Have I been a twat or should the GP surgery have given me an appointment?

[Isgreasl]

For context I am a single parent and I work full time so I may be feeling a bit overwhelmed with stress. I don’t know if I’m being unreasonable.

I have had swelling on my toe after falling. It swelled up really fast and has lessened since but the bruising is still bad. I asked for an appointment for the GP to review and I was told to go to a minor injuries unit as it might need an x ray. Minor injuries is 40 minute drive (we are remote) and will take almost an entire day to be seen. I can’t go in first thing as I need to drop DD at nursery (unless I wanted to take her with me which I don’t!).

I have asked them again for an appointment and asked for it to be escalated as I’m not happy with being told to go to minor injuries. I’m really exhausted and confused as to whether I’m in the right here?! From what I’ve read it’s usual to have a few signs looked at with the toe to decide if an x ray is needed and that this is something a GP could do.

The practicalities of her looking after her own health are really not the responsibility of the GP especially in the current state of the NHS. The most appropriate place to assess and manage her care is MIU or ED. Being assessed by the GP would mean she was quite likely to be sent to MIU/ED. Even if the GP thought she needed an x-ray she'd still need to be seen by another member of staff who would ultimately make the clinical decision as to whether an x-ray is needed. That's at least one extra clinician's time taken up vs if she went straight to MIU. The clinician at MIU (who is likely much more experienced at assessing injuries) might then disagree with the GP and think it doesn't need x-ray at which point the clinician is in a really awkward position where they either have to disagree with the GP or perform an unnecessary x-ray. If they refuse the x-ray OP will still be pissed off with the GP and probably the MIU staff too. 40 minutes is hardly the outer hebredes... OP could have got there and back or strapped the toe up herself in the time it's taken to argue with the medically qualified GP staff

You’ve massively over complicated this, she can be seen by someone at the surgery, they either offer advice (all gps should be able to assess if something needs x-rating) or go onto a MIU.

It's minor injuries not gp appointment.

That’s not how it works, certainly not round here. And the chances of getting an appointment today for something like that are slim to none anyway.

GP surgeries are not drop in centres, minor injury assessment centres etc. We aren’t sitting around waiting to just check if someone might need an X-ray and we don’t write letters to MIU - someone either needs routine imaging and we refer, or urgent imaging which GPs can’t request. GPs can’t even request MRIs - it has to be requested by a consultant.

You may have worked in ED a long time ago (as did I) but things are a very different landscape now.

Also at a risk of sounding brutal her childcare and work disruption are not really my problem. If she needs to go to MIU, she needs to go to MIU and she’ll need to make that work if she wants her toe injury looking at properly.

I'm not overcomplicating it at all. If she was sent to MIU she would need to be assessed in the exact same way she would if she'd just taken herself there in the first place and it would be that clinician's clincial decision whether to x-ray so it's wasting time and resources. There's no facility for GPs to book directly for an urgent x-ray because they are not commisioned to do this therefore the safe and appropriate advice to somebody who's had an injury is to go to MIU/ED whether that person likes it or not. The patient wanting a more cosy appointment experience and not wanting to travel should not and does not impact that decision making.

A Gp can't make that decision. They are obligated to send you for an x-ray.

Mine WAS broken and they didn’t do anything 😬😂 just sniffed it to make sure it wasn’t infected.

That is outdated advice

Agree! Absolute rubbish @BoudiccaRuled 🙄
My dh walked, and worked, all day doing building work with a broken ankle! Big toes need to be checked.

I don't think you've been a twat, but I think the GP was right. A swollen toe would only be treated if it was a bad break, and that can only be confirmed with an X-ray, so the GP is no good to you.

If it keeps improving you likely don't need to do anything. If it gets worse or gets no better you'll have to find a way to make time for the minor injuries unit.

Hopefully it's better soon!

Absolutely right of the GP to say you need to go to minor injuries unless he has x-ray vision! It would be a waste of an appointment just to be told to go to minor injuries! No doubt if you’d seen the doctor and he’d told you to go to minor injuries you’d be here saying why did they not just tell you to go to minor injuries !

