To be appalled by this new system at the GPS

[Comedycook]

Haven't had to go for a while but my DC needs to see a doctor. We used to call up in the morning to get a same day appointment or we could book in advance.. usually a two week wait. Called up this morning and told next available appointment is over a 4 week wait. I asked what happens if you need to someone more urgently. Was told that what happens is a paramedic will phone you and triage you over the phone. They then decide if you need to see a doctor. Wtf. I hate this stupid country.

There are so many conditions whereby you don't need urgent care but you also can't wait a month for help. Also, what about work and school. How do you know if you are going to be granted access to a doctor that day after your phone call from the paramedic? Do you keep your DC off school, do you take the day off work just in case they can see you?

As for myself I have several minor health niggles and in all honesty, it's not worth even trying to see a doctor so I just live with it. However, I obviously wouldn't do that when it comes to my DC.

To be fair, I felt sorry for the receptionist. No wonder so many people just turn up at A&E.

I ended up paying privately for a smear for this reason, I just couldn’t get through to book one for weeks and weeks. Really a shambles. I’ve moved to Babylon online GP now which is hugely better (for now) if you’re in London or Birmingham.

Are you aware that ‘urgent’ does not equal ‘emergency’. So something like cystitis or a potential chest infection I would class as urgent and be quite happy to speak to a medical professional to decide whether o needed to be seen that day or not.

Completely agree
9 out of 10 times things can adequately be dealt with by a paramedic,emergency care practitioner or pharmacist.
I must see a doctor is ridiculous.

I see your confusion OP, but paramedics work outside hospitals /ambulances too. My df’s care home employs a paramedic who sees each resident every week. I was a little taken aback by the terminology at first too.

Honestly, I think this is a great system in GP surgeries. Maybe it’s just me, but 9 times out of 10 when I need to access my GP surgery I don’t actually need to see a GP in person, or even, some of the time, speak to a GP- another medical professional can handle it. Our GP surgery has a paramedic, nurses, physio, mental health professional, and so on. I’ve never ever had an issue getting an appointment for myself or my children with a GP when it really was needed, even in the middle of the pandemic.

This is where my confusion came from. I thought that unless it was an emergency you'd have to wait for a month... therefore I was confused as to all what would happen if you needed to be seen soonish but your head wasn't hanging off

They're not. They're doing triage, far better than your average Drs receptionist is able to AND its giving them someone to pass it into, which they need, it's not within their remit to prioritise patients

A bit of a derail from the thread, but you don't have to have parental responsibility to take a child to the GP - as a nanny, I regularly take my charges to medical appointments, you need to have a signed letter from the parent for vaccinations but I've never been asked for one for a GP appointment and I always make it clear that I am not the child's parent.

It is shit, and I believe just as much time is wasted on triage episodes first online, then a call from a nurse, then a call from a registrar, then you need to make an in-person appointment...in the past you would have been in and out in 5 minutes. But this way their activity looks huge (when activity of any real value is low) and patients' time is wasted freely because it has no cost to the surgery.

I'd be happy to have the system your GP has, OP - with ours you're pretty much just told 'no appointments left, ring again tomorrow'.
Seeing them for an ear infection was absolutely awful, in the end it was 111 who arranged the appointment for me (after being on hold for 45 minutes).

The whole system needs re-jigging - we need to look at a system like some European countries use where seeing a GP is £20 or so, but if you have a chronic condition or you're a child you are exempt.
I'd happily pay that to actually be able to see someone when I'm ill.

I agree, it is pretty crap @Comedycook . Like you, I used to be able to get a doctor's appointment the same day. And a face to face appointment within probably 5 to 8 working days. You could turn up at the surgery at 8.15am to 8.20am (10 to 15 minutes before the phone lines opened,) and there'd be anything between 8 and 16 people in the queue at the door.

You would put your name down to be seen by a doctor and by 9.30am to 9.45am, pretty much everyone was seen. They had 2 doctors allocated for the people who turned up 8.15-8.20am who would be dedicate that first hour, to hour and a half, to the people who came to the surgery. There was never more than 20.

