GP didn’t call me because their “workday has ended”

[angelinlothian]

I had a telephone call booked in at 15:40.

It rolls around and no call. 17:30 comes and goes which is when the surgery closes.

I get a text to say it’s not been completed as they got to the end of their workday and couldn’t make the call, which means at least 8 people were in the same position as me, they didn’t have their calls made.

So I now have to compete again tomorrow for an on the day call, and even having one booked in doesn’t guarantee it!

AIBU to think this is exactly why so many people end up in A&E? We’re told to go to our GP, but our GP won’t see us!

Meanwhile here GPs are sitting there googling your symptoms with you

Google is sometimes embedded into specialist or academic databases which are not accessible to the general public. Your gp is not looking up your symptoms on wikipedia.

I’ve not read the full thread. But this just makes me so sad. I’m a GP.

Yes, it’s poor that a planned appointment didn’t take place - this should be rescheduled ASAP without any further input/effort needed from the OP.

But this thread demonstrates beautifully a couple of things.

1. How hospital delays are directly increasing GP workload, leading to harder access for patients - if she is seen more promptly by the specialist team she’s waiting on, this appointment may not even be needed as she’s not waiting in pain for ages needing prescribed pain relief.
2. How things have been spun so cleverly to paint GPs as lazy/inadequate. Whenever the topic of busy A&Es comes up, the narrative seems to be “poor A&E, they are so overwhelmed, the staff are heroes, social care and GPs let them down”. However if the topic of busy GPs comes up the same understanding and consideration is never applied. I don’t know a single GP who doesn’t work absolutely flat out for longer than their shift each day. But if we struggle to meet demand nobody ever says “poor GPs. Hospital waiting times, the increasingly frail/demanding population and hospital teams pushing more and more jobs for the GP to do is making their job harder.”

I would love it if this comment provoked some thought/reflection.

If they need to leave, they need to leave. Do you want the childcare providers to be calling Social Work because the parent didn't rock up on time?

Its Mumsnet how can people not get that GPs are also Mums and Dads who have children who need collecting ?
Clocking of at 5.30 isn't exactly early.

Totally agree the issue is there just isn't enough GPs.

I'll think and reflect.

1. Yes, hospital delays aren't helping, and I'm sure they add significantly to GP workload
2. However. I'm just not seeing this 'hard-working GP' thing in practice.

All the local GPs in my practice, which has several surgeries, close the actual building for an hour's lunch break. A and E don't do that. Shops don't do that. I don't know of any workplace that does that. They also just close in the afternoon sometimes without warning or any reason given. You cannot ring them up. YOu cannot just call in, and if you do you're told to go away. My partner (M) had to go through the entire booking form on the website to be given a list of available appointments. There was one. It was an appointment for a smear test. If he did not accept it he was sent right back to page one again. Obviously this is one anecdote, but can you not see that if basically everyone has an appalling time trying to get anywhere near a GP, just reiterating how hard you all work is not going to cut it? I heard some GP on the PM programme on Radio 4 the other day whose immediate response to the idea that GPs might - shock horror - actually have to see patients with urgent symptoms was to place 'urgent' in inverted commas, explain that probably most people think it's urgent when it isn't, and defensively explain all the reasons they wouldn't be doing that.

You can't blame people for seeing, noticing, and being angry about, what they experience day after day. And it's like there isn't even a wish or a will to see more patients - just an immediate passive aggressive defensive insistence that they can't and won't, and in fact we should actually 'appreciate them more'. What, actually, for?

Be lucky you can actually book an appointment in advance. My practice is the 8am hanging on the phone, hitting re-dial.

I certainly don't believe GPs are sitting twiddling their thumbs.

They will also need to fit in some house calls.
Possibly go deal with some shit, sign a death cert confirm nothing suspicious to police. My limited experience, that had to wait until after morning surgery.

So yes I do get why having a break in the middle of the day makes sense.

But why were there enough GPs in 2018, but by 2021 there weren't. I would be very sad to hear that the Covid 19 virus killed thousands or even hundreds of GPs - well, it would, of course be very sad if it even killed one GP - but it really didn't take the lives of many GPs at all probably because they refused to see patients at all unless really, really, necessary, they just sent all their patients to see the nurses who still had to turn up and do all their normal jobs, plus extra that the GPs sent their way - so what hsppened to them all, where did they go to once they could no longer use lockdown as an excuse? Yes, some inner city GP practices did have trouble recruiting new GPs before the Pandemic, but in most places, their huge salaries or shares, and much better working hours than junior doctors in hospital had, still drew GPs to the nicer GP practices.

