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?

@bertiesgal - I hear you.

The lack of understanding of how a GP works is so distressing.

I am watching team members literally falling down with the amount of stress whilst trying to do their best for everyone - and with comments like those above it is awful.

Being a GP is a vocational role, and there will always be a few who locum for the money but they are in the minority, as ever.

Take care all GPs who are reading this thread and unable to post in fear of backlash.

@RosesAndHellebores - by your comments you obviously have zero understanding of how a GP practice works.

At DH’s surgery they give 2 hour time slots for phone consultations. They aim to give you a time which works for you but if the time you want has already been taken by someone else, it won’t be free for you. They are doing f2f and phone consultations as some of the more elderly can’t manage the phone options and some appointments need to be seen f2f. Today DH had a morning surgery 8am - 1pm and this afternoon he is going to the local mosque to try and persuade more people to have vaccinations. They have taken on four additional receptionists to manage the increased calls. They are also calling and texting those people who haven’t booked a vaccination. If you can’t get through on the phone it’s because they are on the phone to someone else. The phone lines are open 8am - 6pm.
GP surgeries have increased numbers of patients each year but no additional staff = less availability of time for each patient.

I don’t blame the front line GPs but the systems that have been put in place for whatever reason are failing patients too often and those failings are surely going to add to the workload either for the GP or other nhs professionals.

I am sure most GPs work very hard, but every time there is a thread like this it is obvious there is a huge variation in services around the country, and that can't be right for a nationally funded service.

I do know, what it is like to read endless criticism of your profession, but I try not to take it personally as I know I have worked hard throughout the pandemic too (I'm a teacher) but I'm not a priority for a vaccine - and luckily I'm part time or I wouldn't be able to see a doctor either. The system just doesn't work for anyone who can't have their phone on at work, or for commuters, or for full time workers, or for people with mental health conditions, or for chronic conditions, or apparently for the HCPs...who does it work for?!

I really like the phone and online consults. Much quicker response times. And much more convenient as avoids having to go into the surgery. I like this particularly at the moment as wish to avoid unnecessary contacts. Everything I've contacted them about could be dealt with perfectly remotely.

I know if a F2F is needed they will call me in. But it's really not been necessary and I have loads of health issues.

@Parker231 I wish my surgery would take on more staff. We've had the same number of Receptionists - 4 one full time, 3 part time since I started work 11 years ago. I busted a gut on Thursday to get the scanning up to date so someone will have that time on Tuesday to ring all the over 80's to book them in for their 2nd covid jab in 2 weeks time, which will be on a Saturday. No extra pay just minimum wage.

Today DH had a morning surgery 8am - 1pm and this afternoon he is going to the local mosque to try and persuade more people to have vaccinations

His time would be better spent dealing with patients, not trying to persuade people to have vaccinations who don't want them. It would be quicker and more efficient to do all the people who want to be done, and then go back and persuade the doubters. In my view he is not prioritising his time right - he could either be out there vaccinating under 50s who want to be "done", or doing telephone/video consultations with people who have conditions other than covid, having done F2F in the morning.

busted a gut on Thursday to get the scanning up to date so someone will have that time on Tuesday to ring all the over 80's to book them in for their 2nd covid jab in 2 weeks time, which will be on a Saturday

where my mum lives they booked first and second appointments at the same time - I would have thought that was more efficient and half the work. OK some over 80s might forget but even if you phone them today for tomorrow they might forget

I would be perfectly happy to pay more tax for the NHS if I felt it would extrapolate into higher quality and better service. Regrettably I don't think it will because too many people in the NHS think they are doing the public a favour and we should be grateful for the sub-optimal and all too often inaccessible care.

When DD was ill with her MH there was no help available on the NHS for a 15 year old who was cutting, restricting food and taking overdoses. The GP blamed CAMHS, CAMHS blamed the CCG and the government, the CCG blamed CAMHS, the GP and the government. One GP actually told me to get her a therapist off the Internet because CAMHS were useless. Not great in front of a 15 year old who had reached out for help. My tax statement tells me how much is paid to the NHS; it does not tell me that it no longer funds mh services for children and young people. I later found out that the year before the CCG had not paid its quota for CAMHS to the MH Trust. GPs sit on the CCG board, yet despite knowing that quota had not been paid happily told people CAMHS were useless and they couldn't refer to any private providers.

The system absolutely stinks and the one time we did need the NHS it failed us. Thank goodness for BUPA and the ability to fund the enormous amount of therapy required and the assessments for ASD/ADHD. All masked due to a high functioning child from a loving and supportive home.