It's not like that anymore. You have to ring dead on the dot of 8:30am or dead on the dot of 2.00pm to get callback from the doctor. THAT is just a call back, not an appointment. The the doctor (when he/she calls) will decide if they need/want to see you. If you ring 30 seconds after 8.30am or 2.00pm, you'll be like 25th in the queue, and there is very strong chance that you won't get a call back. (And you will not be seen!0

Unfortunately, I think we have to accept this is the way it is now. It's never going to be the same. There is a shortage of GP's, the population of the country is a lot more than it was 20-25 years ago and beyond, and I don't think things are ever going to be same again.

It's like with everything. Some 35-40 years ago you used to be able to pick what Council house you wanted. If you were on the list even just a few weeks, and you told the council you liked a particular house, then three to four weeks later, you would be offered that house. (In MY county anyway.) This was pre 1990s... Now you're lucky if you get housed within five years. AND you have to have what you're given.

AND you used to be able to guarantee an NHS dentist anywhere and everywhere you went. Now you're lucky to get one within a 10 mile radius, and even then they probably turn away two out of three people that want to join, as they are at capacity with their patients.

A&E waiting time now is between 10 and 12 hours - sometimes more. In our hospital when I took our kids (once or twice when they were little, maybe 25 years ago,) we spent maybe two hours from start to finish in A & E. DH went back in 2006 I think ... He was only in 3 hours from start to finish.. I know people now who are in there between 12 and 16 hours now.

You can't get half the stuff you want anymore. Half the food is missing, and what IS there is really expensive. Haircuts at the hairdressers costs three times more, and food costs double. Electric and gas is between double and triple. Mortgages are becoming unaffordable, private rents have doubled, and nothing is the same.

Nothing ever lasts. Electrical items only ever last two to three years instead of the original 15 to 20 years+ they did years ago. Clothes and shoes only last a year or two. I have several items of clothing that have lasted 20 to 30 years. Now I would be lucky to get 20 to 30 months out of an item of clothing.

Tldr. Just a little bit of a rant, but yeah, I'm with you. It is SHIT, but I don't think it's going to change anytime soon. I think we're stuck with this now. I'm knocking on for 60 now and to be quite honest I'm glad I am in the early winter years of my life. I don't think I could live another 50-60 years with life as shit as it is right now. I feel sad and disillusioned and worried for the NHS, and if I will have enough money to live on as a pensioner. SO many pensions have tanked. What if mine does? What if the STATE pension does?

Dark times indeed.

Well exactly, this is how I imagine it would be at our surgery without a triage system. If you only have a certain number of GPs, and you allow non medically qualified patients (or receptionists) to decide whether it’s a GP, or other medical professional, they need to see, in person or otherwise, then the result is that more appointments with the GP are used unnecessarily, and there will be fewer appointments available for all.

So granny can lie there with a broken hip at the bottom of the stairs for 7 hours waiting for a paramedic... the same guy who is now supposed to be readily available to 'triage' a worried mum through the more urgent matter of her son's earache (something the GP/nurse should just be available for!). Am I understanding these latest shenanigans correctly?
I was married to a GP. He'd been one for 30-plus years. Believe me, they have the fucking time to see their patients. They really do. And nurses... nurses in GP practices have loads of time. There is so much more they can be shouldering. It is ridiculous that the service of GPs and nurses is being outsourced to paramedics. How absolutely absurd.

No, you’re not understanding it correctly. Because it’s not the same guy that is supposed to be picking granny up off the floor. It’s someone who happens to have the same job title but works in a GP surgery. A bit like a ‘doctor’ doesn’t have to just work in a hospital.

Obviously the nhs is falling apart although I have to say that the ambulance service worries me far more than GP appointments. A few years ago people would have been concerned about a ten or fifteen minute wait and now we’ve kind of all accepted thirty two hour waits (which effectively means there is no service at all). You’d think there would be protests but people seem to have just sleepwalked into this rubbish and (conveniently) the government have made it far more difficult to protest.

Our GP will call back…they don’t specify a time usually but they’re pretty flexible about calling after school hours. Then if it’s necessary they will see us face to face immediately or they will book us an appointment within a week. I prefer this because it’s more convenient for me to not have to go in, it’s nice and quiet in the waiting room and I imagine it saves GPs a lot of time.