I could keep on about all my complaints with our once great NHS, but there is absolutely no point.

How does that help? They go through their checklist and then tell you they can't help and to go to A&E.

I think some have retired and I think a lot must be doing private work on the side and only doing their NHS work one day a week or something.

It wasn't that easy to get an appointment before COVID, but it was much easier than it is now.

Private GPs charge a ridiculous amount. But you pay £20-30 for an eye test, so I would have thought £10-20 for a face to face appointment would be reasonable. A lot of people still wouldn't need to see the GP in person and could be dealt with in other ways eg sending a prescription, referring, a nurse sees you etc.

If you paid for a GP appointment they would magically become available.

I don’t want to get into a lot of back and fro-ing as I think most people have fairly fixed opinions.

But do you really think that we turn off the computers and go and watch TV when our clinics aren’t running?

I’d also be interested to know if you think A&E queues are because the doctors there don’t work hard enough; or if you think 15 month waits for outpatient appointments are because the consultants aren’t working hard enough.

It’s entirely equivalent - demand/supply mismatch all over the NHS, but my point of the narrative being held very differently is probably proven in your reply.

Because since 1948 Needspaceforlego, and up until 2020, they all seemed to manage fine working the sort of hours they should work, to enable them to see a normal day's worth of patients. They get remunerated very well for the longer hours and greater responsibility that they should be undertaking.

You also seem to be missing one, maybe two, important facts about the poor doctors who have to pick up their small children by 5.30pm every day. The main fact is that they can afford to have a 'nanny' pick up their children, and give them their tea.

The second fact is that most of them chose to be doctors, and chose to have children, so they already knew that most of the casualties in their lives would be any children they chose to have, and potentially their life partner as well. I have had 3 family GP's in my lifetime, which was due to me moving to different areas in England. I loved and appreciated all three of them, they were fantastic! Now that I have had to move area for a fourth time, I despise, and even feel afraid and humiliated by the few GP's I have been able to see since 2020. Most of the hospital doctors and consultants I have seen in hospital settings have still been brilliant.

Oh so a nanny should just work longer hours too.

We must be on a different planet because I don't know anyone who uses a nanny.

Lots of GPs work part-time / flexible working for a reason not so they can work hours and hours of unpaid overtime.

What I don't understand is why the UK cannot train or retain enough Doctors.

I agree they should automatically roll
you over to the next day, rather than you having to go through the booking process again.

I think they can’t help it if everything overran/ there was an emergency. They can’t be expected to stay all night.

Tbf some GP surgeries work quite well. I am moving and am sad to leave my amazing GP, will action any child request on the day and adult requests (non urgent) will be seen in the next few days. We live in London (so assume more funding) and it's actually easier to see a child GP on the NHS than using our family BUPA (as lots of private GPs wont see kids).

I wonder if the problems with medical grads getting "starter" jobs is beginning to seem through (theres a long running thread somewhere on this).

Also to the poster upthread who said GPs can afford a nanny, GPs earn 100k (?), when i was working i paid around £200/day for my nanny so unless their DP is also well paid, no they absolutely cant.

Every single time I've tried I can't get through. Every time.
I've been down to the surgery to try and get an appointment in person for my sick child because I can't get through on the phone and I have had the door literally closed in my face. They wouldn't even let me over the threshold. And no, this wasn't during COVID.
GPs are hidden away in back offices now, googling symptoms for those few lucky lottery winning patients that actually got to see one, guarded by Rottweiler receptionists who jump down your throat if you dare to say you really do need some help. Loong gone are the days when you had a friendly respected family Dr who came to see you at your bedside.

A few years ago I never thought I'd say this, but I just do not see what the point in them is.

A&E is now the only way to get seen by a healthcare professional. Even 111, after ringing you back five hours after you made the call, will invariably tell you to go there and then look up your local hospital for you on Google maps, then act like they provided a service.

Was there really enough in 2018?

I can't actually remember when my GP started the 8am madness but 2018 I had a toddler who'd been in hospital.

