My GP has told me that 80% of their appointments don't need a GP appointment.

[Hiptothisjive]

So I get that there are always people that need reassurance but this number shocked me. Basically a lot of people are visiting their GP for reasons they don't need to and taking up a lot of GP time.

It's great some of the prescriptions that can be given via a pharmacy now, but surely there needs to be a re-addressing of when to visit a doctor?

YABU - to expect people to know better than go to their GP when they don't need to
YANBU - people should go to the doctor whenever they want to no matter what the issue

I’d probably count as one of these when I go for tonsillitis. But having ending up in hospital because a nurse practitioner failed to recognise quincy I’m definitely going to insist on doctors every time.

I did econsult which told me to phone the receptionist immediately for an urgent appointment.
Phoned the Dr where the receptionist, after I'd told them what econsult had said, told me that there were no appointments and go through econsult...

Result is I haven't seen the Dr and still get bouts of severe pain. I suspect gallstones, but it could be more serious, but econsult always rejects it because it needs urgent checks....

I left a message another time about 6 months after I'd been signed off work with depression, asking to see A Dr as I was spiralling downward quickly. Got a text message back "go to the website for advice".

Another time I left a message about something for one of the dc, saying we'd been to the pharmacy and they said they couldn't help, he needed a dr. Got another text message "See a pharmacist" .

Honestly, I think I've seen more effective help from two four year olds playing doctors.

I'm on HRT, my prescription was changed from 3 monthly to 6 monthly last March. So the 28 day thing isn't universal.

Our GP practice play a fun game of ‘hunt the prescription’; you request a repeat prescription and request it goes to a specific local pharmacy. They send it to a random one. So you have fun times going round all the local pharmacies trying to track it down. Sometimes it ends up back at the surgery. If you are lucky a helpful receptionist may offer a few clues to help you on your hunt…

No it won't .it'll only effect the 10% who currently pay for prescriptions. These are not the problem. People who work don't generally use as many appointments as the elderly and ill

We have millions of people on long term sick in this country. They need making better

I've actively refused sick notes for years because I worked for myself and it'd do me no good. And most importantly I wanted them to make me better.
Was I an idiot for continuing to work?

Two middle aged men i work with go to the GP almost every week.

Because the charge is per item on the prescription. They'd get paid the same whether the item was for a one month or six month supply, therefore it's not financially viable to prescribe six months' supply at a time. Although I don't understand why there isn't a work-around for this, such as listing one months' supply six times, or writing x6, i.e. patient must pay six charges

Men go less than they should.

Sadly, this is more common than you might think. I work in a pharmacy (relatively small town, high elderly population) and at least twice a week we get a big bag full of returns. We calculated the value of the last bag of returns we had and it was roughly £1500 😖

I appreciate that 28-day prescribing is annoying (it increases everybody’s workload, too!), but I can see the benefits. Particularly as we get older and pick up more ailments, changes to meds get more common, and you’re stuck with the excess.

It's because I was on it for hormonal migraine

For all your know there may be good reason. Frequency does not imply fault.

And?

Maybe my DP would still be alive if he hadn't had so little faith in GPs taking things seriously because they're more interested in "lifestyle". Oh, I encouraged him, I gently suggested that worsening heartburn and persistent tiredness and random headaches plus a family history of throat cancer might merit a check up, and yes, fear probably played a part in his reluctance. By the time he collapsed with a brain bleed, went into a coma and died after three weeks, his throat cancer had metastasised to his liver, lungs and brain, and was diagnosed at post mortem.

Those of us in middle age are continually reminded that we're on the slippery slope to being a drain on society in our dotage, and as many chronic conditions rear their heads at this time, is it not better to try and head off the decline while one still has the will and ability to do so? And that might include visiting a GP, perhaps regularly.

And where is this Utopia where anyone can get an appointment "almost every week" ? Or are these two men demonstrating the advantage of the patriarchy?

I honestly think the original GP quoted in this thread was pretty unprofessional (if he exists) by voicing his claims.

Everyone knows that the NHS is overly bureaucratic, underfunded, and that getting the care one needs, even when desperately ill is a lottery. It's not all the fault of patients. And people seem to forget that the mismanagement of health services during Covid just doubled down on the chaos and has increased the number of people with ongoing complications from the virus itself, who might have to seek help because it's still not properly or fully understood.

And if you have children, and don't make a GP appointment for something because "it's probably nothing" you face the wrath of SS if it turns out it was "something" . Hence parents possibly taking up appointments for mundane things "to be on the safe side", also when your child is suffering for any reason, seeking reassurance is surely understandable? The horror stories of missed sepsis even in hospital settings are going to have an effect, no matter how "rational" or resilient" one tries to be.

GPs are the gateway to health provision in general, or used to be. Yes, you can be probably be seen and treated adequately by a pharmacist or practise nurse or whatever, but as related here, sometimes you get bounced round between them for various "protocol" reasons, which delays treatment and diagnosis and potentially wastes the time of three professionals as opposed to one.

