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'm not sure about this list. When my dd was younger she had long term constipation. The sachets of stool softener that were suitable for children were only available on prescription. I actually asked the pharmacist for them and they said I needed a prescription.

Our GP surgery has been using a triage system for many years - as long as we have been at the practice and that's 10 years pre covid.

The current triage hours are 8-11 and 2-4 daily - you just call and ask to be added to the triage list then a GP or Nurse Practitioner call you back and either advise, prescribe or ask you to attend a f2f appointment the same or next day.

You can also do an online consult which can included adding a photo if required.
I did an online consult for my teenager yesterday because she has been getting progressively worse since she had a UTI 2 months ago that she had antibiotics for (done via triage). The Nurse Practitioner sent a secure text reply to say that she wanted her to have a f2f appointment and urine dip.
I called at 6pm last night and was given an 8:30am appointment for today. We've been, given antibiotics, urine dipped and sent off for culture. bloods appointment made for post antibiotics and if the culture comes back positive then they will arrange an ultrasound for her. Bloods will also check her iron and vitamin D because of other issues we discussed today.

Our surgery is amazing and they manage a huge caseload with 3 GP's and 3 Nurse Practitioners because this system frees up so much of their time.

To be fair, that is what my GP does. But you’d still have people complaining that they can’t be free at that time 🤷‍♀️ And it also means you have to be pretty confident about how long it’s going to take you to phone each person in that virtual queue. Person 1 takes 3 minutes. Person 2, 5. Person 3, oh they didn’t answer. Now I have to call them back. By the time you get to person 30, what time is it? I think that’s pretty hard to calculate, and if you do try, and get it wrong, person 13 is now complaining that you missed their window and they had to go back to work. It’s never going to be perfect, and I agree, some do it better than others.

Sometimes you need to see a GP for those things. I had headaches, if I had gone to a pharmacist I'd have been directed to the appropriate painkillers but nothing else (and probably told to go to the doctor anyway if they don't help) but I went to the doctor, got a thorough examination to rule out anything serious and a referral to physiotherapy because the cause was musculoskeletal - painkillers wouldn't help in that situation.

Exactly. I've had migraine for over 10 years now. The pharmacy won't be able to do anything. And the last time I had constipation I had to speak to my GP as it was the medication I was taking.

@Natsku

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.

Well, exactly this. As somebody said (sarcastically) further back in the thread... 'They can't just make a note of whatever time Susan or Jeff are available, like one's available 10.30 to 11am, and another's available between one and two pm.. lalala' But it's true, some people CANNOT just sit there and wait for a phone call that will be between 8.30am and fucking 6 at night!

The fact is, most people will be at work and are not fortunate enough to work from home in an admin kind of field, or even working in an office. Many are not able to sit next to their phone on their desk, and are not just going to be able to answer a random call from a doctor (when they don't know when it's coming.)

What about people that work on the frontline, like at checkouts or behind the counter in a shop or in a pharmacy or a bakery or butchers or supermarket, or whatever. They can't just stand there with their bloody mobile phone and answer the doctor, in the middle of serving somebody. I am sure some people think that most people are doing nothing with their day, and don't work. Some schools are the same. Assume every parent (mother usually) has fuck all else to do but work around THEM.

Another thing that doesn't work, and is a stupid stupid idea is the 'hospital admin team/bookings team'... just sending out random appointments to people for a specialist...or a certain clinic appointment. They need to do what they used to do and send a letter with a code name and a password for people to select a time and a date themselves.

Like on the GP surgery website, (before covid,) you could select your own appointment, but since March 2020 - 3 years now, online booking for doctor's appointment is still suspended. Why? Why is it still suspended? Absolutely ludicrous. It was so much easier booking online to suit YOU. Why have they not resumed this? And why have hospital bookings teams not resumed this?

But yeah, with them sending out 'specialist' appointments with appointments convenient for them and not for you, this does not work! Almost every time myself and my husband (and quite a few people I know of,) have a hospital/clinic appointment, we have to ring up and change it because we're at work and can't get the time off. And then what they do is they will send you another appointment, and of course that's fucking inconvenient as well.

