GPs - will they ever be open as before?

[Toastandjams]

Any ideas about if GPs will ever be opened back as before?
So that you book appointment online or over phone and turn up in person?
Or will it from now on only phone consultation?
I spoke to my Gp receptionist last week on the phone and she said this will be like that forever.
No coming back into GPs room, only if Gp decided on the phone it warrants a physical examination..

Lemon makes a good point. Face to face are booked for 10 minutes. They can ring 3 patients in that time. Then maybe just book one for a 5 minute face to face. Should also mean if you need a longer appointment they'll be more available.

I much prefer this.

I can email something in 2 minutes. This would have been a full appointment in the past...

And emoji don't forget the 5 minutes minimum trying to actually get someone to answer the telephone and 10 minutes persuading them receptionist that you are actually unwell and their lack of medical knowledge doesn't mean they can decide for you how ill you are and if you need a GP

I feel hugely sorry for anyone “popping to the shops” ie secretly going to the doctors about something they don’t want to disclose to their household as it’s not like you get a specific time to go somewhere private, they can literally call you any time in a day, that’s what I’d change

I love the new system. I have called for an ear infection and also for HRT over lockdown and it was all sorted quickly and easily. I filled in the e-consultation Sunday night for HRT and by 10.30 Monday morning the GP had called me back and we had about a 10 minute discussion about it all. Blood tests booked, and if all ok HRT will be prescribed afterwards. In normal times this would of been 3 face to face appointments in total. Now it is a much better use of my time and the GPs time.

I have a smear booked also so they are getting back up and running.

I think it’s been brilliant for me but not brilliant for the children. When my baby was poorly, we had a video consultation with the GP but we ended up in A&E a day or two later. Really she should have been seen and I think now they’ve got more to grips with hot/cold sites they probably would see her.

That’s not how my GPs work MostPeculiar, they give you a 1 hour time slot during which you’ll be called back, so you can keep it free or negotiate a convenient time. In most circumstances that’s much more convenient than having to go to the surgery, wait for an unspecified period of time, see doctor and come home.

Wobbly, my GP won't give you a time slot for telephone triage. At best you might get "morning" or "afternoon". If they miss you, they tend to try again at the end of that triage session but if they still can't get through then you'd need to call back and do it all over again. DH's GP surgery is the same. He works in A&E. The likelihood of him being able to take a call from the GP triage at a random unspecified time in his day is close to zero. One of our old GP practices a few years ago you could actually book telephone appt slots in advance via calling and booking with the receptionists or online, just the same as a normal GP appt, you just had to specify you wanted it via telephone instead and leave a phone number. That was really useful for me at the time when I had very regular appts for mental illness but didn't feel the need to be seen face to face a lot of the time. But I appreciate direct access booking telephone slots like that might be ineffecient in some ways as you will get people booking a 10 mins phone consultation when really they need to be seen in person and that could have been determined in about 3 mins via triage rather than wasting a whole slot like that etc.

I’m a big fan of the new system. Far more time efficient, I’m quite happy to have a phone or video call triage and only be seen physically if necessary. I’m not sure how good it is though for the elderly, vulnerable, people who don’t have phones/internet/privacy.... core users of GPs I imagine.

I foresee a day when the phone triage and potential prescribing etc is done by the equivalent of 111 centrally not by individual GP practices, and local GPs only see people who actually need to be seen in person.

Tbh, phone triage and consultations are a bit old hat. Practices can use online messaging type services to sort out a lot of problems before a voice conversation is needed. They take even less time and mean people can choose when to reply and can do it silently at wrk or at home. They also work well for people who have issues expressing themselves verbally.

Of course it doesn’t work for some people who have complex issues and need the long consultation in person. Practices are supposed to offer both.

@LemonTT

Tbh, phone triage and consultations are a bit old hat. Practices can use online messaging type services to sort out a lot of problems before a voice conversation is needed. They take even less time and mean people can choose when to reply and can do it silently at wrk or at home. They also work well for people who have issues expressing themselves verbally.

Of course it doesn’t work for some people who have complex issues and need the long consultation in person. Practices are supposed to offer both.

That’s a good idea it alleviates the anytime from 9-2.30 a little and the privacy issue a lot

I don't think they'll ever go back to routine face to face appointments, except for children and elderly or disabled people who may not be able to deal with technology. The rest of us will have a phone or video appointment first. Although it might be more efficient as someone might actually "see" you and if someone is eg self-isolating at home they can still do video consultations whereas before they would have been off sick and that was a GP or nurse down.

I don't know how it works for people in jobs where you can't answer the phone at a moments notice, for example my mum is a teacher and would never to speak to a GP during term time under this system unless they happened to ring during break time

They'd have to say they'd phone at a specific time or within a specific timeframe and stick to it as far as possible so during a free lesson or lunchbreak (ha ha, I know teachers don't get their lunchbreaks!).

