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?

In Germany it is paid for by employee and employer payroll contributions with government funding for those not working. Many also have private insurance with the level of contributions based on risk - the older you are and more medical conditions, the more expensive it is. A friend of mine moved from the private back to the state system when she got to 55, as it was becoming too expensive.

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 don’t get “annual leave”, I work in school. I’m not allowed my phone on me. Non emergency appointments have to be arranged out of school time but I can’t make an “appointment” of ANY sort with my doctor. You email and get told you will be called at some point “in the next seven days”. I’ve had an osteopath appointment, DH has had a dental appointment, I’ve even got a hair appointment booked for after April 12th but I can’t get to speak to my GP about an ongoing issue I am on medication for OR have a smear test that was due last April.......

I agree with everyone here who has mentioned how inconvenient and unworkable the new system is at many surgeries.

GPs if you are reading this. I work full time freelance. I do not get sick pay or annual leave. I cannot afford to take the whole day off every time I need an appointment with my Dr.

I have to call at 8 am and am told I'm on the list and the GP will call me at some point that day. They refuse to give a time and if I miss the call because I'm at work and can't answer my phone in that moment, they remove me from the list and I have to try again the next day.

So, my only choice is to cancel all my clients for the whole day at a cost of £100s and sit by my phone for the whole day, waiting for it to ring.

This just is not reasonable and it's not good service at all.

I have a chronic health condition and have had to do this 3 times in the last month. Once, just to ask for a medication to be added to my repeat prescription list. This was after a consultants phone appointment, for which I was given a time and asked to be available for 15 minutes either side - very reasonable and workable.

Why is this deemed an acceptable way for GPs to run? Why are patients who pay for this service not beong given choice and a workable, reasonable solution?

Sorry @Punxsutawney I haven't read after this post but wanted to comment.

Camhs sent the GP an ED protocol to follow on what they should be doing but the GP said that all they can do is ask the practice nurse to weigh Ds, measure his height and do his BP and pulse. If his pulse is not below 60, then they have said he does not meet the criteria for an ECG. And there is no available appointments to do that for 12 days. Is this where Covid had left us? Our surgery is empty, I can't understand why they can't see him earlier.

If they are wanting these checks - height, weight, BP, etc - these can be done at CAMHS. CAMHS regularly do these as part of regular assessment when stopping, starting or reviewing medication and treatment. We have attended CAMHS in person for these checks during the first lockdown, but have since purchased the equipment to do it at home since it is an hour round trip. Don't let them fob you off that it has to be done at a GP if it is delaying treatment starting.

Thanks Dumplings, I don't think CAMHS think it's within their remit, hence refering Ds back to the GP, who said 'i'm not sure what they want us to do'. Dh emailed our GP Thursday afternoon (after they put the phone down on me) and was told by one of the admin team that a doctor will decide on Tuesday if Ds can be seen by the nurse sooner, if they say no, then he will have to wait until the week after next. All this despite me being told by Camhs he needs to be seen urgently but Camhs won't see him themselves.

There is no treatment plan, as nobody knows what to do. In the meantime, Ds continues to struggle. It amazes me that nobody can support a child who's food intake is so restricted he hasn't got the energy to attend school.

Although we are used to this. Ds has ASD and SEN and everything is a huge fight. I'm exhausted with it all.

For everyone saying they "pay" for the NHS ' you do - but NOT ENOUGH.

If we were all taxed more there would more money to fund training and have more GPs to provide more apptmts.

Another problem is who'd want to be a GP when the public treats them with such vitriol. Most newly qualified will pick a hospital speciality where they only have to think about one specialist area and are given 20-30 mins per pt. Why be a GP where you consult with st least 40 pts a day in such a thankless arena working 11+ hrs daily? I am sure there are a minority of lazy ass GPs and GPS who have let you down, but most are not like this.

We will be paying for care in the future privately then you can get your guanteed slot time and find something else to moan about.

Has everyone forgotten about the pandemic...?
There are lotdvof posts on MN where people are still scared to go back to work and these posters are sympathised with and empathy given and done told- don't go back. Well, your GP surgery staff have been there every day since March 2020 - have a little empathy and cut them sine slack.