The NHS needs root and branch reform and if GPS can't service the number of patients registering they need to stop registering them. Only then will the shortfall be recognised and dealt with.

As I have said before 30 years ago I needed one prescription per year for levothyroxine. Now with 56 day prescribing I need 6. I would venture that much of the problem is that GPs make work for themselves by going along with these silly initiatives and that is where my patience begins to cease.

The system needs to change.

I really like the phone and online consults. Much quicker response times. And much more convenient as avoids having to go into the surgery. I like this particularly at the moment as wish to avoid unnecessary contacts. Everything I've contacted them about could be dealt with perfectly remotely

It would work fine for me. But imagine someone without a smartphone who wants to get a photo of a suspect mole to their GP (or practice nurse). If they ask for a F2F appointment the receptionist will have been told to tell them to bog off, but actually they should ask can you send us a photo and if they say no, get them to come in and a nurse could look at it quickly and let you know if she thinks it needs a GP or it could go straight to a referral. They could even stand in the car park and someone could look at it (depending on its location :) )

But they won't, the receptionist will just breezily say "oh we're not seeing people for that, take a photo and send it in" and put the phone down and the person is left hanging with a potentially dangerous mole.

I don't mind the telephone appointments if f2f isn't necessary but my surgery won't commit to even a vague time slot which is impossible when I'm at work. I asked could my appoint a be anytime after 3.30 when I finish but no can't promise that???? 😐

As for the NHS being underfunded, it is, but the money is also badly spent and it is inefficient. The money could be better spent and get better results without needing a penny more in tax.

too many people in the NHS think they are doing the public a favour and we should be grateful for the sub-optimal and all too often inaccessible care exactly this - it's "free" so we should be grateful. It isn't free, and we do pay for it, and therefore we should get a decent service. And if it makes things better then charge for things like GP appointments and smear tests. But stop nonsense like you can only deal with one matter at one appointment.

@poppycat10 - he went to the mosque to talk to them as the take up of the vaccine from BAME is low and they are at risk so DH has been giving priority to those at greatest risk. He is working with local mosque leaders to build up support and understanding of the vaccine benefits. He’s following the group priority set by government and at the moment it’s not the under 50’s. Their surgery is handling the CV and those requiring vaccinations at home or in care homes

@poppycat10 if there was a problem with supply them we'd have to ring to cancel and ring again to rebook. If we couldn't contact them all then someone would have to sit in the car park waiting for people to turn up to apologise. Not everything is straight forward.

Also if someone was unable to send photos to the GP then the GP would book them in for a f2f appointment. Our Receptionists wouldn't fob anyone off.

@RosesAndHellebores
Now your last post I agree with.
We've tried to decline registrations but our CCG immediately advised we cannot as we would be in breach of contract. It's disgusting.

If you ask GPs where funding is needed the answer will be Mental Health (specifically CAHMS) and Social Care.

The amount of times secondary care MH services bounce back inappropriate work to a GP is incredulous - but it is because they also have constrained resources. We are sympathetic to their position. The volume is increasing due to the MH crisis during the pandemic. It is so upsetting knowing wait times are circa 2yrs. A GP is a consultant in generalism but these patients need a MH consultant.

I don't feel that people should be grateful and accept sub standard care. Money is badly spent. Our CCG has funding to support resilience but they won't release it to practices without a gazillion forms being completed and staff attending unnecessary meetings- their time would be better spent answering the phones to patients. Our CCGs spend a lot if money investigating new ways of working but don't actually listen to those on the ground- this results in enforced IT solutions that don't work but millions has been spent on consultants and project managers and IT solutions that don't work.

@Tistheseason17 Interesting that you say the GPs want better funded CAMHS Services. I don't quite understand how that squares as CCG Boards comprise in largest part GP representatives and it's the CCGs who commission the services.

To be fair when dd was ill, I'd have been satisfied with some help with a referral. Fortunately BUPA helped source a child psychiatrist but it worries me hugely that thousands of young people have parents who can neither advocate for nor pay for their care. The result being that young people sink and drop out and the impact on them is unacceptable but also comes back to bite the NHS on the bum when those young people are unable to fulfil their potential and pay the taxes they otherwise might have paid.

It would also be helpful if healthcare providers could be a little more honest about CAMHS and what it does, doesn't and should do.

At my practice the GPs are largely fine but the admin around them is hopeless in the context of efficiency, organisation and basic courtesy.

very good question. You can see GPs at our surgery but have to go through a telephone triage first...but they won't tell you when they will phone which is impossible if you are working.