My DH has had a second or third appointment and it's still inconvenient - and he just ends up booking the morning or afternoon off. And then at least one in three times it ends up being cancelled on the day of the appointment when he booked the time off. Absolutely infuriating.

I remember somebody complaining profusely about this on a thread once, (about 4-5 years ago,) and they got absolutely slaughtered. Told they were horrible, and vile, and an ungrateful twat, and they didn't deserve the NHS and there were a DISGRACE for complaining - about constantly getting these times and days that were inconvenient for them and they wish they could choose.

I mean, we pay for the National Health Service, I think we have a right to complain about it. Yes, it's great to have a National Health Service, but it isn't perfect, and it does have its flaws, and I think we have a right to say that.

This is the most ludicrous post on this thread.

Instead of calling, our GP now has a message triage service. You message with the issue via their website, a doctor reads it,triages, and in a short amount of time you get a text with a time frame that day for a phone appointment. If that phone appointment indicates that you need to be seen face to face, then that's arranged (or might be from the off if the message indicates it, but mine haven't needed it so I'm not sure).

It's pretty new, and at first everyone was convinced it was a stupid idea. But it's massively massively better, and our normally grumpy community FB page is full of praise for it. No hanging on the phone at 8am, and really prompt communication. Lst time I used it, I got the text back ten minutes after I messaged, and the phone appointment an hour later.

I'm all for the triage system, to be honest. And the phone appointments have been excellent, and saved a load of time and travelling to and from the surgery.
Obviously (older?) people without the tech ability can still call and the receptionist will do it all for them. But at least they'll be able to get through.

I wish my GP was that advanced, nothing can be done electronically - they stopped using email and any other electronic system.

You have to phone and, if you get through, explain what's wrong to the receptionist who in my experience doesn't write it down properly. The GP then calls back (no particular time, just wait and hope) and goes through it all again.

Like on the GP surgery website, (before covid,) you could select your own appointment, but since March 2020 - 3 years now, online booking for doctor's appointment is still suspended. Why? Why is it still suspended?

Because there aren’t enough GPs to allow for enough appointments to allow everyone to book an appointment with the GP because they want one, when they want one. So they’ve put a system in to try to filter out the folk that are booking an appointment with the GP but actually need to see a physio. Or a nurse. Etc. I’ve been registered at GP surgeries that had online booking and no triage system, and they would make the appointments available, and people would book them, and then there would be no more. So someone who actually needed to be referred on for an appointment with the physio might get to see the GP unnecessarily, but someone else, who did need to see the GP, might miss out.

I don’t disagree that in an ideal world we would have enough GPs for that. I’d love that too. But we don’t.

We have to do an e-consult to get an appointment - fill in a form online and they call you back within 48 hours. Last time I did this the e-consult system wasn't working - unbeknown to me - and they never called me. It wasn't urgent, but still something I needed to talk to a dr about - so I phoned the surgery (30 mins listening to music) and managed to secure a phone call appointment - this was for a date more than 6 weeks after my original e-consult request.

I have this week been prescribed something for the initial reason which prompted me to request an appointment in the first place - the whole process has taken 4.5 months. Required some blood tests (wait 2-3 weeks for this), then a call with GP to discuss (another 2 weeks), some blood results weren't processed so repeat the whole thing again. The whole system is utterly broken.

There aren't enough GPS. The ones that do exist tend to be aging and leaving due to the pressures on them.

It's a broken system. The first thing that needs to change is incentivising studying medicine and staying in the UK to practice. Many graduates go to Saudi, Dubai, Australia etc because the pay is massive and responsibility and pressure less.

The government need to focus on training and retaining staff. Otherwise, unfortunately, it's a case of managing resource as you've experienced.

If we privatise healthcare, we'll have to pay through the nose to get enough doctors to the country. I hope to god we keep the NHS, people would be scared at the costs of a private system.

