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?

As a pharmacist, we are picking up the slack and the workload has increased considerably. It wouldn't be so bad if we were paid for the service but advice is totally free. GP surgeries are still being paid but we are picking up a lot of the workload for nothing!

Hmmm, I am a HCP so absolutely see the need to protect GPs from covid, but, if telephone consultations only are the way forward forever, that will be the end of me ever attempting to seek medical help for my wobbly mental health. I would really struggle to explain what is going on face to face, there is no hope over the phone as I struggle on the phone even having a normal day-to-day conversation with someone I already know.

I was surprised that it was possible to book for a smear test last week, so I went to the surgery. There are signs on the door, saying they aren't seeing anyone face to face, only by phone and if a face to face appointment is needed it might be at a different location. I turned up for my appointment, had to go to an open window in the car park to let the receptionist know I was there, wait for the nurse to come and let me in. Surprisingly, it was not compulsory for me to wear a face mask (I did anyway)

My GP surgery are great and there are definite advantages to telephone triage and appointments. I do worry some GPs feel forced to make difficult decisions over the phone due to policy when some people do need to be seen. My GP sent me to A&E who were a bit miffed as it could’ve been dealt with by the doctor. It’s a tough balance.

Pre Covid, I saw a GP with symptoms of a chest infection. I get them regularly and my consultant and GP had agreed a plan of care. Nothing horrendous, just thought I needed my usual antibiotics. GP took one look at me and called an ambulance. She couldn’t have done that over the phone. She wouldn’t have known and I really didn’t realise how I unwell I was. I was admitted to the high dependency unit within a matter of hours.

Now waiting for another video call - because the rash from yesterday has progressed dramatically. I think there's a very strong case that if we had had a face-to-face appointment this would have been resolved on a first appointment and cost less time than this to get to the bottom of (and not put a 7 year old's health at risk)

I work in the community and we and the District Nurses are getting a bit fed up of the GPs not visiting.

Yes, we have changed our ways of working and are doing telephone and video assessments but a lot of our work has to be done face to face.

So when we call a GP and ask for a visit - which we only do when it's really necessary, and get told 'we aren't doing them' we feel 'OK, so it's OK for us but not for you then?'

It's wearing a bit thin now.

Our Medical Practice has been amazing
I had CV19 in April, I am sure.
I felt awful but didn’t have the cough which was the defining symptom then so just stayed in bed
Since then I have totally lost smell and 80% of taste, am often breathless, generally fatigued, GERD, upset bowels and bladder and swollen legs and ankles with aching joints all over my body.

My GP triaged on the phone and then saw me in a socially distancing appointment. I have had a chest X-ray and blood tests

I am waiting fir a scan, to see a rheumatologist and neurologist and to get a physio appointment as all this has triggered an. Already existing condition
I have sunk into a pit of depression and anxiety and my GP has really talked to me and offered brilliant support

When I have visited the surgery there have always been a few people there. Our practice is always excellent and have really responded well in the last few months
They even have friendly receptionists!

I am not making this up, it’s all true even the receptionist bit! I have contacted the Health Trust, our MP ahd MS to ask why their model isn’t rolled out across the country. Another local practice is horrendous but are allowed to continue without charge

(Sorry that was epic, when all I meant to say was, you should be able to see a real live GO if your condition requiresit!)

After my post this morning I started thinking beyond myself, and surely this is an issue for plenty of people who won't feel comfortable discussing their health on the phone in a house full of people. Whatever happened to patient confidentiality? For mental health, sexual health, contraception, abortion, early pregnancy that you might not want the rest of your household to know about yet etc etc. Since March I have never been in the house on my own and I am sure I am not the only one, so phone calls about confidential problems are going to be very difficult for a lot of people, especially if you have no idea when the GP will call so can't try and arrange an excuse to be out of the house for it. I also think a lot of safeguarding of vulnerable children and adults and domestic violence victims will be missed by not seeing people face-to-face.

happy I agree. DD has just started taking the pill, the nurse said she would review by phone in 3 months. When we came out DD’s response was how is that going to work when I am at school. I can’t exactly take a call in the middle of a lesson. We will have to try for a telephone appointment at half term.

It's like something from a Kafka novel, isn't it? A health service that doesn't actually see or treat patients. The NHS appears to now exist as a bureaucratic organisation which doesn't do anything, but needs to be protected at all costs anyway. I wonder if it's original purpose will be forgotten in time.

