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.

YANBU
Phone triage in itself is a good thing, but having to wait an indefinite time for a call back to find out if you need to take the day off or not is not good. That's not a system that works well.
Here I can call and a nurse answers the phone to triage over the phone, or I can go on the app and do an online consult with a nurse who can arrange an appointment if needed, or consult a doctor and get a prescription/treatment advice. Or if I know for sure my issue is urgent I can call the urgent number and get a same day appointment.

But a working system requires better and more appropriate funding.

@jigsaw234 do you have consultants triaging in a&e or are they treating patients? What happens in nurse led urgent care settings? Paramedics and ANPs have advanced qualifications in assessment some with prescribing abilities. Totally appropriate for paramedics and ANPs to be triaging

Our GP surgery has a similar system in place - and has done since a few years before the pandemic, so it wasn't that which triggered the change.

With ours, it's not a paramedic who calls you back, it's one of the GPs. They then decide if they need to examine you in person (in which case they offer an appointment) or whether you can have the consultation over the phone.

I can understand why they adopted this system, as previously they had an awful lot of time wasters, ie people making appointments for trivial matters that could be dealt with by over-the-counter meds or a quick chat with a pharmacist and people making appointments and then not turning up. However, it does have its downsides, namely:

1. you never know when you'll get the call back from the GP and it could be at a very inconvenient moment, such as in the middle of a work meeting, while you're driving, while you're in the loo, while you're in the supermarket etc.

2. it's so much less personal than a face to face chat. I find it much harder to say what I want to say.

3. it's no good for people, like my DH, who have hearing loss and mishear things on the phone.

4. it's not good for people, like me, who simply don't like talking on the telephone.

@TheVanguardSix lol the nurses in general practice are sat around drinking tea for the majority of the day 😂
Most GPNs are now managing all asthma and diabetes, contraception reviews, hypertension reviews, smears, all childhood vaccinations, dressings, all the ECGs/bloods/swabs that the GPs request, reviewing bloods and filing results, escalating any concerns. Sounds like an easy job I wonder why there is such a shortage for GPNs

It’s taken me a while but I think I have it sussed now.

-ring GP at 8:00 AM avoid Mondays
-wait in queue for half an hour
-be told all urgent appointments have gone
-explain politely that I have a urine infection/acid reflux/boil on my bum and ask what is the best way to get some medical attention if there are no appointments available
-Receptionist has without fail then offered me a phone appointment the same day
-wait by the phone for a three hour slot for GP or nurse practitioner to call me (cut off Teams call “accidentally” if GP calls when I’m on one.
-GP will do consultation over phone then offer a prescription to collect or ask me to call in with a sample or for face to face.
-explain I work 20 miles away, surgery will then accommodate me at an evening or early morning appointment.

It is exhausting but it seems to work once you understand it and can manage your expectations.

Not perfect but it does cut out a lot of unnecessary face ti face visits. DS would rather have all phone appointments if possible, I don’t need a face to face to tell me I have cystitis and I don’t need an urgent same day appointment for that cyst on my neck that I’ve had for six months.

Because before Covid doctors were resisting the change. They actively campaigned against on-line GO's as they feared they would be out of a job.

Effectively forced into doing it because of Covid, it has, generally speaking, been a much better system. Many people actually prefer it. All the youngsters I know don't have GO's any more, they all subscribe to on-line services.

It will just take time to settle down, for everyone to get used to it, and for the Covid backlog to filter through.

We have a 6-12 week wait for pre-booked appointments though I managed to book my DS a same day one last week (on the third day I'd tried). Unfortunately they won't let me book the further tests he needs because the doctor forgot to add it to his notes that he had agreed he was happy for me to arrange these.

The whole system is struggling on but as long as people keep voting Conservative it won't get any better!

The refusal to ring back if you miss the call is pretty poor, unless they ring you bang on the appointed time.

My GP will keep trying till they get hold of you. They realise that people may be busy at work etc. And it's just as well, as sometimes they're a couple of hours late ringing you.

I was on hold for over half an hour before anyone answered the call. Luckily dh took our other DC to school this morning

The argument about the call back being at any time. Don’t get me wrong, I get that it’s frustrating, it is for me too. But what’s the alternative? Bob works in a job where he only has his phone at lunchtime. Right, triage person can call him at lunchtime. Jane has a break at 10.30 because she works in a school. Right, they need to be called at 10.30. Hang on, now we have an appointments system to be triaged for the appointments system…..So we might as well just revert to one appointments system. Except, oh yeah, we don’t have enough GPs for that. So we’re back to ‘sorry, no more appointments, you can have one next month, or call again tomorrow for the limited number of same day appointments.’ Or, we throw (huge amounts of) money at the problem, and have more GPs (I’ll ignore the fact that this takes time, and they need to come from somewhere). Huge amounts of money isn’t something this country has at the moment, and if we throw it at this, to allow for everyone to be able to make a GP appointment when they want, based around their own personal schedules and circumstances, and regardless of whether it’s actually a GP they need to see, then it won’t be available for other things. Personally, I think that it’s probably a good compromise.

And this demonstrates why it is so difficult for many, many people.

It's not acceptable. I don't want to live like a boiled frog, accepting more and more and more . . . . It's a mess.

My GP did something very sensible a few weeks ago. I had a phone appointment at which my ailment was identified and she prescribed far more tablets than needed for that bout (its not a ‘complete the course’’ medication, but a ‘take while symptoms last’ one) because, as she said, I could take the tablets when the ailment recurred without needing to approach the surgery.

It’s a lot more complex than that…

GPs were resisting the emergence of non-geographic online GP services who were allowed to accept and reject patients.