My OH has cancer and initially couldn't get anywhere at all with our surgery, nor the oncology dept - basically just left without any help from anyone. It was a very worrying time that he couldn't even talk to anyone let alone get any treatment/advice. That was the first few weeks of the lockdown - even the oncology dept was shut completely.

The last few weeks have been VERY different and MUCH better than the old system. He's has a telephone consultation with the oncology consultant which will hopefully enable his treatment to restart - far better than waiting in the usually crowded waiting room for a couple of hours which was the old "normal" for a consultant appointment. In the past couple of weeks, he's had an infection and needed to call the GP a few times - every time, a proper GP has phone back within an hour, and prescribed anti-biotics which were available to collect from the pharmacy within a further hour. He's never been able to get things done that quickly before. It flared up over the weekend and phoned the GPs first thing Monday morning. GP phoned back straight away and wanted him in for a "face to face" 30 minutes later with the GP fully PPE'd with hard full head shield etc. Issued another prescription, which was ready for collection at the pharmacy next door as soon as he walked in, straight from the GP surgery.

So, they're certainly a lot more efficient at the moment. I hope that they can keep the phone system and drastically reduce the number of face to face appointments for only those that really need a physical examination. Must be massively more efficient and safer for patients and staff too!

I foresee a day when the phone triage and potential prescribing etc is done by the equivalent of 111 centrally

They'd have to massively improve the qualifications/training of those at the other end of the phone. My OH phoned 111 recently and told them he had myeloma (a terminal cancer that causes impaired immunity) - the person he was speaking to hadn't heard of it and asked him to spell it for her and asked him to tell her what it was and what it caused!

I would also imagine that anyone who needs to take a call at work in private is using up less time than taking off a few hours to go to a face to face appointment. This benefits employers as well who given the choice between a 5 minute call and a morning off will opt for the former.

And if I was the aforementioned A&E doctor I would be looking to do something similar to reduce their footfall.

The receptionist is an idiot, she doesn't know if it will be like this forever, no one knows anything yet. I hate threads like this. NO ONE KNOWS! I highly doubt it will but it might be like this for a while and then everything will be reviewed based on the risks....

DH works in health IT, and this has been a "hope" for some time. It's interesting it took a pandemic to change doctors position on this.

The original issue with video/phone calls, was that they were initially set up by private companies, and GP's were against that, as they felt these companies were creaming off the young and "healthy" patients. If you signed up with one of these companies, you were automatically off listed from your GP. This was an attempt by GP's to force you to stay on list.

Now, we are all in the same boat. I am pleased, as 98% of the time, I just need a repeat prescription or a referral letter. Job done. No need for those private companies any more.

There were some GP's who had already embraced this new system a while ago, and were being set up as "best practice" settings, in order to role the system out nationally, being part of the digitalisation of healthcare. I think this pandemic has brought everything forward, which is probably a good thing, as it has forced the GP's into a new way of doing things, and they have actually found it to be productive.

My GP's were already half way there to be fair, and they have been really good in rolling out the new systems.

I think Covid has brought in so many ways of working and GP surgeries will cherry pick what works best going forwards.
In any area in ordinary times different surgeries will have different procedures for appointments and patient care depending on staffing levels and practice ethos. Some surgeries are partnering up to offer better in house treatment options. Some are more independent.
I'm hoping that won't change

I'd prefer being even more efficient by being able to send in a message, then get a reply / call-back / in-person as needed. Often I'm doing things like saying "I need an extra blood test because" and they say "yes, I'll print out now" when they could just log it with phlebotomy and say "go and do it"' with hardly any effort from me or GP. Hopefully then the in-person slots wouldn't feel rushed because they would expect those are the longer appointments.

Conversely, I don't understand why one hospital dept is demanding that I go in at the end of July. They could speak to me by phone to triage, which should be the case for 80-90% of their appointments, but they apparently actively want in person apps.

My GPs were already doing phone appointments where appropriate. I have regular thyroid function tests and it’s so much easier for all concerned for my GP to ring me in a named time slot with test results, discuss and represcribe as appropriate. Prescription goes direct to my pharmacy for me to collect on my way back from work.

Ours is working really well to be fair but it is a big practice. I’ve had issues with my asthma being unstable. I’m high risk for Covid19 and been avoiding going out if I can. Every time I’ve contacted them I’ve heard back either by phone or video chat. None of my chats have really needed a face to face (It might have helped to listen to my chest at times). Most of the time my issues could be dealt with by phone and I reckon a lot will be able to be dealt with in the future.

Obviously some places are refusing to do any face to face which can’t go on long term but I think many places will stick with phone calls first, reducing time taken for patients and staff.