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?

Also remember that GPs and their teams have given 70% of all Covid vaccines. That has been a massive additional workload - not just actually giving them, but the incredibly complex organisation of the programme. All my colleagues have been working weekends and many of us worked over Christmas/NY to provide the vaccines. But, as usual, GPs can do no right on Mumsnet.

Regarding dentists, I have had two urgent appointments in the last six months. At neither was I given a proper checkup; only the problem was dealt with. This is despite both the dentist and nurse being swathed in PPE and the surgery being cleaned between appointments, for which there is currently a surcharge. I haven't had a checkup now for nearly two years.

I work in community pharmacy and can safely say that many, many GPs are still refusing to see patients, or at the very least making it extremely difficult, but are happy enough to refer them to come and see us. For example, they won’t do a blood pressure check but send them to us to do in the pharmacy.

@swiftt

I work in community pharmacy and can safely say that many, many GPs are still refusing to see patients, or at the very least making it extremely difficult, but are happy enough to refer them to come and see us. For example, they won’t do a blood pressure check but send them to us to do in the pharmacy.

Surely that makes sense? If someone else can administer a check, seems like a waste of their time. Sure enough the PCT should allow more funding for the pharmacy in that case but I know that is ridiculous.

I was told by a consultant at 111 that my GP really should see me in person and that he'll personally call them to make an appointment for me ASAP, "they'll call you to confirm", he said. Waited for the call for a few hours, when I called them they said "no need to see you, just pick up the prescription". I appreciate there are many amazing hard working GP surgeries, but ours is really poor, sadly we don't have much of a choice

111 operators have a few weeks of training. GPs have a minimum of 8 years' training. 111 call handlers are not in a position to judge whether or not a GP needs to see you face to face. and they are not supposed to give this advice. They should have told you that the GP will contact you for further assessment.

...I get texts from her or messages via the receptionist telling me to come in for blood tests or ECGs or ultra sounds or CT scans but she has never spoken to me.

So you are getting the blood tests and other diagnostic tests that you need?

*Yep, if pubs/restaurants/holidays etc happen in Summer, then the NHS needs to be back operating as normal and making a start on their waiting lists. There's no excuse.

Enough is enough. They can't hide at home forever.*

You really have no idea. The NHS didn’t suspend much elective work during second wave. They had to try and manage green and red demand. Very occasionally P3 (required within months) surgery was cancelled for a few days but not much more. Most urgent surgery went ahead. All cancellations had to be signed off by the NHSE regional director. It wasn’t local decisions.

GPs have not been hiding at home. They are the front line of Covid management and have been working flat out seeing patients- but yes, sometimes that’s needed to be prioritised because they had to deal with ‘hot’ hubs as well as ingrowing toenails. The amount of work has risen enormously (for example vaccination programmes).

There have been increased waiting lists but lots of that isn’t about the NHS being closed. In one patch in the south, for example, they have had real problems getting people to go to hospitals for diagnostic testing because the people likely to have cancer are the elderly - who are scared or shielding. The local system is actively encouraging people to get the tests and treatment they need. As an example, they have set up and are delivering chemotherapy in people’s homes or on a chemo bus that travels out to people. They’ve made one hospital in the region a ‘green site’ for urgent surgery - but staff cant be in two places at once and there are only so many anaesthetists.

GPs meanwhile are managing everything thrown at them. Most things can be managed via video calls - even if a patient prefers to have a chat. Many things can be a direct referral without being seen by GP (post menopausal bleeding, for example), increasingly a GP can refer directly for scans but doesn’t need to actually see the person first.
A person with depression doesn’t need face to face - there’s no physical examination necessary.

What are the risks for GPs? Being stuck in a small room, without full PPE, with no idea whether the person with a bit of a temperature and cough has Covid. Examining dead bodies where they’ve died of Covid. Visiting care homes full of very sick elderly people with Covid.

I love the FaceTiime appointment offer. Luckily not needed one but DH has and DD at uni. Hope that stays as I’d much rather speak at home than go and sit in a waiting room full of ill people.

My aunt has a couple of long term conditions, and has struggled to see her GP for the last year. Telephone conversations only, then told to go to A and E. She is now dying of secondary cancer. She would have died of it anyway but if her GP had seen her he would have noticed how much she had deteroriated and how the pain was extreme not just 'unpleasant side effects' of the medication she was on for a different condition.