The issue is that demand is greater than supply. Pay more tax and it may get resolved - but that's not popular is it?

@LadyDanburysCane

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 don’t get “annual leave”, I work in school. I’m not allowed my phone on me. Non emergency appointments have to be arranged out of school time but I can’t make an “appointment” of ANY sort with my doctor. You email and get told you will be called at some point “in the next seven days”. I’ve had an osteopath appointment, DH has had a dental appointment, I’ve even got a hair appointment booked for after April 12th but I can’t get to speak to my GP about an ongoing issue I am on medication for OR have a smear test that was due last April.......

Okay that's really shit. You should be able to talk to an actual receptionist on the phone, it's appalling if it's all done by email. How do people without email manage? Our surgery offers econsult as an added service, where you submit the issue online and they either call within 24hs or send a prescription and text you. Otherwise it's call first thing on the day for triage that day, if you can get through, though there's usually afternoon appointments left if you call by 12. For nurse appointments you can call any time and book weeks in advance, but usually get an appointment within 2 days. We also have evenings and Saturdays.

I sometimes forget how good the surgery I work at is, compared to some of the horror stories on here with people basically shut out of primary care.

Write to your CCG and complain, they are failing patients with this approach.

@Tistheseason17 I don’t really agree with this. IME patient care in the nhs is often not great and I don’t think it’s all about the money.

@Punxsutawney although I don't agree with the philosophy might it be worth considering whether you should take your ds to A&E on the basis that his ED is a form of self harm and you are concerned the risks are too high for you to manage him at home. They are likely to admit for CAMHS specialist assessment and review and if that review says go back to the GP, then dig in your heels and say you are not satisfied and wish him to be reviewed by a specialist consultant paediatrician before you agree to the discharge. You will almost certainly leave with a better plan than the one you went in with. If possible go at about 3pm on Tuesday - CAMHS will be on a skeleton staff over the Easter weekend and catching up on Tuesday.

@Tistheseason17 I beg to differ. I am not going into our tax assessments here but we most certainly are net contributors as have been our parents and grandparents. Whilst I thinkntreatments should be equal I believe access should be differentiated and working people should have precedence over early am and late pm appointments for routine matters. When I was a SAHM I could attend at any time of the day, likewise I shall be able to when I retire. For now DH and I cannot - so as well as being net contributors we source a lot stuff privately. Honestly when dd was very ill with her MH I could not have held down a job if all her appointments had been at 10.30/2pm and she would likely have dropped out of school. If people have to give up work due to an inflexible NHS that lacks agility the result is that less tax is received from those people. It's basic common sense.

The NHS will wang on about equality. If the NHS gave a hoot about equality outpatient ts would cease calling in the male patients as Mr x and the female patients as Jane Smith and when those patients met the consultant (or other Dr, including the salaried partners at my GP but paradoxically not the partners) the consultant would introduce themselves as John or Jane if they assumed they could use my first name. If they introduce themselves as Dr/Mr/Miss//Ms they may not use my first name, they may address me as Mrs Hellebores, indicating they regard me as an equal stakeholder in my care. That goes too for the staff around them - if they call the Dr Jane, Fred, Penny, Patrick - they may use my first name, if not they may address me as formally as they address the Dr. The reason is very simple. I am not subordinate to any care provider.

[quote Foxhasbigsocks]@Tistheseason17 I don’t really agree with this. IME patient care in the nhs is often not great and I don’t think it’s all about the money.[/quote]
I agree, my post did not say it was all about the money. There are other factors. I also agreed there is poor treatment- I have experienced it myself - but when I count up all of my NHS interactions the poor treatment is in the minority. The reality is people generally focus on negative experiences so that is all that is heard.

@RosesAndHellebores - most people work so there are not enough if these early/late apotmts for everyone that works. Non - workers are not the majority demographic 🙄 so someone has to be cinsulting with GP between 9am and 5pm... with only 5% declared as not working do tell how... Even if 50% did not work then what you propose is not viable. Maybe you'd like GP s to be open 24/7? Aah, but we do - they are called out of hours GPs- problem is everyone wants to see their fave GP at a time convenient to them. Hmmm, spot the problem, yet?

