GP's please why are you not back to seeing us face to face

[whenwillthemadnessend]

Just that really ?

Please can any GP's explain the reasoning

If dentists physios and accident and emergency doctors can see people why can't GP doctors?

@LemonRoses
It is not a competition. You have the NHS, I have Sozialversicherungsbeiträge . There are advantages and drawbacks for every system.
And I do not comment on UK GP situations as that would be inappropriate as I have no idea.

Shame about your grommet experience. My DC are grown up now and 25ish years ago there was no chance of getting grommets on the NHS. I am aware that some smaller private hospitals have to draft in a paediatric nurse when children have surgery. Believe it's a bigger issue outside London.

@Parker231

Schnitzel - DH is on a countdown to leaving. Would have already happened if it hadn’t been for Covid. Instead he volunteered to go back to working in a hospital for eight weeks at the worse of Covid. Now back at the practice working too many hours a day. Hopefully soon the borders will open and we can move. No one to take over DH’s GP surgery so it will close, locums have new jobs in Australia and South Africa. Patients will need to find a new GP.

Was it you upthread said your DH was the only GP and the others were all locums? If the practice closes will he be hit by the "last man standing" issue? A friend of ours was almost caught by that but, luckily the practice merged with another

Queen - yes it was me. The practice is closing. It’s quite a big practice as are others in the local areas so too big too merge. Our leaving the U.K. has been planned over a number of years and the lease at the surgery had break clauses which are being exercised. Thankfully the agreement was well written and all the legal steps are being followed.

I wondered the same. Seemingly no face to face GP appointments either (although the nurses are still having a full stack of patients). Will take an hour on hold to book a phone appointment a week/two later even if it’s for something clearly they can’t do over the phone (eg ear infection). Rather than actually take a look at you themselves they’ll pass you to the hospital so you see a specialist who wonders why your GP hasn’t seen you. I think it’s pretty poor myself given the risks the hospital staff have to take daily.

@LadyWithLapdog that sounds like poor practice. We also needed grommets for a dc under 3, were advised up front that needed a shift to a different private hospital which is what should have happened with you guys. Not great!

@LimaFoxtrotCharlie

I don’t want telephone consultations. I want to book a face to face appointment in a couple of weeks time, when I can arrange it around my job. I can’t answer the phone when I’m working, so a call simply doesn’t work for me. I don’t have set breaks or lunch hours either, so cannot ask for a call back at a specific time

Not only do you want face to face, you want to pick the time and day? Most surgeries in normal times you'd get offered a time and date and not much choice in it! At the moment, many are only booking on the day rather than in advance because we don't know whether the clinic will be running in 2 weeks time because that GP could be isolating for some reason.

I assume you'd have to leave work for a face to face, so why not leave work to take the call? Most will give you a time window and you can ask the receptionist to put a note on that you can only answer between certain times.

Telephone triage is done first, to see if you need to be physically seen or if, as with most calls, it can be resolved over the phone. My colleagues are seeing around 10% of their patients face to face, I am seeing 90% of mine as I'm a nurse and my job is mostly hands on. If someone is called and they need to be seen, they are usually brought in that day. It's working really well.

We have a responsibility to all our patients to keep the footfall as low as we can, so that we reduce the risk to staff and patients. If the GPs all got sick/had to isolate and couldn't work, it would put patients at risk. If patients caught covid off each other, that would be bad too.

My private gp I just get a list of times and then click the one I want. Seems to work really well

@RagzReturnsRebooted surely GP staff isolating must be becoming more unusual as you should all by now be vaccinated?

[quote RosesAndHellebores]@RagzReturnsRebooted surely GP staff isolating must be becoming more unusual as you should all by now be vaccinated?[/quote]
My husband and kids aren't vaccinated though, I've already had several periods of isolation despite being vaccinated.

[quote RosesAndHellebores]@RagzReturnsRebooted surely GP staff isolating must be becoming more unusual as you should all by now be vaccinated?[/quote]
You still have to isolate even if you're vaccinated. Many of our GPs have children who either develop symptoms or have to isolate due to school contacts.

We have at least one member of staff off each week due to their children either having symptoms (because they're all back at school and exposed to germs and catching everything going!) and needing testing or having to isolate and needing childcare.