She has suffered for a year, taken unnecessary drugs (we can't get a straight answer on whether the original diagnosis still stands or it was always the secondary cancer), self isolated and couldn't even see a GP.

DM needs physio and is losing mobility in her shoulder because the phone advice isn't enough, she's prescribed strong painkillers instead.

For some of us, me included for asthma reviews, my dh for a chest infection and then a sinus infection a phone consultation is fine.

For the older or more vulnerable a GP or actual medical appointment is essential. And it should be standard throughout the UK not dependent on surgery.

111 operators have a few weeks of training. GPs have a minimum of 8 years' training. Nearly right. The minimum training for a GP is actually ten years, although most have more. .

@swiftt

I work in community pharmacy and can safely say that many, many GPs are still refusing to see patients, or at the very least making it extremely difficult, but are happy enough to refer them to come and see us. For example, they won’t do a blood pressure check but send them to us to do in the pharmacy.

Because of PPE and cleaning requirements, it would now take 15 minutes to do a BP check in a practice. It's sensible to find alternatives, leaving nurse/HCA appointments free for more complex issues.

And you do realise that additional footfall increases your pharmacy's profits and keeps you job secure, don't you? Most pharmacy owners are extremely keen to encourage this sort of joint working with general practice.

@LemonRoses

111 operators have a few weeks of training. GPs have a minimum of 8 years' training. Nearly right. The minimum training for a GP is actually ten years, although most have more. .

I am a GP, you nob

@Bluesheep8

We have never stopped seeing patients face-to-face.

It should be the case across the board. I'm guessing that GP's who decide that they're not seeing patients face to face are still being paid the same as those who are....

That's the trouble. Same with NHS dentists.

Funny how private sector without guaranteed income manage to find ways of working but those paid via the NHS don't have that same impetus as they're paid regardless.

@Diesse

They’re not around my way. Any GPs here able to shed any light?

I think my doctors are seeing people if they absolutely have to, but at my mum's practice it is nigh on impossible to even get a phone call. Although that isn't really a covid thing, it was like that before, but it has got worse.

What I don't understand is the GPs refusing to refer people - so much of the time they don't have the specialist knowledge to know what's wrong with someone. Obviously that doesn't apply if eg they can see from a photo that the "mole" is actually a harmless freckle!

Compare and contrast:

Pre pandemic spend 25 minutes waiting for phone to be answered then speak to an abrupt receptionist who offers three appointments at inconvenient times and gets army when you say I am making the apt at the Dr's request for an annual review, it is not urgent so please give me the first available appointment before 9am - I am happy to wait for it. And it goes on ad nauseum. Arrive three weeks later five minutes early at 8.40, see Dr arrive at 8.55 (late) at 9am leave the heaving waiting room with sick people and have a 2 minute conversation with Dr who gives me a blood test form and go through the whole fiasco with reception again to book an early appointment.

Post Covid
Send and email noting the condition, setting out clearly I have no concerns and am well and would be grateful for just an annual blood test, preferably first thing.
Receive email confirming blood test apt. At 8.20 five days later.

I know which I prefer and it is 10,000 times better not to have to deal with the receptionists over the phone.

However I would like to know why our local adhd service is still working entirely remotely with offices closed and all contact having to go through central switchboard. In September dd was given a 10 hour window for an appointment and told to weigh herself and get her bp done at the pharmacy. All trust office staff continue to work from home. Now that is an absolute disgrace. The public locked down for the NHS parts of the NHS need to lock out for the public.

I hope they carry on with this level of telephone appointments as it’s much better than sitting in a waiting room with sick people

Because of PPE and cleaning requirements, it would now take 15 minutes to do a BP check in a practice. It's sensible to find alternatives, leaving nurse/HCA appointments free for more complex issues

I don't disagree but what happens about blood tests? You can't do those yourself? My mum is supposed to have a liver function check every year because of her medication, and her GP practice is refusing to do it "because of covid". She says the nurses are there, but they still won't do it. In my area there are walk-in clinics at local hospitals for blood tests, so they are doing them, but in my mum's area it's still a GP thing. Until it isn't.

Primary care is abominal in this country. Once you get into the system it's fine, but it's outrageous that GPs are taking the money and refusing to work at all effectively.

abominable

@CallmeHendricks

Well, I suppose technically you can see one, but at our place it's like getting into Fort Knox. I've always wondered how come it's supposed to be so risky for a GP to see one person at a time, yet teachers are rammed into small rooms with around 30 with zero safety mitigations and if they object, are ridiculed and told they're being lazy shysters and to just get on with it.