Do most people work? 15m were between 60 and 80 for their vaccinations, I believe about 5 million are too ill, 2 million are unemployed, 40% of 18s to 21s are at uni, the under 18s don't (although may need a working parent with them), the SAHPs don't. I'll look up the exact figures but I don't believe the majority of the population does work full-/time and certainly not full-time 9-5.

And as I have said I'd like to see slots between 8am and 9am and 6pm and 7pm ringfencednfor working people. GPs are self employed and mostly work part-time. It is not therefore unreasonable to expect themnto work variable hours to meet the needs of their patients. The people who throughbtaxation fund their services. FWIW DH has been to the GP twice in 30 years sobI would venture that if the per capita cost of care is between £2500 and £2900 per annum, the NHS has had more than its money's worth out of him and that would be if he paid tax on circa £40k which he doesn't.

@RosesAndHellebores

And as I have said I'd like to see slots between 8am and 9am and 6pm and 7pm ringfencednfor working people. GPs are self employed and mostly work part-time. It is not therefore unreasonable to expect themnto work variable hours to meet the needs of their patients. The people who throughbtaxation fund their services. FWIW DH has been to the GP twice in 30 years sobI would venture that if the per capita cost of care is between £2500 and £2900 per annum, the NHS has had more than its money's worth out of him and that would be if he paid tax on circa £40k which he doesn't.

Unfortunately, you have posted incorrect information.

A 3 day a week 6 session (part time!) GP works at least 33 hours in practice and at least 10 hours from home. So that's 43 hours per week part time. Most are also supporting out of hours work when you child gets poorly after the GP practice is closed - my kids are rarely poorly during convenient times!

And do look at Pulse for the stats, which confirms the average hours worked per day by a GP is 11 hours.

You state that GPs are self employed which is not correct. Most GPs are salaried employees of the practice, as are the nurses who support them.

Only partners are self employed and they usually do more than 12 hours on a working day and then extra hours on non working days. Salaried GPs are pulling their weight, too.

As you can imagine, you cannot tell a salaried employee to fit around the lifestyle of all of its patients.

We love it in general practice when someone calls us and demands an urgent same day appointment - we offer it and say please come straight down here and we'll see you - then they say, well I'm at work and cannot get there - so how ill are you exactly that you need an urgent same day appointment but you went to work???

If you/your family member is that poorly perhaps you should prioritise their need over that of your work? Just saying...

Caveat - we do have have 7-9am appointments for working people at our practice and apptmts 6.30-8pm. However, a lot of working people say they prefer to take time off work rather than use their own time to attend - we cannot please everyone!

btw -income tax and NI does not cover the cost of lifetime NHS services - if it did the NHS would not be in such a state. Tax is as a whole and not an individual basis - perhaps you are a high tax payer and perhaps you have not used the NHS much, yet - but as you get older, you will contribute less tax and need the NHS more. That is just how it is. And as we all live longer than expected, there is not enough money in the pot to fund this prolonged care that is necessary.

@Tistheseason17 and anybody in a professional, high paying role works 11 hour days, not just GPs. Of course if an apt is urgent one is available immediately but it's the routine follow up stuff that is a pain. When one spends 40 minutes waiting for the phone to be answered and all the future apps are gone, so phone back tomorrow when more are released. And when one arrives at 8.30 four weeks later the waiting room is heaving with people who clearly don't work.

Vis a vis tax and NI, please don't generalise - not everyone is on average pay and some of us expect to hit the 40% tax rates from our pensions.

For a professional person I don't think £85k for 33 hours is bad. I only get £103k for 55.

Insofar as salaried partners are concerned, the partners are responsible for negotiating their contractual hours and most certainly can ensure they will cover early and late clinics in their contracts. That is their right as the employer.

I cannot believe you have assumed that every individual in the UK will stop funding the NHS when they retire, through income tax, CGT and IHT.