Phone triaging makes complete sense and is a good use of resources.

After reading this thread, I think I don't actually object so much to the idea of a triaging system. I can understand why it helps and weeds out people who don't need to be seen. What I find so frustrating is spending my whole morning whilst trying to organise two kids for school on hold for over half an hour....I'd happily fill out an online form.

@TheVanguardSix when were you married to a GP - 1962??

I'm quite insulted at your comments about practice nurses having nothing much to do. I'm an NP in a GP surgery - I've seen 19 patients this morning, just eating my lunch whilst doing my emails and admin tasks and have another 14 patients to see this afternoon.

I assess, treat, prescribe, manage and review patients with acute and chronic conditions, as well as doing all the other things practice nurses do. I have a specialism so teach student nurses and F2s in practice.

I'm hardly scrabbling around looking for work to do...

I don’t think anyone can disagree that it’s a system put in place out of necessity due to staff shortages, an ever increasing population, an obesity crisis and an enormous elderly community, a mental health explosion and no resources allocated to it, a woeful lack of funding and mismanagement from the top.

Its a basic net which filters out non urgent cases, the “worried well” (although I find that term used condescendingly)and “time wasters”.

The fact is many patients who need symptoms investigating are falling through the net, like my friend who struggled to be seen in person for months with her symptoms and was only referred for an MRI when she had a violent seizure at home and was vomiting blood. She died of advanced bowel cancer weeks later aged 43.
She was basically treated as a “worried well” on the phone and flung various tablets and laxatives to treat her symptoms without investigating a cause.

I was thinking about this, because I’ve been frustrated by this too. My GP used to do econsult and I loved it but they don’t now, I don’t know why. At a guess though, based on how many people in my own line of work can’t specify a fcking problem properly (“It’s broken”. How, in what way is it broken?!), I’d wonder how many of those econsults led to people having to be phoned back to get enough details to triage properly, and then you’re back to the problem of people being called back at inconvenient times. Or an extended electronic “conversation”
that takes many more times as long as a phone call would. I dunno. It’s shit. We need more GPs. But until the government does something about why we don’t have enough now, I have to give the GP surgeries the benefit of the doubt that they are managing demand and capacity as best they can.

Sadly it was far from unusual to be misdiagnosed before phone apppointments came in. My DH was diagnosed with stage 4 incurable bowel cancer 18 months after he first went to the doctor about his symptoms. He was fobbed off with a diagnosis of piles.

In general I think this system is better. Oddly enough I've found the phone appointments less rushed than face to face ones. Maybe because they're more efficient? But of course anyone feeling that the phone appointment hasn't covered things well enough, can ask for a face to face one at the end. It might not be that day, but at least things are set in motion.

Fair points @saraclara
Im sorry to read that about your husband

We had the phone triage system during covid and it's now reverted back to being seen on same day appointments.

Having sadly needed to see the GP a lot in the last few years I can absolutely say the triage system worked well.

I found that speaking to someone within an hour or so was much more useful than an open GP clinic where you all queue outside at 8.30 and are all seen before lunchtime having sat in the surgery waiting room all morning.

Many times the need could be met rapidly without seeing a doctor but being authorised by a doctor. During the triage if you needed a face to face appointment you were booked in straight away.

You may find it works out well.

Same at ours now I'm looking to move GP as most of the partners have left and the new lot don't seem interested in anything but same day appointments. It's a shame as it was good

When we did pre-book appointments our rate of people not turning up was close to 20%.......that's a lot of wasted dr time

Of course they should - sometimes

Rash - I've been because they wanted to check a rash on my breast wasn't cancer, and because I needed a referral for urticaria
Cough - chest infection and needed antibiotics
Cystitis - had a UTI, needed antibiotics
Pain in my shins - low vitamin D that needed a blood test

We have given up with our GP. Although it is £120 for half an hour or £60 for telephone consultation I now see a lovely private GP who takes a very holistic approach. She works part time in an NHS practice and private part time too.