@RagzReturnsRebooted

This assume the poster wants to book so she doesn't have to let her employer know last minute or she would have to take annual leave or sick time.

Why shouldn't he prefer a appt that suits her job

If she was a lawyer she couldn't bugger off half way through a court setting

If she was a nurse like yourself she couldn't bugger off during ward rounds easily waiting for a call

Or a midwife during a women's birth.

If I wanted a call at work I'd have to take sick leave or holiday as we are mot allowed phones in us at all. Why should I have to do that to my employer or use my holiday up. I'd want an appt that works around my working day.

There are hundreds of jobs where this couldn't not be feasible.

It might be easy for you to take calls in work but it's not easy for everyone

I’ve always taken time off work for GP appointments. Doesn’t everyone? I work 3 days a week and you could argue I can organise it for days I’m off. Great, it might work. But how about a hospital appointment for my DD, or an MRI appointment, or a physio appointment, or orthodontist, or dentist, or parent-teacher meeting or the dozens of other things. It’d be a full time job shuffling things around for my two days off work. And I know not everyone has the luxury of that.

My point is that it was always so, it is a bit crap, but it’s unrealistic to expect everything to change to 24/7.

Or should I add waiting at home for a soda delivery (a whole day and I e already paid thousands), or the gas-man or the Internet guy. Again, things you pay through your nose for.

I’ve always taken time off work for GP appointments. Doesn’t everyone?

No. Not all employers allow it and they don't have to.

@VanGoghsDog

I’ve always taken time off work for GP appointments. Doesn’t everyone?

No. Not all employers allow it and they don't have to.

Maybe I wasn’t clear. By time off I mean annual leave. Lots of half-days for appointments. I have DH with whom I can share this so it’s a bit easier.

I found a few comments from a friend’s in USA’s Facebook page which might put things in perspective:

“I have insurance, which costs me a fortune, and I’ve already paid $4,000 out of pocket this year alone. I literally have to choose between eating, or medical treatment. “

“My hip replacement cost me $50,000 out of pocket. I had to make a $25,000 prepayment to even get them to touch me. Wiped out my savings. :(“

“It is sad. My brother has stage 4 tongue cancer and he had no insurance when he had surgery at UAB. Even my insurance when I retired 835.00 a month. Just a rip off. And that is single coverage.”

I wonder if in Germany they are more likely to tell people what’s available but then certain things are at an additional cost

That King's fund graph will make the UK figures look better as its showing people who Did not fill/skipped prescription, did not visit doctor with medical problem, and/or did not get recommended care due to cost reasons. People failing to get treatment and care due to lack of appts, rationed drugs and long waiting lists are unlikely to report that as a cost based blocker. I can't see the raw data sets to understand how that was considered.

Interestingly that report suggests spending in the UK isn't particularly different to quite a few countries who perform better on many measures.

None this either explains variability of care and service (its always blamed on money, despite the much better care provided by others in the same boat) and the utter failure to modernise business practices. There is no point having so called "universal" health care if people die on waiting lists or go into debt for basic essential treatment privately.

If the price of maximum access on paper is a bad system for everyone then its a failure. By making the NHS a sacred cow for which we should be "grateful' as if we are the recipients of charity we stop a proper discussion about a health care system to suit the needs of C21st. On an individual level this constant berating to be "grateful" or feel "lucky" stops improvements and feeds the culture of "system first" instead of patient first. Patient/customer centric systems actually produce better outcomes for both sides.

The NHS was built for the 1950s and then bastardised to suit the convenience and profit of GPs (who have always been private businesses) and consultants' private businesses. Its been tinkered with, defunded, refunded, reorganised and it gets worse not better. Its not just about money either and lets face it - every election sees a majority of doctors voting Conservative which historically is the party of cuts and privatisation in health care.

Its time to rethink how we deliver health care in the UK instead of treating the NHS as the national religion and acknowledge that other systems and even other industry sectors can contribute. Leads who boast about their lack of wider experience are part of the problem.

Then of course there is the related issue of social care which is an utter scandal in this country and for many old people effectively non existent.