And not only have you made that assumption, but you have made it in a spectacularly patronising manner. I can quite see that you work in a GP practice to be honest.

This has pissed me off incredibly aswell. Every time I post on mn I get told I'm unreasonable.

What about other HCP's? I went to see my surgeon for my soon frozen shoulder op, yesterday. He's livid that nhs physios aren't doing any work other than virtual.
He's complained about it. He says they are doing private work though!

Can we work off facts, please.
A part time 43 hour GP in our region earns £55k. You can find job adverts, too, with this.
Give your head a wobble.

A partner may earn £85K but they have to own and take all the business risk and usually working 60+ hr weeks. I do hope in your 55hr week earning 100k+ that you're saving lives and responsible for employment law, health and safety for all your company employees, redundancy costs, buying all equipment, paying sick pay, the list goes in.

If you look on a GP website it tells you average earnings of a GP - inc those mega rich partners that you think are everywhere... its usually £50-£60k pa

Good to know you earn circa twice as much and work less hours than a GP partner👏👏👏

@Oblomov21

This has pissed me off incredibly aswell. Every time I post on mn I get told I'm unreasonable.

What about other HCP's? I went to see my surgeon for my soon frozen shoulder op, yesterday. He's livid that nhs physios aren't doing any work other than virtual.
He's complained about it. He says they are doing private work though!

Can only speak for our practice but we employ Physios and they telephone or video triage in the morning and see F2F in the afternoons. However, I do think some community Physio teams are not, which is frustrating as it is doable with PPE and if they are seeing privately that is disgusting and worthy of a formal complaint. Hope you get sorted soon.

What I have quoted is precisely as it appears on our GP website. It is a shame you are unable to comprehend that what happens in your practice doesn't happen elsewhere.

And FWIW my role includes everything you quote above and much more, except I don't save lives but then again I'm pretty shit hot regarding employment law! DH is an expert in his field nationally and internationally, so yes some of us are more than equal to medics in our professions.

cannot believe you have assumed that every individual in the UK will stop funding the NHS when they retire, through income tax, CGT and IHT

I did not say that, but do keep peddling misinformation.

Roses thanks, we may have to consider this, will see how Ds is over the next few days. As a family we try really hard not to use the NHS, unless it is absolutely necessary. But I do feel Ds needs help.

It's interesting that in Germany there is a major contribution from employers (of course that's true in the much-maligned US system too). Maybe that's where we're missing a trick in the UK. I teach at a small private school and we have healthcare insurance we can optionally pay into (it's not much - about £100 a month). I've had two lots of surgery paid for that I would have struggled to access through the NHS (gynae and vascular) so it's more than paid for itself. And I was able to arrange the appointments for the evening and the surgeries and therefore recovery for school holidays.

An employer who paid for GP services for their staff would avoid this issue with staff needing half days off to access non-timed appointments.

Any other GPs feel like they just can’t do this anymore?

The demand is so much greater than capacity.

We have to make so many important decisions with limited resources

The public don’t understand what we do/ how much we do/ how impossible the job is becoming.

I have never commented on any other profession as I don’t know enough about them to make judgements as to their efficiency/ deserved income etc. However everyone has an opinion on GPs.

We’re on nowhere near as much as the papers say. I work on average 50 hrs/ week but it’s not enough to get the job done. I genuinely feel guilty for going to bed/ enjoying a weekend with my family.

My husband has forced me to sit in the garden today but my laptop is calling me.

This is not sustainable and every bit of vitriol from strangers who don’t understand my job hurts me far more than I should let it.

GP partner in Scotland here-never ever stopped seeing face to face, not for a single day!

Like it was ever easy to get a doctors appointment, and if you anything controversial like work full time, you may as well forget it. The more you see of the NHS now, there is an argument for privatisation, doctors are to well paid, seem to do as they please-around me especially, so hard to get a suitable appointment for yourself. Covid has been one huge excuse for the inefficient and indolent in our services, to be more so, for providers not to provide and so forth. Britain today sadly.