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

Referring on sooner could help. I had dozens of appointments over ten years for thrush before I was referred on. After a six month course of fluconazole it was back within a fortnight and it was still around 18 months before a referral was made.

I'm sure there are many unnecessary appointments, it's not all down to the patient though.

There is a workaround. It’s call batch prescriptions, or repeats. The protocol is that they can only issue 28 days medication per script (unless it’s for something where it doesn’t come in those doses like inhalers), and so a repeat script is a new charge. I really don’t understand any surgery where they are suggesting you need an appointment every 28 days and they need to be challenged on this.

Hahahahahaha

Unless you have an issue not many people have a annual/bi-annual eye test.

Have you tried to see an NHS dentist recently?

Biennial eye tests are recommended though. Perhaps, simply, the wrong word was used.

I can understand your leaving
it not a nice job

but our local practices, I’ve used all, switch off Econsult out of office hours. You cannot use it to submit anything, even a draft. It is office hours only. They all say it stops a lot of the insanity ;) (my friend is a receptionist in one)

But I had bowel cancer symptoms
6 months of calls and econsults
all resulted in telephone appts until one finally asked me to drop off a sample. Funnily enough I was called and seen immediately once results were in.
it was resolved, through surgery, and I’m recovering. But I paid to go privately after all that. I simply didn’t trust the NHS at all after that. And I was right. 5 weeks after surgery I was finally called in for my first colonoscopy. 3 months later. I dread to think how far it may have spread if I hadn’t had the ability to pay

I'd say that's utter bollocks. It's more likely that a vast number of people who need a GP don't ever get round to going because they can't get an appointment so they give up!

I dint feel sorry for GPs. They aren't doing the job because they are heroes of the night. I worked in the NHS in my first career and I walked away because I didn't want to be complicit. We all have a choice. Walk away if you dont agree with the fact innocent people die because GPs, the people who have the power to help them refuse to do so. I actually do believe that its seen as the easy option for school hours and working mums and it impacts on the patients because they could do with out of hours and weekend care.

Maybe not so easy for an 85 year old with poor eyesight to do all that on an app though.And that's the age group tthat do see a lot of the doctor

Having recently been pregnant, I found dealing with my GP surgery so frustrating! I was on anti-emetics from 9 weeks and every 28 days had to see a GP (invariably a locum) and explain it all from the start. It was such a waste of time! The first medication I was given worked! I just needed that on repeat but every time they had to consider my case from the start, at one point in the third trimester, I was sent off with a prescription for a medication that should not be taken in the third trimester! Why was it so difficult and taking up so much time to just get a safe, frontline medication on repeat for the duration? I wish my midwife had just been able to prescribe it. I had to see her anyway.

I avoid going to my gp unless I'm desperate. It's always running late and just getting an appointment is a headache. I've got away without seeing them for a few years but they wanted a face to face for hrt then another in 3 months then further reviews. I'm not sure why they want me in person for this. It's a pain for both of us. Then there's all the screening I've been avoiding that they're nagging me about. I'd love to keep away but they insist 😭

I wish there was an algorithm that would identify the people who never bother their GP. Between me and my three young adult DC we have averaged less than one visit every 20 years. (Routine screening such as mammograms and smears excepted). Two of the DC have never been.

You would think that if I tried to make an appointment they would know it was serious!

I think the point of the comment I was replying to is that repeat prescriptions still need to be signed by a GP/prescriber, even without an appointment, which takes time out of their day.

But that doesn't have to be every 28 days or whatever. The way it works where I am, the prescription is issued for a much longer period but you can only pick up a certain amount of medication at a time. For instance my thyroxine prescription is for 12x100 pill bottles but I can only pick up 3 bottles at a time, which is about 3 month's worth for me, but the doctor doesn't need to then do anything about the prescription until I've picked up all the bottles, then I send the request for renewal so the couple of minutes work for the doctor is only every 12 months rather than every month but I still can't stockpile much so less chance of wastage and I pay each time I pick up.

It's good to read on here that some people are having good experiences with econsult and that it's being used properly where they live. I'm just not convinced that's the case for all GP practices though. And it's terrible that in some places you can't even submit a problem outside of normal practice hours.
When I used it recently, I seriously doubt anyone medically trained looked at mine. The issue I had is one that should at least have been suspected by the very classic symptoms I had. But it was dismissed without even a phone call.
Econsult really could help in so many cases but it does feel like in some places it is really making a positive impact in patient care, while in others, it's just another barrier being put in place.

I think some people do choose it for those reasons - just like a lot of people choose jobs around their childcare commitments etc.
But they’re horribly misinformed.

My GP day started at 7.45, I’d log off at 6.30 and go home so I could collect my son from childcare, get him fed and to bed then log on again from about 9 until I fell asleep at my laptop at around 11.30. When I worked full time pre kids I’d go in one weekend day a fortnight too for a few hours.

