To think GP surgeries shouldn’t be closed over Easter weekend? [Title edited by MNHQ]

[Albertslittletie]

AIBU unreasonable to think there’s no reason for Gp surgeries to be closed for four days over Easter weekend? They aren’t even closed for this long over Christmas.
Why does this happen? I don’t work in the NHS but I don’t understand why most other services seem to run apart from a GP surgery, doesn’t this just force people towards A and E?

IM glad your getting a well deserved break!

But this was my question (which has been answered by a PP) that other services remain open. They get the bank holiday time back in lieu. Lots of other services ensure holiday days are covered.

this isn’t an attack on staff but the system in itself. I also questioned the logic behind it as it forces people to urgent care and a and e which are also completely stretched out. Those staff presumably also deserve and need the time off.

Yup the 111 dental emergency clinics open 9-4 over Easter, I worked today.

Which is exactly what I said to you that you took in ridge with and accused me of snarking - I said to you isn’t it better to support ways for all staff to have more time off? Instead of saying that GPs should be open? And you got arsey about it.

Everyone deserves a break. This is the GPs break. Hopefully the rest of the staff who do work bank holidays get that time back to use elsewhere in the year like I used to when I worked all public holidays.

You don’t have to kick down on one group to relieve the pain of another.

Enjoy your weekend, and thank you for doing what you do.

Those who work in urgent care or a&e don't have the choice to have bank holidays as they are an emergency service and a last resort. Imagine if a&e decided to take a long weekend as they are tired? Those people choose to work there and won't get bank holidays but get plenty of other opportunities to take long weekends.

I say this as an ex nurse who has worked in an emergency care area. We never begrudged GPs their holidays.

Not the same but I remember when my DP was very seriously ill and in hospital, they told me that Easter is a time to really worry as there is not the support from the consultants etc if anything was to happen. I remember being told this and thinking that he may pass away over the Easter break. It’s not just GP surgeries.

Urgent Care and A&E are staffed in a different way.
A&E doctors and nurses work shifts. Day shifts, night shifts, early shifts, late shifts - it’s a totally different structure to General Practice. Most A&E doctors don’t work in A&E long term. It’s usually a 6 month post as part of a training programme. They’ll all have a turn at working bank holidays.

You can’t compare opening hours of GP surgeries with A&E.
If you want to draw comparisons, you’re better comparing GP surgeries with outpatient departments, which I expect you’ll find are closed for 4 days.

Doesn't make much difference really, GP surgery just signpost to Walk in Centre or A&E
Used to be able to call in at the surgery at 8am for same day appointment but now that's hit and miss

They have always been closed on bank holidays I think. Urgent care centres and 111 is still available.

we had to call the out of hours doctor for my Dad on Christmas Day, he was on the end of life pathway and he needed meds to make him more comfortable. They treated him with care and dignity and we were grateful that he was able to stay at home.

Unfortunately there are too many people in this country for the NHS to support, and not enough money put into it. So each area of the NHS tries to pass work to other areas.

General Practice has taken on a phenomenal amount of work away from the hospital system. There are things GPs are responsible for now that would have been unthinkable when I started in the mid 1990s.

People used to be admitted to hospital to initiate insulin. Now many GPs can do it. That’s just one of many examples. It’s good for patients because it saves them travelling to hospital. But it comes at a price.

While your GP is doing insulin initiations, minor operations, joint injections, anticoagulation monitoring, “shared care drug” supervision, spirometry, heart failure drug titration, diabetes management, end of life care etc - they aren’t able to offer basic appointments. All these things used to be done in hospital.

Gosh, I must be hallucinating the 40 phone calls I took and 20 or so patients that I saw face to face in my most recent day as a GP. I do apologise for sending one to A&E, but as I couldn't rule out an ectopic pregnancy it seemed reasonable. All the others I sorted out myself. You're talking nonsense.

wow.

isnt it mad that the general
public opinion seems to be that it’s vice versa!

Hmhm I'm not so sure. They are paying Locum GPs handsomely including on weekends.