I found a few comments from a friend’s in USA’s Facebook page which might put things in perspective

Ah the last refuge of NHS bureaucrats - wave the scare stories from the USA and pretend that is the only alternative.

@C8H10N4O2 I couldn’t agree more with your comment in response to mine.

I am a huge advocate of everyone regardless of income having access to a good level of healthcare.

Unfortunately I don’t feel the NHS provides that. Hence I would welcome a system modelled on the German one.

@C8H10N4O2

I found a few comments from a friend’s in USA’s Facebook page which might put things in perspective

Ah the last refuge of NHS bureaucrats - wave the scare stories from the USA and pretend that is the only alternative.

No, not a bureaucrat and no last refuge. I sincerely hope that the NHS will be my last refuge. I might suggest resorting to personal insults was the last refuge of the ill-informed with nothing but opinion to go on.

I keep asking for the alternative that gives the same for the same amount of money? Please do explain. I’d like greater investment so a fair comparison could be made instead of comparisons with countries that invest far more in the health of their nation.

The UK spent £197 billion on healthcare in 2017, equating to £2,989 per person. That’s below the median for the EU15, which was £3,663 per person. Our nearest comparators are Italy and Slovenia.

Shall we look at their systems and outcomes? It’s good for it’s money. However it’s chief issue in primary care is low GP density- remarkably similar to U.K. It has lagged behind most EU countries leading to problems of access and over-referrals to specialist care in some parts of the country. This not only leads to over treatment and over investigation but creates long waiting lists. It is marginally better at treating breast cancer but much worse for colorectal. Cervical cancer screening and treatment have much poorer outcomes than the U.K.

Their non-Covid19 vaccination rates are very worrisome, particularly for measles and flu.

Their 30day survival for stroke patients is very poor.

As with many nations where the provision is predominantly through private hospitals, there are concerns that the wide range of specialised services offered by relatively small regional hospitals may undermine care quality and patient safety because providers will tend to perform only a few procedures of a specific type per year. This is a huge risk and why our own private hospitals are limited. High risk care needs specialists staff and care; our NHS offers that but Slovenia doesn’t.

The NHS is about far more than whether you can get an appointment at a convenient time. That’s only one consideration.

[quote Foxhasbigsocks]@C8H10N4O2 I couldn’t agree more with your comment in response to mine.

I am a huge advocate of everyone regardless of income having access to a good level of healthcare.

Unfortunately I don’t feel the NHS provides that. Hence I would welcome a system modelled on the German one.[/quote]
And who will we pay for it? How will it reach poorer people or do they only get emergency treatments?

The UK spent £197 billion on healthcare in 2017, equating to £2,989 per person. That’s below the median for the EU15, which was £3,663 per person. Our nearest comparators are Italy and Slovenia.

And here we go again - reel off numbers but don't address any of the issues in this thread which are simply not explained by budgets.

The NHS is about far more than whether you can get an appointment at a convenient time. That’s only one consideration.

Well it certainly isn't about convenience. The issues here are the lack of access to care and treatment, lack of patient centric approaches and inconsistencies in both which cannot be explained by money alone.

Like Hellebores upthread I also remember an awful lot of waste in the '00s and unwillingness to modernise at a time where there was a government pumping money into the system. For me much of that time was an opportunity wasted, often due to this obsession with the national religion. As someone who has, all my adult life, voted for more money to go into state backed health care its that period that convinced me we need a better system. A decade of cuts has just aggravated and exposed those systemic problems further.

So Lemon is your position that the NHS is just fine and its only money which is a problem? In which case why the inconsistencies?

And if not, what would you change? You are always very quick to run to graphs and cherry picked numbers and surveys. You have often insisted that services must be available because a bureaucrat has contract in a filing cabinet, rather than listening to the experience of actual patients unable to access those services.

I can't recall seeing you talk about how things could be better in terms of structure and reorganisation short of just throwing in money. I'm actually interested in ideas for change or new models first, then consider the funding model.
I've long since lost interest in listening to lobbyists/politicians/bureaucrats on either side who respond to every health related question with a list of numbers to support their view that NHS is perfect or rubbish depending on their particular axegrinding. They never actually address the question or provide solutions.

@LemonRoses it seems to get paid for in Germany - I would be really interested to learn more about how they fund it