Not everybody works those sort of hours but you’d be surprised how many do. It’s not uncommon for my friends to work four days a week in the surgery but treat it as a full time job and spend their ‘day off’ doing the admin from those days, to make it a full time job but where they can actually leave on time.

You can work ‘school hours’ in some places but that would be a session that’s supposed to be 4hr and 20 minutes but in reality will end up being 8-2 minimum and everyone criticising you for being part time.

I work not dissimilar hours to those as a mid career teacher employed 0.8 FTE. If I didn't have that day "off" I'd quickly sink under the marking and admin.

I do get school holidays of course but then probably earn less than half what a GP does.

Public service jobs are like that these days (don't want to say public sector as GPs aren't employed by the state).

For what it's worth, I'm very happy with my GP: they're well organised as a practice, courteous and nice individuals.

I did ask a mate at the PCT which practice they got most praise for/least complaints, before switching to them though!

So there have been a lot of posts with really horrible personal experiences and this is what I am actually taking about - those are in the 20%even if doctors didn’t think so.

What I am talking about here is the 80%.

So while all of the horrible personal stories are indeed horrible it doesn’t change that 80% of appointments aren’t needed.

You didnt read the links I posted, then.

Evidence showed roughly the opposite: around 20% of appointments were 'avoidable'.

I don't think a throwaway comment from your go is evidence of accuracy, just frustration. Have you any research or quantitative data to back this up?

You’re assuming that the patients are able to tell whether or not they need medical intervention for their problem. But they usually don’t have the knowledge to do that and surely that's what the GP is there for. So the 80%, or certainly most of them, aren’t wasting GP time as you’re implying.

This makes no sense. A doctor says 80% of consultations aren't needed. People have posted about times when they have been dismissed, and you say those are in the 20% and not the 80%, even if doctors think they're in the 80%. The 80% can't be true then can it if you agree some of the people counted belong in the 20%.

And this is not the case anyway. Latest figures from 2023 show that from submissions by doctors themselves, the reported figure is 'up to 16%' of consultations that are deemed not needed. And this will include all the people who've been sent away, so in reality that percentage is even lower.

I reckon a lot of the "avoidable" appointments also would arise from the gatekeeping aspect: you can't arrange anything like a prescription or blood test or get a minor injury seen often without GP involvement (waiting time in our MIU regularly tops 5 hours - who can manage that if they've got a job?). So they're picking up slack from the rest of the system, because the rest of the system isn't bookable.

Econsult doesn't work for people with certain disabilities. That's a bit of an issue if you are undiagnosed. Some patients need face to face because of communication issues not because of medical issues. This isn't being recognised and it should be. Econsult works well for a lot of patients who want it, but it shouldn't be enforced and an a substitute for patients who still want face to face. There should be a way of saying this really doesn't work for me.

What is a really telling sign is that there is a large number of people who will go to a&e for minor ailments and wait for hours upon hours to be seen. You have to examine why they are prepared to do that. It's a strange thing to do for no reason or being 'they don't really need to see a doctor'.

They quite clearly do NEED to see a doctor. They are doing so for a few reasons; their relationship with their GP has broken down possibly due to attitude, they can't access their GP for some reason, they feel they are getting inadequate care from their GP or they have significant health anxiety and need adequate reassurance.

One key issue is you can't just change GP. If you have an arse of a GP with patient skills issues you are effectively often stuck with them. If they take a particular dislike to you or think you are being 'difficult' and have decided you don't have a problem and it's 'all in your head' or are just plain prejudice in some way, you are stuck with them. There's absolutely no recourse. Anyone saying you can change GP has never been through the process. It's a fundamental flaw in the system in this country which I really believe harms patients on multiple levels. GP surgeries are by design local monopolies. They are private businesses which operate within the NHS framework. This also means there are financial incentives for not treating certain things or aggressively pushing others to meet targets. Again there's problems within this.

If people need significant reassurance with their health, it's worth pointing out that anxiety itself IS a health condition. Saying that people with health anxiety are 'timewasters' is appalling in an age where we know that mental health is important. It's backwards. Anyone with health anxiety perhaps does need more time with a GP and it should be seen as time well spent on mental health grounds rather than purely time wasting.

If you effectively scare people off the GP because they've become so anxious about seeing them because you've lectured them to death about 'inappropriate' appointments, you risk harm the time they do need medical care but disengage due to loss of trust. This has implications for particularly vulnerable patients and safeguarding. People take messaging about 'not wasting the doctors time' in different ways - the target for this often are so thick skinned and tone deaf it goes over their heads anyway and it's actually listened to by more diligent groups who already only attend when they should resulting in them failing to book appointments when they start to have an issue and then only doing so when the matter has progressed to crisis point.

One of the issues is no one is really examining the whys on this or measuring the right things to actively identify the problems.

Getting unfit GPs struck off is impossible too which doesn't help matters. When you have creeps for doctors who have been involved in sexual assault cases but they arent struck off, it begs some almighty questions about implications for patients.

I found it quite easy to change GP. Does this vary by area then? I'm in London. I just had to find one with spaces, where I fell into "catchment".