Mad. Frustrating. Exhausting.
Now imagine you’re being told you’re a lazy GP not seeing patients on a daily basis.

Considering that most people don't celebrate Easter in the traditional sense, GPs should be open. They should be open and operate on weekends by rota. The idea of a health service being shut for 2 days is old fashioned and don'ts meet the needs of service users. I also think people should pay a contribution towards their GP appointments.

It is.
When I was a junior hospital doctor, if someone was admitted with a heart attack they’d be in hospital for a week, and we’d send them out with all their medication, having done all the tests during their admission.

Now they can be sent home a couple of days letter, with a letter to the GP saying please start a statin, start an ACE inhibitor, titrate their beta blocker dose up according to their BP, arrange a chest X-ray in 4 weeks, refer for an echocardiogram, consider anticoagulation if their CHADvasc score suggests it, refer them for weight management, refer them to an exercise programme, optimise their diabetes control - the list goes on.

I’m not blaming secondary care for doing this. It makes sense for more care to take place in the community. But there are only so many hours in the day and GPs to do the work.

Another DN here and on duty all weekend. Usually palliative patients are covered by us as usual we have the support of our specialist palliative nurses and IMPACT line for specialist advice if needed. Not all of our patients are under the palliative team at present. OOH GPs and the walk-in centre are available, but both ridiculously backlogged. The Easter weekend can be incredibly frustrating when we need the input of the usual GP of the patient, as OOH can only do so much and are buckling under the pressure too. This can lead to delays and an impact on our caseloads. Some of the other community services are also restricted of a weekend and bank holidays, so we also find delays here. It’s not double time for bank holidays at my trust.

We also have been made to join the bank a good while back, which has put a stop to any type of overtime payments. This is quite naughty, as the hours we pick up extra are usually to help our own teams so it is effectively overtime. Personally I will pick up additional shifts to help the team out, as we can get so short staffed that things just build up otherwise. I work across a city centre and we don’t have permits either. I have had a number of fines that the trust are being difficult about, and they have now said essentially we have to find a pay and display or car park, then walk to patients. Sometimes we need bulky equipment, or we can’t take everything we have in our car as a just in case so this isn’t viable. The trust have refused to pay fines, and are trying to wash their hands of the parking issues we face. Sometimes there isn’t parking even within a 10 minute walk, and it still doesn’t negate the fact of potentially needing something from the car during the visit. The trust have been “negotiating” permits with the local council for years now and we are still waiting. We can claim back the cost of car parking, but we have to wait until the next pay month to get that.

Sorry I went off on a tangent there, but essentially although I don’t begrudge their time off the current system isn’t working (has it ever?). We are feeling the pressure more than ever and patients are surprised we are a 24/7 365 day service. I have found from experience that the majority of GPs I have been in touch with here are actually getting worse. Inappropriate referrals, refusing to go out to patients, not following up requests, not communicating to DNs. This is across different practices. Some GPs and other services definitely seem to be stuck in COVID as an excuse, and it is very infuriating. There is no reason for GPs to not assess a patient in person before making a referral, but all too often they speak to a patient or relative via phone, prescribe antibiotics for wounds before talking swabs and get DNs to go out for things they should be going out to first. For these reasons I don’t think GPs should be shut for the full 4 days, as health is a 24/7 service and OOHs GPs aren’t really built to provide 24 hour care for a 4 day weekend.

Well that’s private medicine, which isn’t what the NHS is about. There are private GPs available, for those who can afford it.

Absolutely no one has suggested that’s what needs to happen.

But this is happening. Maybe not on this thread. There are however many many other threads, articles, headlines implying that GPs are not working hard enough. Morale is low and it’s no surprise that more and more GPs are leaving

Actually I had back surgery over Easter once. Consultant operated and then went off for the weekend. I had no idea then how it worked but looking back, gives me the heebie jeebies!

Indeed. The NHS needs reforming and people should contribute out of their pocket as they do in most Western countries, including Ireland.

I agree. The current GP system is not working.

I’d start from the beginning and set up a new system

Which no doubt compounds the problem and makes it a vicious circle