Why can we still not see GP's?

[ssd]

I had to send pictures on WhatsApp to my gp this morning after a telephone call appointment. Why are GPs still not seeing patients? How on earth do old folk manage?

It has good and bad points doesn't it. I like the fact I can speak to my Dr on the day instead of waiting six weeks like before lockdown. But they are putting people at massive risk by not looking at people's lumps, bumps etc. It's do important to have a smear until covid ruled the world. Now suddenly you and your cervix can wait! Hmmmm.

Makes you wonder why things are opening up yet we can't access essential services still.

They would give you a face-to-face appointment if it were necessary, you said yourself you have health anxiety so it probably just isn't as bad as you think.

@xLovexstoryx

It has good and bad points doesn't it. I like the fact I can speak to my Dr on the day instead of waiting six weeks like before lockdown. But they are putting people at massive risk by not looking at people's lumps, bumps etc. It's do important to have a smear until covid ruled the world. Now suddenly you and your cervix can wait! Hmmmm.

Makes you wonder why things are opening up yet we can't access essential services still.

Two week wait for a telephone appointment at my surgery and you can't book too far in advance either as they only put appointments available 2.5 weeks in advance. Makes for it being fun.

[quote StatisticalSense]@Hearhoovesthinkzebras
How do your GPs check it's the right person when seeing people face to face. I honestly cannot think of a singular preventative measure that they use in person that couldn't also be done over the phone or video (other than for their most regular patients a GP won't have a clue what people look like and people can quite easily look upto 15-20 years older or younger than they actually are (especially when ill).[/quote]
But they'd clearly know if they were expecting a 21 year old (my DD) and I turned up (50).

Or if say, I turned up with a black eye or worse, a child turned up with bruises or showing other signs of neglect. Bit worrying if face to face appointments are being abandoned unless strict clinical need.

@ssd

They are. They just aren’t seeing things that aren’t urgent. I’ve physically seen my drs 3 times since this started. Once was for a suspected stroke

And sadly they are missing things. Not the drs themselves. But because people aren’t going to A and E when they should. So heart attacks and strokes are going without drs.

The gp though is generally not missing much. If you explain your symptoms and they think they need seeing. You’d see someone.

It has good and bad points doesn't it

Very much. My dad got three years from diagnosis to death thanks to a face to face app with his GP. Had she not seen him and been concerned, I think he would have died much sooner.

Dh loves it. No hanging around, no germy waiting rooms. I'm much more uncomfortable with it lomg term as I struggle when I can't see people's faces to gauge their reactions. Plus for me it's mostly mental health and I hate talking about that in the house because finding a spot away from the kids is hard.

Video calling would be hard for lots of people - me included. I don’t have a smartphone, and my PC at home doesn’t have a camera. They are not doing video calls at my GP practice as far as I know. Audio calls only.

@Heartofstrings

That looks like a viral rash. However. I’d want a GP to verify that

If worst comes to worst. Turn up at the drs. Although mine wouldn’t let you into the waiting room. You’d see someone face to face. Receptionist. You’d see someone face to face and the. I’d show them the rash. For sure. (I mean receptionist).

I think it entirely depends on the situation. DP spoke to his GP recently about going on anti depressants. there was no need for him to physically go in

Actually for depression: mental health , I think face ultimately face can be critical

When I had a peri natal mental health crisis I went to the GPs and he said he could see immediately from my face that I was unwell. I was so scared to say what was going on but he just knew. I really worry that so many sensitive issues like this are missed on the phone.

Telling someone on the phone that you think you are losing your mind just doesn't have the same effect as seeing a very distressed person face- to- face.

Ah, @Emeeno1 - I hadn’t read your post when I posted above. Your example is very on point about the desirability of face to face For mental health

Exactly what my surgery is doing and normally get back to you the same day and see you if you need to been seen. Can’t see them reverting back to old system now.

What I don’t understand though is they won’t do Health checks eg blood glucose, cholesterol, weight, blood pressure. Surely this means cases will be missed and when identified people will be worse. Anyones surgery restarted health checks?

If this is the new normal, I don;t like it.

Our pharmacy no longer delivers, because they say it is too dangerous. They won't let anyone in the shop, so we have to queue up outside and answer personal questions in front of the rest of the queue and passers by.

In our city of 350,000 people, there is now no A&E for anything other than COVID or major trauma, so for broken bones etc, it's a thirty mile round trip not doable by train or bus.

We cannot get in the GP surgery at all. All conversation with the reception staff is via their shiny new intercom. The blood test form I collected this morning was pushed through a crack in the door. All appointments are by telephone. Doctors have their phones on speaker, so that they can type at the same time, which means I find them difficult to hear, but although I have two serious physical conditions and rapidly declining mental health, they will not see me, which again contributes significantly to the decline in my mental health.

Consultant appointments are also by telephone, but they send letters out for face to face appointments and only change them the week before, and yet they were happy for me to actually go to the hospital for investigation even when I was supposed to be shielding.

I need to be examined, but have not seen anyone face to face since 12 March and have not been examined since 8 February. The stress engendered by all this is incalculable.

So after sending photos, my gp rang me back, only 1 of the photos could really clearly show the problem, even though I sent lots from different angles.

Gp said what she thought it looked like and asked if I was happy with that? I was, but I sort of felt she was asking me incase it went tits up and she couldn't be blamed for a wrong diagnosis. I've never been asked that in the surgery, if the gp has a good look at something she knows for sure what her diagnosis is. A few WhatsApp pics just isn't the same.