A community GP is obliged to accept any eligible patient and can’t turn someone away if, for example, they will need lots of appointments for a chronic health condition.

The way most GPs balance their workload is by having a cross section of patients on their books - the ones who have loads and loads of appointments but also the ones that hardly ever come in.

But the online GPs have been set up to take all the low-maintenance patients and all their funding, and leaving all the high-maintenance ones for the local practice

The government reformed the system to allow the online services to come in and cherry pick patients but didn’t have any answer for how it would impact the traditional practices

and at the same time, they hadn’t given any clear instructions on how a traditional GP could start offering video appointments without a multi-million pound app to deliver it

Of course it's rubbish. Some people will defend anything. My Gp is excellent. Nothing like this. Have you tried elsewhere?

I haven't had to call the doctors for a long time, thankfully, but I've just looked on their website for what the process is and it's as clear as mud!

Surgery opening times 8.30 - 18.30
Telephone lines open from 8.00 for emergencies and 8.30 for everything else

Urgent appointments are available for emergencies only, please telephone early (after 8.30am) if you need an urgent appointment

I do like the idea of a triage system so that only people that really need an appointment get seen (rather than someone that could wait 3 weeks stating that they have an "emergency" just to get seen), but I understand OPs issues with what do you do in the meantime.

In an ideal world, the person doing the triaging would be the one answering the phone in the first place but I suspect that would put even more pressure on the system as the queue gets longer while people wait.

We’ve had this system (nurse / doctor triage rather than paramedic) for a few years and it works fine for us. I’ve never been able to not get an appointment if needed. My surgery’s definition of urgent is broad - basically something that cannot wait for 4 weeks.
Plus there is now more flexibility around telephone appointments. Also if I just need a prescription often that’s dealt with at triage rather than taking a doctors appointment.

Someone disagrees and they must have Stockholm syndrome. 🙄

A&E is different as the triage is to do with whether it's an emergency or not - triage is more complex in primary care. I'm not saying that it's wrong for paramedics to do it, I was replying to the idea that it's a waste of senior staff time to do triage, which isn't the case.

Yes, and since in most European countries you have to pay to see a GP, I bet if you told someone in one of those countries that people in the UK expect to be able to see a GP on demand completely for free, they’d also be amazed.

Well no . Patients could be put in a (virtual) queue and told an approximate window of time in the day when they should expect the call.

For example, “a doctor will ring you between 5- 6pm” The patient can fit their day around that, taking an hour or so off work, instead of a whole day.

We're not saying it's tickity. Or it's brilliant.

We're saying there is a massive shortage of GP's and there are not enough appointments to go round. That, sadly, isn't something that can be changed easily, and it will get worse and worse. They can't create extra appointments out of thin air. The only way to have phone triage to remove those that don't need an appointment.

When people are bitching about too many GP's going part time - remember, a 40 hour week is what a "part time" GP would work. 60+ hours for full time. This isn't what they're paid for, obviously, but it is the reality.

Sadly, we need to find the best way of working with what we have - not what we wish we had.

Our GP surgery is terrible.
You have to phone up at 8am, where you are instantly put in a queue after listening to a literal 3 minute speech about Covid government mandates etc.
I've been connected at 8am and was already somehow number 50 something in the queue. If you get through and there are no appointments left - tough. Try again tomorrow.
If you are lucky enough to get an appointment, you are allocated 10 minutes and no more. If you run out of time, you need to go through the whole rigmarole again to get another appointment. Case in point, I was there to discuss some worrying symptoms. I'm NEVER at the doctors, there have been spaces of 7 years or more when I've not been to the GP. During the appointment the GP decided to take bloods, but had run out of time. I was told to make another appointment to do bloods so had to do the whole thing again (anyone decent at taking bloods can do it in about 30 seconds). Then I couldn't get another appointment for TWO weeks.
To my mind it just clogs up the system and takes up more appointments, I cannot see the logic in it at all.

When I eventually got the blood results, the doctor phoned me and told me they needed to see me face to face to discuss them. I asked if I could make an appointment while they were on the phone. Nope. Phone at 8am tomorrow morning........

And to top it off, EVERY time I've been there in the past few months, the waiting room has literally been DEAD. Maybe one other person.
I'm not sure what is going on but it's not the service I remember from what was once a great practice.

I said similar at the time! What about nannies etc. I was told they’ll only see DC with someone with PR, because someone with PR would have to agree to any treatment, so it would be a waste of time seeing children unless alongside someone with PR. It’s very frustrating!

Did you go to the pharmacist?

Our GP has a notice up specifically asking that for certain things, that the pharmacist should be the first port of call, to try and free up appointments for things that definitely need to be seen by a doctor

Noone should go to the GP for any of the below:
Cough/cold
Headache/migraine
Sickness
Aches/pains
Rash
Emergency contraception
Diarrhea or constipation
Cystitis
Red eye
Earache
Teething
Athlete's foot

If everyone stopped going to the docs with these, there would be far more appointments for everyone!

Our practice have an online system - you click through it selecting who you need to see (nurse / GP / face to face / phone) and the nature of the problem, it then gets triaged internally and you either get a text with a future appointment or a call to come into a Rapid Access appointment.

Just yesterday morning I sent my online request to see a nurse for wound care and they called me within an hour and I had a nurse appointment at 5pm.

Same for whenever I need an appointment for one of my DC - if you are specific about what you need they usually can offer the appropriate appointment... and no hanging on for an hour listening to hold music and "you are 18th in the queue"...

It's not the triage part that is the problem - that works well - it's the telephone part.