WHAT IS A PARAMEDIC. 'A paramedic works autonomously as a generalist clinician across a range of healthcare settings, usually in emergency, primary or urgent care. They may also specialise in clinical practice, education, leadership or research.

No you aren't understanding at all.

They work at different places. The GP paramedic is not employed by the NHS or ambulance service. That's like expecting a tesco employee to jump on the till in Asda because there is a queue.

And just because your husband used to have loads of time doesn't mean that the majority of GPS do now. How ridiculous to think that one example from the past of reflective of a nationwide service.

Ok, so they are seeing my ds today. I have calmed down a bit! I still thinks it's a crap system but I think a lot was lost in translation. The whole paramedic thing massively confused me...made me think it was like 111 were they just tell you to go to A&E...I assumed that's what they'd do. I'm not great under stress so my first thought was, they will see him in a month or they will send to a&e. What a choice! It's very horrible when your DC needs help and you feel that every step is a battle

An average person does not know this

I remember being triaged by a medical receptionist for a Dr appointment in 2008 when I collapsed at work so it is nothing new. It has now moved to an AHP/ANP triaging and I am much happier with that. That is a healthcare professional with a degree and registered under a professional body with significant experience and a further masters degree in advanced clinical practice.

My Gp is excellent, I put my request on the online chat in the morning and they will get back to you that day. For example the last time I spoke to them they booked me in with the phleb, then once results were back GP called and we had a phone appointment. The old system would have had me book in with GP, then another appt for bloods then another appt to discuss. That would have been 3 wasted appointments for me and for them. I have had another appt for backpain which was triaged and I was booked directly in with the physio that week, again saving wasting a GP appt. We have a pediatric ANP and pediatric GP and my children have never not been seen on the day if required. If my generation is able to use the online triage system effectively it frees up the phone lines for people with cognitive impairment/elderly who can't.

Just wanting something done quickly does not make it "urgent" - very, very few things would actually fit that definition.
GPs have suffered for years because of the demands of "the worried well", so anything that properly prioritises access must be an improvement.
If only the cost of setting up and administering a payment system weren't so prohibitive, I'd say there are good arguments for asking people to pay for GP services - it would focus everyone's minds.

I agree for low level infections (for eg) requiring a prescription delivered remotely, the system works adequately and saves time/resources.

Fir that sort of thing perhaps pharmacists should be permitted to issue anti biotics?

However, a friend continually rang and asked her doctor’s surgery to be seen for a catalogue of worrying symptoms: abdominal pain, constipation, fatigue etc. She was continually given phone appointments and diagnosed with IBS, constipation, even anxiety. When eventually referred fior an MRI months later she was diagnosed with late stage bowel cancer and died weeks later.

I can’t help think if she’d been seen by a gp who knew her, had built up a relationship with her (remember when that was a thing!) and didn’t assume she was being neurotic or anxious then they may have been more cautious or thorough in investigating, or at least seen her in person in the early stages!

This system is a blunt tool in dire circumstances but it’s failing a lot of people.

We all have to learn new things when things change. Doesn’t mean the change is bad. As you’ll have read on this thread, plenty of other GP surgeries haven’t changed from the old system in response to greater pressure and not enough GPs to keep doing it the old way, and if you’d been registered with one of these you’d have been told to just call back tomorrow as no appointments were available.
Glad your dc is being seen, OP.

What else makes people confused is that a lot of these telephone consultation and triaging systems were brought in because of covid. A lot of people are left wondering why we are still doing it.

it's a 7.5 week wait for a routine appointment where I live. Very depressing and worrying. Especially for those not able to question what they're being told by a surgery and just be accepting of what they've been offered, which sometimes will be to their detriment health wise.

My parents were like that, I swear I prolonged their lives by being pro active on their behalf and getting them seen when they really needed to be.

Sad times.

Demand for GP appointments has gone up since covid. Apparently total appointments in the three-month period September to November were up by 10% or more in a lot of areas compared with 2019. That’s not taking into account covid vaccinations. At the same time, GPs and other medical professionals are burning out and reducing their working hours.