Oh and they should stop blimmin texting me about the vaccine. I have had a letter. a text from the NHS and now numerous texts from the surgery. It is irritating and time wasting. People who want the vaccine know how to get it. Stop harassing people and focus on more important things.

@RosesAndHellebores

Yeah, GP reps on CCG boards... yeah... they are token members. If the CCG wants to do something, GP practices get lip service and the CCG carries on irrespective of the feedback.

I'm ex -Corp board member and really thought moving to NHS with GP input was real and valued. 10 years in and my cynicism is at its peak. I am sure there are some great CCGs - but not ours. Money gets moved around by these managers and when you tell them you have no resource to provide unfunded work and will they be commissioning the service? Regular response is nothing and to expect GPs to fill the gaps. Also each CCG operates differently resulting in postcode lottery fir patient services.

We were hopeful that ICPs would allow GPs to drive delivery of care models to support patients but recent changes mean CCG staff will be crowbarred into the new model so more lip service with more bureaucracy and managers.

We are told by CCG there is insufficient money for MH and insufficiency of resource even if funding was available. It makes me so sad and sorry your DD had an awful experience.

@Tistheseason17 to be fair she was protected from an awful time (though it was awful) because we had/have enough money to fund her care. Turning point was the ADHD assessment when all the pieces of the jigsaw flew together .......there had been a crisis the week before when she was assessed by a CAMHS NHS practitioner and GP told me to let them know about the diagnosis. The CAMHS nurse guffawed "bruar, huar - she's tool old to have that at 17 .

I think we paid about £6.5k in addition to BUPA over two/three years. She's fine now, medicated and manages her depression and anxiety and is at Cambridge in her final year. But if we hadn't had the money, if she hadn't been loved and from a state home, things would not have turned out so and it breaks my heart that nobody cares.

The other thing that horrified me is that CAMHS jumped into action as soon as my MP intervened and it shouldn't take that despite contacting PALS and trying to complain because they can only investigate with the permission of a mentally unwell 16 year old who is distressed enough.

Things have to change. I work full-time, all the time for a public sector institution but when I retire I am sorely tempted to get myself elected as a local Councillor to help get on some boards and start exerting pressure and making a difference.

@RosesAndHellebores
Agree - access should not be defined by affordability.
Check out Psychiatry UK - they are promising the earth to potential ADHD patients, diagnosing after one conversation, prescribing high cost meds after a very short video conference - they then discharge and tell a pt - you're GP can do this now- they can't! As you know this area is complex and it takes more than 1 hr to accurately assess and diagnose - my friend's son took 4 separate assessments but now it is right. People are not getting the full assessment but because it is being offered very quickly people jump on it believing it to resolve everything.

This is an area that needs enhanced funding. I'm glad your DD was well supported but agree with your comments re access ❤

I personally love the telephone appointments system- I can speak to the GP, get a prescription sorted & sent electronically to my local pharmacy

From what I've gathered, patients are most definitely seen face to face if the scenario warrants it.

I'm much happier with telephone appointments & eConsults instead of being obliged to sit in a festering waiting room with a dozen others with symptoms eg fever, co

Posted too soon!

Sitting in a waiting room with others who have cough, fever etc

What a way to encourage spread of illnesses and of course Covid

Personally I think the GP practices were absolutely right to covert it from face to face appointments to a telephone triage system

I hope it doesn't go back to how it was before eg 100% face to face so I am obliged to physically go into the surgery

The telephone appointments system works well, I can get on with my day whilst awaiting the GP call

There will be no face to face appointments at our surgery for the foreseeable future, except in 'very exceptional circumstances'.

I have a serious medical condition, but despite begging, I have not seen a GP since February last year, so 14 months. Nor have I had the regular blood tests I should have in connection with this condition, a review of my heart condition, my flu jab, my smear test, or anything else.

The surgery is locked and all communication with Reception is via intercom. When I had to collect a letter, it was literally pushed through a crack in the door. They don't offer e mail, or e-consult and a telephone call from a doctor can be any time between 9am and 8pm.

@poppycat10

I'm pretty sure if a patient reported a suspicious mole & did not have a phone capable of taking photos, the GP would arrange a face to face once they'd had the initial telephone consultation

Something like skin, photos are brilliant for diagnosing skin conditions but if these cannot be sent, a face to face appointment is surely the obvious next step

@NaToth

That doesn't sound right at all

My GP surgery is back to do doing smears, no idea how long they suspended smears for but I had mine done at the end of the summer

Also I know they continued with baby immunisations- there's no way these could have been suspended!

If you need a routine/monitoring blood test, just get an appt with the doctor to explain this & they can get the form ready/you book a blood test appointment/however it works