So i appreciate this has turned into a bit of a rant and covers multiple issues. It's a muddle. And it reflects the muddle that dealing with GPs and the NHS in general often turns out to be.

And it can't just be bad luck, because so many people end up frustrated and have shared their stories here.

Last year I spent a large amount of time helping my elderly father, including navigating multiple strands of healthcare until he died in April. He actually started to believe that the way he was passed from pillar to post was to hasten his demise as he was no longer worth the effort. After a while, I couldn't help but wonder.

I think GPs should perhaps look at systemic issues that apparently lead to "too many" people seeking an audience with them, and also understand that most people don't want to be ill, and don't want to die prematurely because "it's probably nothing".

Good post.

There's a lot of scoffing and sneering at people for being the wrong sort of patient, or doing it wrong, for not knowing stuff.

Why is there so much flipping moralising and judgement around healthcare?

Ive found the opposite, ive had to push and push for help. Where they’ve been dismissing me I’ve become more ill and lost my job.

I took me 17 years to get diagnosed with Ehlers Danlos Syndrome. If anyone had bothered to look at me properly in that time I might have avoided the wheelchair.

And yet practices manage it just as mine does. They use GPs and occasionally the lead practice nurse for triage. The whole point is it saves them time, money and appointments and their patients get a better service and less wasted time as a result.

Patient time has a value too, although you wouldn’t believe it considering the dysfunctional structure and communication between providers/trusts etc.

If you were on triage eg one morning a fortnight that would be your appointment schedule for the morning planned in advance. The overall demand for appointments goes down. Using minimum wage, non medically qualified staff as cheap triage is shitty employment practice and even worse patient service.

I think much of the NHS confuse being busy with working effectively.

Yes I have doctors and other HCPs in the family. Everyone of them has the tale of the broken toenail in A&E. The difference is they don’t generalise that to claim everyone is a time waster or a drama llama.

Your sneery comments about indigestion pain are particularly inappropriate since it can also be a symptom of heart problems. Upthread I posted about two cases I know myself of men with no previous history or alerts who died of “indigestion” which was actually angina.

Don’t blame patient for the dysfunctionality that is the modern NHS. Have a closer look at the piss poor communication between fiefdoms, to patients and the 18th century business practices and fix that. Don’t be surprised if the number of “time wasters” goes down dramatically as a result.

IBS is a diagnosis of exclusion, not of "fuck knows and I can't be arsed to look properly". Unless you are willing to let the NHS play fast and loose with your health, all unexplained symptoms of bowel cancer (change in bowel habit, abdominal pain, bleeding, etc) should be investigated, especially if there is a family history, and you are NOT too young. (I was barely 30 with no family history).

This! I was diagnosed with IBS for 20 years then eventually referred to a dietitian for something else and then diagnosed with adult onset CMPA. Giving up dairy completely meant my "IBS" went away.

After 5 years of no dairy and no bowel symptoms, I get new pain and rectal bleeding plus other symptoms such as weird skin bruising and poor wound healing, perhaps some kind of deficiency maybe? But also I have a family history of diverticulitis and bowel cancer....

So I go back to doc....... and they smile patronizingly and say well you have a diagnosis of IBS and it is just anxiety because you were abused as a child 🤬

It may save on drugs but what does it cost in terms of extra GP time and wasted patient time and of course pharmacist time to fulfil the prescription?

There is no such thing as a “one minute task” as anyone who has to bill by time and justify that time will tell you. Indeed I’m sure most doctors will tell you this from their private practices. One of the long term systemic problems in the NHS is excessive focus on Cost 1 within fiefdom 1 whilst ignoring Costs 2&3 in other fiefdoms. It almost never looks at or even cares about TCO as any business and most of the public sector has to do.

Nail on the head!

I think if a consultant decrees someone a time water, they probably are - no one is going to risk declaring someone that unless they are sure.

Just because you know a few bad examples, I highly doubt it outweighs the amount of drama llamas my BIL seems to see on a daily basis in A&E!

Honestly, it really is no wonder so many doctors are leaving given the scorn the face from the public…many of whole have nothing wrong with them. TBH we’d all be a lot better off if it was privatised - maybe people would stop wasting doctors time then!

excellent idea. Other practises could note what works.

Really? My family member, the A&E consultant with 30 years experience in the NHS at a busy city teaching hospital would disagree with you wholeheartedly.

Oh and I’d be fine moving to state backed insurance models as used by most of Europe. Not least because the sheer dysfunctionality in the structure and organisation of the modern NHS would be forced to be modernised and the concept of patient time having a value is much higher.

'Using minimum wage, non medically qualified staff as cheap triage is shitty employment practice and even worse patient service.'

Suggesting that those on minimum wage cannot be taught how to allocate appointments is just not true. It's a GP surgery not an a&e anyone presenting will have minor ailments and those with issues that need seeing that day can be seen that say. To have a GP answering calls and allocating patients is crazy. No wonder some say they're overworked.

Ours just use econsult. You submit one, someone <even those on 'minimum wage'> review it and the appropriate person gets back to you. Works fine.