The system that was implemented during lockdown should now be adapted as things are relaxed just like every other profession has been told to do! Our dd had a suspected water infection- I had to get an initial telephone appt which as pp have said means being available to discuss private matters whenever they call. They said they needed a sample to test so I had to drive to the locked up surgery, ring the bell and get a sample pot shoved through the door at me, then get the sample, drive it back to the surgery, drop
Off again through the door. Heard nothing so called them back and was advised if symptoms still there they needed another sample so I repeated the two-drive process to collect a sample pot and drop off sample. When I tried to drop it off they came to the door to say they were closed so couldn’t take it so I had to wait until the next day take yet another sample in and finally got the infection confirmed and prescribed
Antibiotics. Then when she still hadnt improved I called to try and get an extension of the medicine to be told I needed another telephone appointment but this was a Thursday and no appointments available until Monday. Dd was wetting herself about 20+ times a day FFS! My dh basically complained and said it’s not good enough and magically the Dr could call us Friday. It was a waiting around all day job again and a 2 minute conversation which resulted in more antibiotics.

This system is a farce and will result in missed opportunities to diagnose, people unable to access healthcare and more pressure on hospitals and pharmacies as a result.

They've been operating here throughout, if you phone for an appointment a doctor phones back and decides what the best route forward is. I've been in for a face to face app and some of my friends have had theirs over the phone.

Perpetuallytiredzzz

Could you imagine all of that if you didn't drive?

In theory if a patient had a car and there was a car park, patients could be called in from their car and have their 10 min appointment and leave. So reducing the 30 min wait with other people inside.

However, very soon in Scotland staff in schools are going to have to work indoors with large numbers of staff and children, with no PPE, yet Gp’s are able to limit seeing patients.

@Hearhoovesthinkzebras

Perpetuallytiredzzz

Could you imagine all of that if you didn't drive?

@Hearhoovesthinkzebras it would have been a nightmare, I did actually walk it once for the exercise but I didn’t have to take my 3 year old with me that time! And this is my issue completely, this system is disadvantaging a number of people and groups and it also is unworkable for anyone who can’t be hanging at the other end of the phone and/or with quick and easy access to the surgery if you do get asked to come in as well. If I had been at work getting treatment for my dd would have likely been delayed further, it gives me the rage when every other key worker service is having to respond and adapt and this hasn’t changed at all since the start of lockdown!

I don’t drive. My GP practice doesn’t have a car park either.

Perpetuallytiredzzz

I completely understand. My sister works in a school and her GP practice decided to triage all appointment requests, either routine or emergency. She had no end of problems trying to book appointments for either herself or her children because she had to be available to answer the phone at any time - which you can't if you're in a classroom.

How do they think these policies affect people who work?

I hardly EVER go to the GP. Literally prior to recent episode have been once in 3 years. recently I was really unwell with horrendous rash over my full body, burning hot skin and both arms swelled up, ridiculouds headache and didnt eat for about 4 days. It was 6 days before I could even speak to a GP. Then 2 days of sending photos and further phonecalls. Then another 5 day wait for a blood test. I was actually at the point of going to A&E I was so unwell. It was a total joke.

I should add, I am an NHS clinician and have been seeing patients face to face (with PPE) in an outpatient setting throughout this whole thing.

Hearhoovesthinkzebras I think there is going to have to be an appointment system back or otherwise The only solution is to say have 30 children will have to be told no school place today as teacher XYZ needs to be off to wait for a Gp to phone them. I am pretty sure once key worker children ( including those of Gp’s) are made to have a day off the system can change.

Without wanting to be provocative, what are GPs doing? I see the pp above mentions holidays abroad. But how does it work? Are they going in to the surgery and scrolling through Facebook all day, apart from the odd phone call? Or doing the filing? Or...what?

@okeypoke

Friend is a nurse at a GP surgery and told me most of the GPS are refusing to come in for face to face as too risky.

But it's fine for the nurses to take the same - and probably worse - risks.

There were 3 GPs at our surgery the other day doing face to face appointments, all ones who were partners at the surgery.

I see the pp above mentions holidays abroad. But how does it work? Are they going in to the surgery and scrolling through Facebook all day, apart from the odd phone call? Or doing the filing? Or...what?

Relative GP is working from home at least part of the time, doing video calls etc from her home office.
Our GP was in the practice when she's video called me though.