It's not the way forward, and I can imagine GPS aren't 100% happy not seeing people face to face.

If they wore ppe and I did too, what's the problem? A consultation usually lasts ten mins or less anyway. I can understand the problem with waiting rooms etc, but people could wait outside like the hairdressers.

Am actually really amazed this is happening. GPS need to see patients face to face, there's no substitute.

I think it entirely depends on the situation. DP spoke to his GP recently about going on anti depressants. there was no need for him to physically go in

Yes this should be face to face and bloods should be taken first to out rule any thyroid issues etc. GP should also monitor blood pressure

And actually no, having health anxiety and not seeing my gp isn't better. I was prepared to go to the surgery with my mask on, I knew social distancing would be there, one way system the hand gel etc. To me who works 8 hrs a day in a busy retail shop, 20 mins at the Dr's was less risky than a shift at work. And to know she'd seen me and diagnosed me face to face is perfect. Hoping she's got it right from a few pictures isn't.

GPs are being told to offer a 'telephone first' service by NHS England. How each surgery interprets and manages that will vary but all should be conducting a remote (telephone or video) assessment in the first instance.

I find it frustrating that they can only offer telephone appointments, with no indication of what time they might be.

For urgent things, that would be OK, as I would be at home ill anyway, but it's difficult to do anything else that day in case I don't hear the phone, or if I'm having Zoom meetings and can't just pause them as I'm being paid specifically for that time I've arranged, etc., - I can't cancel the whole day just in case, when I'm waiting for a routine prescription check or something simple. But it has to be done via telephone appointment, and you can have no say in what time of day it will be, and I don't think you can really not answer, or ask them to call back. So I've given up trying to get an appointment now, and am just waiting til I can book a certain time again.

Tried to get an appointment for my DD (she had been stung by a wasp a week ago and it wasn't getting any better). She had seen the pharmacist who told her to see a doctor but on speaking to the care navigator she was told to go to MIIU at our local hospital which we duly did only to be turned away, as was the chap behind us from the same surgery, as we shouldn't have been sent. Phoned 111 who advised us to go back to the hospital (luckily we hadn't left, just moved car parks) who then saw her. It was all ok but as this was the first and only time she had been stung we wanted to make sure it was ok.

My last and next appointments for my skin cancer check ups have been cancelled. I have been asked to keep an eye on myself but am worried that I could miss a change or think nothing to how a mole looks which they would have picked up.

Saying that I did get to see a doctor who arranged two hospital appointments for me which did go ahead.

It does worry me that our doctors are not doing routine or face to face appointments as a lot of people like the reassurance of seeing a doctor. It also irritates me that they say go to a pharmacist, who I have found great in the past, but when they say you need to see a doctor they won't see you.

So could they in the end blame the patient for not describing or photographing their issues correctly? or for having insufficient tech?

My concern is no chance of booking a telephone apt. Have to be triaged to get a Dr on the phone and they phone you at their convenience, rather than at a booked time. So in the last I could go after work, whereas now if they phone in the middle of a training course of meeting I cannot take the call, despite needing to. Therefore I ended up leaving a situation as could not get a time when not working and sadly got sent to hospital as I did not know the situation would deteriorate - as I am not medical. However, I cannot take a whole day’s annual leave for a 10 min call.

@ssd it’s not about the risk to you!! It’s the risk to the GP. Do you think they would want to see you given the work you do unless necessary? They see multiple people in a day, PPE isn’t infallible, the GP is the one at risk that needs protecting.

it’s not about the risk to you!! It’s the risk to the GP.

Where we live the risk is non existent. But the phone appointments persist. The worry is that this will become the future, it's easier and cheaper for GPs. But the risk of people going undiagnosed is a lot higher, especially with mental health conditions and conditions that need a physical exam. It's also inconvenient when they refuse to give you a time for a telephone appointment, which is really difficult if you are at work or are in an environment with no privacy. I've just had to have an over the phone gynae appointment, whilst stood in the street.

Interestingly the nurses are working as normal here, the requirement for PPE has also been removed and the nurse practitioners are happy to see people.

GPs have to remove and bin PPE, wash, then put new PPE on in between every single face to face patient. There isn’t enough adequate PPE at the moment anyway as we know. This isn’t just to protect the GP, but the next patient. The time involved between patients would also hugely reduce the number of available doctors’ appointments.

Equally, one covid positive patient could potentially infect both the doctor and the really clinically vulnerable who have to be seen face to face. They must be protected from potential contact with people who have covid and may have it asymptomatically.

Having said all this, my GP saw me face to face following telephone triage and I’ve been referred on a 2 week breast clinic pathway. I think it’s difficult but part of keeping us all safe.

A telephone call would be fine if you could book a certain time on the day you request it.

I don't know how my surgery is but I know my mum has to wait days for a telephone call. I think they do at least give a window though so you're not waiting in all day for a call between 4-5pm.

[quote Megan2018]@ssd it’s not about the risk to you!! It’s the risk to the GP. Do you think they would want to see you given the work you do unless necessary? They see multiple people in a day, PPE isn’t infallible, the GP is the one at risk that needs protecting.[/quote]
But why is the risk to GPS greater than say nurses, doctors, dentists? They could do the appointment at a social distance in the gp room, then only come up close to see the actual problem. Full ppe on and all patients wearing masks. They could even have plastic screens whilst social distancing in their gp rooms. My Dr's practice won't accept anyone with covid symptoms.
I'm sure teachers will be at greater risk come August and September.