Exactly this. I take thyroxine every day for an underactive thyroid and over the last few months have noticed symptoms which suggest my dose isn't right. The ONLY way of testing this is with a blood test. Do you think I can get the GP practice to arrange a test for me?

First you go to the website and are confronted by massive banners in red bold font about Covid giving the stay away message.

Then when you call, you get a message about Covid, and how they're very busy because of Covid, and Covid Covid Covid and if you really really must speak to someone press 1.

Finally you get through to someone who gives you the third degree about why you're bothering the doctor, because there;s a pandemic on don't you know. Explain that actually you need to see the phlebotomist/nurse for a blood test. Nurses are very busy with the vaccination programme for Covid. You might have to wait. Because, you know, Covid.

If you persist, get stroppy and demand an appointment, you turn up to a locked surgery, secured with black and yellow hazard tape. Huge posters about COVID all over the doors and windows. Stand in the monsoon rain until someone buzzes you inside and locks the door immediately afterwards. Instructions to "stand there and don't TOUCH anything".

What a fucking pantomime. The GP might be open and seeing patients. But the message they are giving out is "stay the fuck away and DO NOT BOTHER US".

@MissLucyEyelesbarrow

Also remember that GPs and their teams have given 70% of all Covid vaccines. That has been a massive additional workload - not just actually giving them, but the incredibly complex organisation of the programme. All my colleagues have been working weekends and many of us worked over Christmas/NY to provide the vaccines. But, as usual, GPs can do no right on Mumsnet.

No, some GPs are not doing right by some of their patients. As the eperiences on this thread shows.

You SHOULD be able to get a face to face appointment if you need one, but the reality of actually getting one involves running the gauntlet of GP receptionists and the passing a “test” deeming you bad enough but simultaneously not a covid danger.

My grandma has just spent a month in hospital and is 3 weeks into respite care in a nursing home as a result of her GP refusing to see her for a raging UTI for the three weeks prior to ending up in A+E with no idea who she was, where she was or what was happening. They refused to see her, they then refused to prescribe antibiotics without seeing her, they wouldn’t allow anyone other than my grandma to hand them her urine sample (despite an active POA). We were told to monitor her and see how she went on. She NEEDED to be seen by a doctor and the ONLY time that happened was when she eventually ended up in A+E because the infection was basically hours from killing her.

So yes. Protect the NHS. But don’t actually use it or try to access any of their services unless you’re dying or have COVID. Because you won’t be allowed.

What I don't understand is the GPs refusing to refer people - so much of the time they don't have the specialist knowledge to know what's wrong with someone

Jesus. You do realise that non-urgent outpatient services have totally stopped in most areas for the last year? Do you think GPs actually want to have to manage a huge amount of additional workload and risk? We are forced to do so because there is no alternative.

Even before the vaccine programme, GPs were 30-50% busier in 2020 than 2019 (NHS England figures).

There aren't enough GPs. There isn't enough funding. Community/GP teams do 80-90% of all healthcare for 8% of the NHS budget (Dept of Health figures). Much of the work GPs do is invisible to the public. Consultations are maybe 40% of our work.

We're in the midst of delivering the most successful vaccine rollout in the world. No other country of our size has come anywhere close.

My GPS wont do face to face either. The nurses and health care assistants in the same practice do but not the gps. You cant even get an appointment time. They just ring whenever which leaves people who work without a gp. While I like the surgery, I think the way they've behaved is a bit of a disgrace. I was in the hospital a few weeks back and all the staff in there were working away as normal really.

A close friend is a practice nurse and she describes her practice GPs as hiding in their golden towers. While the nurses still do dressings smears etc.

The hospital consultants are reporting a lack of cases coming through to them. How many misdiagnosed patients will there be in the next few years????

The next big scandal i would wager!

They are doing in person appointments here for people who actually need to be seen in person, after establishing that via phone appointment. DP has had two in person appointments recently because he needed to be examined.

Sending patients to other overstretched services so they don’t have to do the cleaning between patients themselves isn’t acceptable. You can’t pass the buck.

Ds needs regular weight/height/BP checks. If he has them done by one professional I will send the information to others who will need it soon. But it would be wrong for those professionals to say “book a GP appointment to get them done” as much as it would be wrong for a GP to expect someone else to do them.