What are GPs actually doing during all this time ?

[VivaMiltonKeynes]

We were discussing this . In our surgery they have e consult online and you get a call back . On the couple of times this has occurred it's not even a doctor at our practice - it sounds like a service they use and it is really appalling . They don't even seem to have read your notes . The nurses are run off their feet doing the usual blood tests, flu shots etc but what are all the GPs doing ?

Ours is phone on the day to book a phone consultation - can't book in advance. No e consult or video consult service and no face-to-face services at all. If all the phone appointments have gone when you get through, try again the next day. Once you've got an appt, keep phone on you at all times as they will only try and ring you once. The call will be anywhere between 9 am and 6.30 pm and it's too bad if your job may mean answering a phone instantly is a problem.

Thankfully, we have savings and are able to afford to use some of the excellent video services that are available with private GP's. 'Protect the NHS' isn't met with any sympathy in this household.

Massive difference in service. My surgery is doing phone calls , but the doctor will call you in if needed .

Providing a much better service than ever before. You complete an on-line form and someone is back to you really quickly. Prescription sent digitally to pharmacy for same day collection. DD had a hospital referral sorted out and was seen early in a very empty unit.

What I don't understand is why more couldn't have been done digitally earlier but then I am able to summarise an issue clearly.

Repeat prescriptions also much better.

It is a joy not to have to wait 40 minutes for a heavy handed and unhelpful receptionist to answer the phone.

Long may it last. I am v pleased with the excellent service my GP practice has provided during lockdown. Long may it last.

Compare and contrast however to the MH Trust DD is under. Their services have more or less packed up for those neuro developmental disabilities and all non clinical staff any many clinical staff are wfh until the end of social distancing. They are key workers I believe. It is a disgrace.

I’m a teacher and under so
much pressure I have had to take anti anxiety meds for the first time in my life. I may not have seen my GP face to face but she let me cry down the phone to her for half an hour. She calls me once a month now to check on my welfare. I may not see her in person but her support is invaluable.

Thank you to all the GPS - especially mine!

@Bluepolkadots42 because advice from NHS England is only to see face to face if it is essential to do so. Because waiting rooms aren’t big enough to social distance safety. Because we have to clean the room completely between patients so a “10 minute appointment” takes 25 minute with cleaning/ventilating the room. Because the majority of our patients even when offered a face to face decline as they are afraid to come out of their homes. And for 50-75% of the things we deal with a phone/video call with photos sent securely if needed is at least enough. And if a face to face is clinically indicated it is offered.

@MrsHarryKane

My GP is triaging patients over the phone and econsult but they are definitely there. As I’ve had to see them a few times.

On the other hand - no idea what my consultant is up to. Haven’t heard from my consultant since February! Hospital is fairly quiet in their department (or so I’ve heard!)

Your consultant could have been redeployed?

During lockdown I had a concerning mole & after a video meeting with GP was given an appointment at the skin clinic at a very large London hospital. Less then 2 wks wait for appointment & when I arrived the doctor was waiting for me. I have never seen the hospital so empty, it was weird.

Ours is doing call backs but of course you have to run that gauntlet of receptionist triage before you get anywhere.

As a GP partner in a fairly large practice this is some of what we are doing:

1. Telephone Appointments for anyone wanting an appointment.
2. Face to face appointments if needing physical exam. (Bearing in mind some of our doctors cannot see F2F due to pregnancy/extremely vulnerable so others are doing more.
3. Running a red hub (triaging and seeing covid patients) in our surgery
4. Care home ward rounds are being done via video link as we’ve been advised not to increase patient risk by visiting the care homes in person.
5. Receiving, processing and actioning blood results.
6. Receiving, processing and actioning hospital letters.
7. Processing and actioning medication requests - routine and urgent. Medication reviews.
8. Receiving and dealing with urgent phone calls from paramedics/physios/district nurses/hospital doctors etc
9. Organising and staffing flu clinics - usual at risk groups, and now the extra over 50s flus.

10. Planning and organising how covid vaccines will be delivered 11. Offering advice/queries from the reception team when patients ring up. 12. Reviewing and actioning eConsults daily (we get around 15-20 per day) 13. Organising and supporting our nurse colleagues in their chronic disease clinics. Dealing with queries that arise from these eg patient with high BP. 14. Medication review phone appointments and reviews of records 15. Supporting and supervising the clinical pharmacists, ANPs, ACPs in their roles. 16. Teaching and training our GP trainees. 17. Teaching and training our medical students. 18. Dealing with complaints 19. Reviewing our covid policies in a regular basis 20. Meetings to review palliative care patients, significant events, new cancer diagnoses etc 21. Assessing patients needing long term contraception and running our Contraception clinics fitting coils and implants. 22. Assessing patients needing minor surgery and running these clinics. 23. Dealing with queries from patients when their hospital teams don’t answer the phones. Likewise chasing their referrals. 24. Care planning for our frail elderly patients. 25. Home visits for our palliative patients 26. Remote meetings with health visitors to discuss safeguarding concerns 27. Medical reports 28. Some of us have additional job roles eg GP trainers, GP appraisers, PCN clinical directors. The work for this is done in our own time on ‘days off’ 29. Supporting our staff who are dealing with a lot of abuse from some patients who think we’ve been shut for 9 months when in reality we have been busier than ever. 30. Staff who are currently covid positive or self isolating are all set up with laptops to work from home.

Can’t comment on other surgeries but we have been busier than ever before in my last 15 years of practice.

@Mummydoctor that’s my experience too. Literally never worked so hard

To protect people who may be vulnerable to Covid19. Minimising contact with people who are likely to have a preexisting illness is sensible.