Why is it she’s wasting time for the Gp and not the MIU, all primary care services are overstretched.

”NHS England is focused on empowering patients with more choice and control, setting standards for care to be smooth, supportive, and convenient”

You don’t have to be a martyr to the NHS. It’s there for you.

It’s a minor injury.
The clue is in the name….
Appreciate you would be inconvenienced attending the MIU but that appointment would have been inappropriate and far better given to someone who actually needed a GP 🙄

Maybe not the whole reason, but certainly a contributing factor. When a person has been told by GP practice that they need to go to minor injuries,A&E etc but still insist they need to be seen by GP they are taking up an appointment uneccessarily.

It’s not a GP issue… ffs.. people complaining they can’t get appointments for serious issues and people wanting toe injuries looking at 🤦‍♀️
Also… MIU is not primary care. Totally different entities

I don't think they could.
Some time ago I fell on the stairs and hurt my finger. It didn't swell and I strapped it up as it was painful to bend. It didn't really bruise, but every time (e.g. every day or so) when I unstrapped it, it hurt.
After about a fortnight I went to minor injuries, who did an X-ray to check it out, even though it wasn't swollen or bruised. I'd broken it.

Suppose you had got an appointment

he looks at your toe
he knows he isn’t qualified to judge so sends you off to minor injurues unit
you have wasted your time and his

Grow up 🙄

A thread diversion but I do think these Minor Injuries Unit and MEC for eyes are really brilliant.

My DD had a big cut to her finger which she was panicking about - got seen right away by nice nurse who reassured and made sure it was dressed properly.

And this year had to go back and forth to the MEC people with my left eye - got appointments right away and not taking up space with the GP.

Unless your gp has xray vision there is no way of knowing if your toe is broken!!

Because MIU are paid to manage injuries and have the facilities to manage them, GPs don't. Nobody is being a martyr but the more stretched the NHS is the more pragmatic we have to be. These types of injury are exactly what MIU is commisioned for and GPs aren't. Could someone take a feverish child to MIU? Would MIU be able to decide how to manage somebody who has multiple comorbidities and is on multiple medications and is suffering with chronic shortness of breath? Is it fair then that somebody with an injured toe is taking an appointment from the many people who will have also likely presented to the GP that day with these problems or similar? On the flipside would you expect MIU to see your feverish child and assess whether they needed seeing by the GP just because MIU is closer/easier to access or would you accept that GP or walk in centre is the best place? Playing another devils advocate if the GP agreed to see you for a query broken limb but the appointment was hours away and when they did assess you the limb was critically ischaemic or there was severe blood loss would you blame the GP then for essentially delaying access to the appropriate treatment and diagnostic equipment that is available in emergency departments? Once again the GP's priority is providing a safe and fair service not your convenience.

GPs don't have x-ray eyes OP. Why the cost of 2 appointments when you only need 1?

If you went to the gp and they decided you need an x-ray. Then what? The logistics will still be the same won't they?

You're in for a shock on here if twat offends you dude.

GP wouldn't have been able to do anything as they wouldn't have access to an x ray. So all they could have done would be to say yeah that needs an x ray, and it would be a waste of everyone's time.

Most of the time you don't do anything for a toe even if it is broken. Unless it's visibly bent out of shape or something I'd just leave it.

It's shit that the minor injuries unit is so far away from you, but that's where you need to be (if anywhere) for the injury you have. It's not what GPs do!

I injured my little toe recently. A GP I saw informally confirmed it was likely broken. This could only be confirmed with a minor injuries x-Ray, but as the treatment was the same either way, we agreed I wouldn’t waste my time. I used ice packs (found a lovely gel one on Amazon that was like half a slipper with a sling back Velcro strap. The best strapping I found was a length of fabric plaster. Micropore just bunched up. The toe/finger straps I found on Amazon didn’t keep the toes together, I don’t think my feet are the right shape.