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.

And that's the crux of it. In the NHS we get £120 per patient per year. Whereas the realistic cost is £120 for a single half-hour appointment. how can we ever provide the service that people want?

Wow. I think we are so lucky at our GP atm. I rang them one morning last week to book an advance appointment and was able to book one for that afternoon. While I was waiting a man came into book an appointment and was able to be seen in 15 mins. Perhaps it was just a quiet day....

The idea of a triage system is fine
The basic principle of splitting medical issues into

1. need treatment NOW (i.e. a&e job)
2. need treatment as soon as possible (gp -urgent, to be seen today)
3. need medical attention in the near future (gp - advance appointment)
4. time wasters who can be put off Is fine

The problem is when the difference between 2 and 3 isn't a few days but at least a month!
There are a lot of things that can wait a day or two but not 4-6 weeks!

I'm thinking things like find a lump in your breast/elsewhere, suspected tonsillitis, anxiety or other MH concern where theres not an immediate danger to life but similarly you cant wait 4 weeks to even start trying antidepressants/get referred to support services/need an abortion/ear infection/abscess or boil that won't heal/need a sick note/ongoing or repeated issues like stomach upset/constipation/etc that wouldn't need medical attention as a one off but as an ongoing or repeated issue might be indicative of something more dangerous/need a sick note for work etc.

Agree with others who have said you can't have a list of absolutes

E.g. obviously there's no need to go to the gp for 1 headache/migraine but at some point you will need to be seen to get anti migraine medication prescribed. If you have repeated heavy headaches all of a suddent of course you need this checked out because it could be indicative of a brain tumour!

Diarrhea or constipation for a day is not a GP issue - diarrhea for several days is incredibly dangerous and can lead to death due to dehydration

Rash - could be sepsis

Even things like emergency contraception - obviously ideally you should buy it but if you can't afford £25/£35 so need a GP to prescribe it for free, the cost of a one-off very short appointment for that is flipping cheaper to the NHS overall than having a baby! If pharmacists could prescribe it for free thats a different matter but only a few can.

If there’s an immediate danger to life it’s an A&E job, no? My experience of my GP is that a lot of the examples you give would be classed as urgent. Some of the others would be triaged away - sick notes you request online, our GP surgery has a mental health nurse….

Our GP practice has gone to second-bottom in the county for actually seeing patients face to face post-covid. I used to be a big fan of their ability to ring and request a telephone appointment if it was something that you just needed a yes or no or point of clarification for - but it was backed with the ability to actually get an appointment face to face if one was needed with either the GP or nurse.

Now you can't get a telephone appointment and you have no chance of a face to face consult - you get told someone will call randomly at some point during the day (which can go as late as 9pm) and often no one will even call and you repeat this for days at a time... I had to have a prescription medication review which they wanted to do over the phone - a month wait for the unspecified some point in the day appointment slot over the telephone, which then wasn't kept and then I got shunted back for a good week and a half - by which point I was dangerously near running out of the prescription I'd booked in to have reviewed as soon as I was told I needed to do so! It was not a prescription I should risk stopping cold turkey either without consequences - so very very stressful, and also really hard to do my own job when I have to be on standby in case of a phonecall for a good week+ at a time while seeing my own patient list! In the end when I did get to speak to them I had to plan how to taper off the medication anyway as I couldn't risk being put in this situation next time the computer decided I needed a medication review... so I'll take raging depression, anxiety, reduced ability to function and shitty quality of life instead now.

I currently have an ear infection - I've paid to go have my ears microsuctioned privately as I had fuck all hearing at all left, one was blocked with wax so I now at least have one functioning ear, but the other has a clear infection in it (I've seen the camera stills and sat in on enough audiology lectures on my own degree) - GP prescribed antibiotics over the phone but they've not fully shifted it and can't get to see/speak to them at all to see if it needs more treatment. It's a mess.

In my case, I always go to the pharmacy first and tend to keep a supply of "Ear Calm" at home as I have one ear that acts up regularly.