A&E/ED the risks are greater in not seeing people face to face but the other way round for primary care. It’s all about risk benefit to dealing with problems remotely or face to face.

I have used the e-consult for myself and DH , I didn't need to be physically seen, but got a call from the GP and treatment prescribed and DH did need to be seen and was seen in a few hours of the e-consult being written.

Our GP are fine for adults (econsults and phone calls) but it's not great for children. You're not allowed to use the econsult system for children (it just bounces back) and can only get telephone advice. I have spent most of 2020, on and off, getting an ADHD/ASD diagnosis for my DD (after lockdown made it obvious that was the problem). They have not seen her in person in all that time and to be frank, phonecalls about an anxious child while they are in earshot are not great! I have spent nearly 2 grand on private assessment now and all that time the secondary services in our town have refused to take the GP's referral.

As a teacher I do find it really peculiar that it is ok for me to be face to face with teenagers every day but the GP and dentist are able to take such precautions.

Particularly as the phone call back system works really badly for teachers. I'm hardly going to wander out of class to take a phone call from the doctor.

@clopper

Not much at my surgery! As a pp said the nurses are doing all the work. I went in with chest pains and had an ecg in the surgery. The nurse took the ecg readings to show a doctor in the next room. I mean... chest pains, this is why more people will die because of covid. I am disgusted. I visited the hospital for a biopsy. No patients hardly. So no I didn’t clap for the NHS. Meanwhile me and my colleagues continue to teach children without any protection. It is a joke.

I don’t understand what you are unhappy about? You got an ecg at the surgery and the doctor was there to review the results straight away and give advice. What were you hoping would happen? Are you unhappy with the diagnosis?

Usually I would receive annual BP check blood test and medical review. This year not heard a Dickie bird.

@sleeplessinderbyshire thank you for that information and insight.
When we've been for flu clinic we weren't permitted to enter the surgery until the exact time of our appointment and so everyone had to queue socially distanced outside which we were happy to do and seemed v sensible. Is it not possible for majority of patients to do this?
I understand with cleaning capacity to see as many patients as usual would be greatly reduced but I do think the option should be there for those who do wish to come in. I just think there's some things that can't be accurately triaged on phone or even by video call (due to quality of patient's phone/laptop camera) e.g. distinguishing chickenpox from other viral rashes (our most recent experience of needing a GP) and I think people should still be able to request a face to face appointment.

@Phineyj yes I totally agree- not being able to use e-consult for children is a real pain and there are definitely things that cannot be accurately assessed just by phone (to be honest I think there's things that can't be accurately triaged by video either- but it's slightly better than just phone).

[quote Smelliethenelephant]@OpheliasCrayon I'm happy you're getting to see your GP every week. Doesn't change the fact that my surgery - and many others on here - are not offering the same. I hardly ever use the GP so would like to be not made to feel a nuisance when I do. It seems to be a massively mixed picture.[/quote]
If you hardly ever use your GP, then I'm not sure you're in the right place to judge are you?

If you had multiple chronic illnesses and needed constant care throughout every week , pandemic or not, then you might be able to judge more what they're doing ?

If you need that level of care and then weren't getting it then maybe I'd agree with you that your GP is doing nothing.

Oh yay, another GP bashing thread.

In the past three weeks we've had:

Phone consult with GP
Face to face appointment
Phone consult with practice nurse
Face to face appointment
Appointment with practice nurse

Tomorrow we have another phone consult, which will be followed up with a face to face appointment if needed.

Medical appointments are there if needed. I'm glad they've been able to weed out some of the queries that don't need an appointment.

@Phineyj

Our GP are fine for adults (econsults and phone calls) but it's not great for children. You're not allowed to use the econsult system for children (it just bounces back) and can only get telephone advice. I have spent most of 2020, on and off, getting an ADHD/ASD diagnosis for my DD (after lockdown made it obvious that was the problem). They have not seen her in person in all that time and to be frank, phonecalls about an anxious child while they are in earshot are not great! I have spent nearly 2 grand on private assessment now and all that time the secondary services in our town have refused to take the GP's referral.

As a teacher I do find it really peculiar that it is ok for me to be face to face with teenagers every day but the GP and dentist are able to take such precautions.

Particularly as the phone call back system works really badly for teachers. I'm hardly going to wander out of class to take a phone call from the doctor.

It is not teacher versus GPs as you are implying. Its the government ineptitude that didn't insist on more distancing and online learning for teenagers were able or wearing masks where practical. The epidemic is raging amongst teenagers who have the same level of transmissability as adults. You should ask the government why they can't prioritize teachers when it comes to vaccinations.

Our surgery seems to be working more efficiently, less time wasters, no missed appointments which waste time and money. It’s a pain to actually get through on the phone to our surgery but once you get through it’s been fantastic service, I had a phone consultation in July and my son had a face to face appointment in September.

Goodness me, so many posters on this thread are struggling with the concept that services are variable between practices.

Ours are flat out with telephone consults, f2f where needed, behind the scenes meetings and planning for the Covid-19 situation- more now with the vaccine being imminent + all of their usual paperwork and admin. As busy, if not busier than before. Certainly not sat doing sod all.

@tikha this is a really good point- I think I've fallen into that trap, which is exactly what the government are probably hoping for.
It feels outrageously unfair that some job sectors are giving their employees better and safer working conditions than others- but you're right, it isn't the fault of those employees who are being kept safe.

I'm so angry. My GP surgery isn't doing f-2-f appointments, neither is my mums, neither are 10 of my friends.
Makes me so cross.