I was knackered and sleep deprived (who sleeps on a kids ward) on our way home, I dropped a letter in to the GP and asked for an appointment for the next week as per hospital instruction - oh no you have to wait and call at 8am on the day - not my finest moment but I did get the appointment booked

In fact I have been with current practice since 2011 I don't think I've ever been able to book GP in advance

No, they can make you an appointment with the out of hours GP.

I've just read 90% of NHS GPs in England work part-time. I knew it would be a fair percentage, but I didn't expect 90%.

Zero point in being part-time if your still doing hours and hours of unpaid overtime. Now it can't all be due to children I wonder how many have reduced hours due to tax rules. Or what percentage are doing private GP work too.

This is why I'm eternally grateful that I have a walk on centre 5 mins from me. If I need a same day GP appointment that needs to be face to face, I can almost never get one at my doctor's, so I have to go and wait to see one at the walk in centre.

They are a good in-between service from GP and a&e. The average wait is about 2 hours but it depends what you go for. When I went this week it was about 20-30 mins. I just go prepared with a drink and a good book. Although the people watching is always pretty good.

No…. That’s why you have start and end working hours. I’m salaried and I start and finish at set times every day. If I don’t finish tasks for the day I still leave at 5 and carry on the next day. I’m not working more hours than I’m contracted for and I don’t think GPs should either

The thing with the point about how we've all been duped into not seeing how hard GPs work and if only we thought about it it's just exactly the same as A&E doctors and consultants, it's just that we're dumb and have fallen for the line that GPs could conceivably do a little bit more to be accessible is, 1) GP surgeries are managed completely differently from NHS hospitals - especially relevant in terms of pay and systems/structures for booking and 2) GPs have specifically had to be told, in law, that they mustn't keep brushing people off when they repeatedly present with the same symptoms (I mean, isn't that supposed to be the actual job anyway?)

Yes, the NHS is underfunded and in crisis. But when this many people report this much frustration and this many systems that seem actively to be designed to repel people, and the GPs, you can't just keep telling them they're wrong and that there's not a single other thing that GPs could do differently or better.

“It’s not unreasonable that the GP finished their work day on time.”

”I think it is when you’re denying people healthcare.”

Have I read that correctly?

So very very well said, most people do not a single clue what it's like to work in primary care, what goes on behind the scenes and how unbelievably gruelling it can be. Then constant media spin of laziness and outcry that GPs won't be their indentured servants. Yet doctors are the selfish ones apparently! 🙄

I think the original post is likely rage bait to be honest, as I've never heard of missed telephone appointment not being held for the next day although it's not impossible of course. And yes, if so, shouldn't have happened.

But otherwise, the post has seemingly achieved it's aims of...checks bingo card... GP bashing, NHS bashing, arguing for private healthcare (and who might that benefit???), hugely unrealistic expectations, entitled demands from the general public and some light misogyny sprinkled in with criticism of doctors who dare to work 'part time' Most part time GPS will still work extremely long hours closer to the standard full time or over anyway, or be pursuing special interests, additional qualifications or part of working groups at Trust or ICB level contributing to improvement projects and service redesign etc. Even if not, GPs and all doctors actually, are ALLOWED a work life balance, time with their families, able to exercise and undertake hobbies, have down time and rest, just like other people do! Many in other careers would NEVER put up with all the pressure, stress, uncertainty and burden that doctors do, yet expect those in caring professions to be machines who just do as the public demands. Absolute hypocrisy and the definition of selfishness to expect your free at point of delivery healthcare service to be propped up on the overwork, burnout and good will of it's employees.

I've written more than planned as some of the comments here are just ridiculous and I felt the need to defend the other side (disclaimer: former NHS staffer, now mature medical student).

Back to the original post, definitely contact the practice if you genuinely haven't been rebooked automatically but the GP bashing and the rest is unnecessary.

I was having a conversation about this only the other day and I know where I live the urgent care/A&Es of the local hospitals are often posting on social media basically begging people not to attend urgent care/A&E unless it is an emergency because the are so busy but I do think it because so many people are struggling to get appointments and with the increase of E consultations is making it even worse I am very fortunate that I have never had an issue with my own GP surgery🤞🏻
My DH was taken to hospital by ambulance in September last year and was in waiting rooms been moved from one to another for over 15 hours he was then discharged and had to return to urgent care 2 days later for a scan where they diagnosed him with pulmonary embolism.