But every now and again, this doesn't do the job and I need Antibiotics. A few times I went to a walk-in centre, which has since closed.
Three times I tried my GP, once they shifted me to the hub clinic (fine), the other two times I was told "no appointment available", both times I went private via the GP service of the work private health insurance.
And no, I am not someone who goes to the Doctor for "little things" but I'd rather not end up with permanent damage.

A lot of surgeries now employ a paramedic. It's their job to be at the surgery. They don't respond to 999 calls.

I bet the receptionists get fed up of explaining the paramedic thing to people. I was confused and thought it meant they were going to send me to a&e like 111 do. I can't even imagine how confusing this could be for an elderly person.

Why a paramedic though instead of a nurse?

Why not a paramedic? You do realise that triage is literally what they're trained to do?They don't just drive an ambulance.

Yes I'm not doubting their expertise. But does it not leave the ambulance service short of staff? Also as an average person on the end of the phone, if they had said to me that a nurse will call me back to triage me, I'd have understood. However, as they said a paramedic, I didn't understand and thought they were going to treat me as a potential a&e emergency.

@Comedycook bcause paramedics are increasingly looking to work outside of the ambulance service due to burn out and high levels of stress. Many have advanced training and are well suited to working within primary care.

must differ everywhere then, We can phone up in the morning and get an appt the same day. They also have prebookable appointments.

Nurses have loads of time. What a laugh. My clinics are booked up for the month ahead. It's so cushy two nurses retired early last month and another set to go. We've had one applicant with no experience.
The number of nurses in GP practices almost ready to go is a timebomb.

So cushy pensions is the issue there, isn’t it? Retiring early for lesser mortals isn’t possible.

Expensively trained (by the taxpayer) and well remunerated doctors just do the minimum years and clear off. Other people have stress at work too for a fraction of the money and far less pension after 30 years. It’s about time early retirement was stopped, unless ill.

For those getting their knickers in a twist about my pharmacist post!
It's a 'first port of call'

Not saying that none of those issues will never need referring further; just that in the first case, a pharmacist can sort you out much more quickly and easily on many occassions - leaving GP appointments for exactly the more urgent instances you have cited

I love the phone triage. I work and so a quick phone call is so much easier. Often a prescription will be sent to pharmacy for my dc without us needing to enter the dr practice. They call me in if needed but otherwise we avoid an unnecessary trip.

It doesn't mean anything as such that they're a paramedic
It could be because they are wanting a change, or have an injury, pregnancy, anything
My friend is a senior paramedic but works at out of hours now, another is working in a doctors as she's injured and needed a desk job as she's fit to work but not to be front line ambulance yet

GP Surgeries are not borrowing paramedics from hospitals & leaving them short. They are advertising for qualified paramedics.
Paramedics are better qualified to triage than a nurse. Nurses don't treat kids under 5/pregnant women.
Paramedics have treated all sorts in their role.
If you're that concerned write to your local MP.
Gp Surgeries need all the help they can get.

Do an online search for your nearest walk in clinic, which may be in a local district general hospital.

Patients are usually seen on the day but there will usually be a wait.

@ImNotAsThinkAsYouDrunkIAm

They keep the online booking 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.

They have THREE more GPs at my surgery now than they did 2 years ago, so that doesn't wash.

AND my adult DD, and my BFF (both at different surgeries to me, and to each other) HAVE got the online bookings back. Others including mine, and my bro and SIL, and several others I know have not. So it doesn't make sense why some have the online booking suspended when others don't.

Are those three GPs working full time? Do you know if the other GPs at the surgery are working full time? Lots don’t. Appointment numbers are also up, apparently on average, around 10 per cent since two years ago, and that’s not taking into account covid vaccination workload.

Six sessions of GP ("part time/3 days") is often 36 - 40 hours, as many GP days are 12 hours plus. So just because a GP isn't in every day, it doesn't mean they are full time. I'm only in the surgery 2 days/week but I do a variety of other roles in primary care which means that in reality I work full time.

Oh sure. But my point to the pp was that, just because there are 3 more GPs working in the surgery than 2 years ago, that doesn’t necessarily mean that there are 3 GP’s worth more GP time. And even if there are, we have no way of knowing if the surgery has taken on more patients, or is delivering more appointments (probably, as most are).