been missing school with fever's at least once a month and now raising to once a week over the last 2 years. I'm worried. I fear an underlying condition and thought blood tests might rule that out. Not sure what's so bad about me worrying about my son and raising it with a GP who I thought would do something not just turn as away hoping we won't be back for another 6 yrs.

I've just finished a clinic in general practice. (Not a GP). The clinics are heaving, absolutely heaving. Fully booked for weeks. The triage nurse was still ploughing through the mornings calls when I left at three. She's leaving next week. Another nurse retired early last week. Two GP's and an ANP at the end of last year all gone.
Was just asked to refer someone to a dietitian, I did so knowing there's at least a two year wait.
It's shite.

Glad to hear some people are having good experiences.

We used to have an excellent GP but moved to a new area 2 years ago and this GP is therefore fairly new to us. The DC I'm talking about in this thread (DS1) hasn't seen any gp for 6 years and this is the first time he's been to this new surgery. I've been to this surgery once since we registered and my other DC (DS2) has been once. Each time has been hard to get an appointment and although they did support me and offer good care, they were useless with DS2 and now are being useless with DS1. We are not a family that use the GP much.

This is somewhat how it feels round here.

I'm a GP, and not sure I agree with some of your statements. GPs are completely overwhelmed right now, we are completely unable to keep up with the demand, despite our best efforts.

Often (much of the time) we do not actually know the cost of prescriptions, some things are cheap, others not so much. But that is never something that would influence a prescribing decision.

Regarding antibiotics, we absolutely do use them, but only when they are needed. Many infections are self-limiting, and will clear up on their own. Antimicrobial stewardship is really important to stop bacteria spreading that are resistant to antibiotics, so most GPs are more cautious now about when to prescribe.

Blood tests are not always needed, and your GP may not have felt like anything useful would have come from taking blood.

I assume the GP gave you some advice at least regarding your sons symptoms? However, it is always possible to see another GP and get a second opinion.

Your son is off school once a week with fevers and has been for 2 years and this is the first time you've sought medical attention?

No, no advice given. We have asked to see another gp tomorrow as I'm v concerned about my son.