I can see a dentist, an osteopath and have an x ray. Why can't I see my GP face to face?

[pinkprosseco]

Where I am Registered the GP only does telephone triage and almost never invited anyone in for face to face appointment whether that's a persistent cough (not Covid), abdominal pains or potential arthritis, a ? Lesion on the skin etc etc. I feel that long after other key workers have gone back to normal, GPS who we depend on as a first line of advice and diagnosis, are shirking responsibility. Surely the missed diagnosis the BBC and other current affairs websites are referring to are only going to get worse. Why isn't there a mandate they return to work properly. Anyone else?

@cptartapp

Abraxan if it was a new machine it would more than likely be more accurate than that used in the surgery! Although calibrated once a year(!), ours are several years old. As you have proved, despite your initial reaction it is extremely reasonable to ask patients not to come into surgery for every little thing. Our receptionists get asked for hundreds of f2f appointments every day. Due to social distancing rules if these were all granted without triage you wouldn't be seen until Christmas.

If I'm fully vaccinated. And you are fully vaccinated. Why would it be a problem to see a gp face to face.

I've gone from monthly appts made by the GP to not a single phone call over Covid.

It's utter neglect. And they have no excuse.
Refusing to test a patient when a hospital consultant and radiologists gave advised them too is also not acceptable to me.

I've been pre judged from a stereotype from 2 Gps that I've never even met.

It wouldn't be a problem if deemed necessary. If we can only have so many patients in the surgery at one time due to social distancing, that might amount to us able to see about a tenth of face to face appointments in one day compared to normal pre pandemic.
So think how long people waited for appointments before Covid, then multiply that length of time by ten. That's following guidelines not making up rules.

One wonders if monthly appointments with your GP were really necessary beforehand? What exactly was he/she physically doing for you each time that to go to zero contact over 12 months has been seen as ok?
And you're assuming I and every HCP is fully vaccinated .They're not. More misunderstanding and misconceptions.

I agree. A GP could spot in person a safeguarding issue that they could not over the phone or online. For some people talking to someone in person could be pivotal for their mental health.

What I don't understand even more though, is not being about to talk to a receptionist. I can buy things at a checkout but I can't ask the receptionist anything in person

I agree its a disgrace, I assume its because they can 'see' more patients virtually so run on less staff and cut costs/run with vacancy gaps.
I work in a hospital and we are seeing the brunt. Emergency department attendences are some of the highest seen in years. The bulk of the patients, GP referrals. Most of these patients just need to see a Dr and do not need the emergency department. A lot of long term condition pstients Eg Lung conditions and heart failure coming in due to lack of review and monitoring. A shameful neglect of our vulnerable older people. GP's need to pull their socks up and get out of their cosy home offices. The rest of the NHS has been working full pelt in their absence.

GP’s are seeing patients daily - DH has never seen so many.

@Nobble

I agree its a disgrace, I assume its because they can 'see' more patients virtually so run on less staff and cut costs/run with vacancy gaps. I work in a hospital and we are seeing the brunt. Emergency department attendences are some of the highest seen in years. The bulk of the patients, GP referrals. Most of these patients just need to see a Dr and do not need the emergency department. A lot of long term condition pstients Eg Lung conditions and heart failure coming in due to lack of review and monitoring. A shameful neglect of our vulnerable older people. GP's need to pull their socks up and get out of their cosy home offices. The rest of the NHS has been working full pelt in their absence.

That's really interesting to hear. I thought this might be the case.

@Parker231 you said yourself further up the thread that your DH is seeing the majority of his patients online. Whether he is busy or deems this appropriate is not the question. GPs are predominantly seeing people online.
@pinkprosseco the NHS England A&E attendence data is very telling with attendences up 104%. I've tried to link but a quick Google and you should find it if it doesn't work.

A lot can get missed on a virtual consultantation. Patient's are being diverted to A&E by risk averse online triage applications and sadly by GP's who should put eyes on the patient first. This is my acedotatal evidence in my hospital where GP referrals have doubled for non acute presentations.

www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2021-22/

NHS England only announced last week that practices should be offering f2f appointments if required by the patient. Decisions are made by NHS England and not the individual GP’s as how they operate appointments.

One question that doesn’t seem to be being asked: how much of the additional number of appointments is because of the phone appointments by default system?

Firstly, does a phone appointment than f2f count as one or two appointments?

But more importantly, how many repeated calls are there because things are being missed, or patients don’t feel they have been heard?

Completely agree. I couldn't get an appointment for my 4 week old baby. Ended up in tears as the receptionist was so rude - I ended up getting some advice on the phone from the health visitor but a f2f appointment would have really helped put my mind at rest particularly as I've been struggling with PND.

My usually wonderful GP really, really let us down with this. My 3 year old was unwell with temperatures over 40 and a cough for 10 days. No improvement despite 3 different antibiotics. They would not see her. I spoke to the GP 4 times. Despite having a negative covid test they would not see her 'due to covid concerns'.

I ended up taking her to a&e as she just wasn't getting better. She had a collapsed lung, with a hole in as the infection had progressed so much. She ended up in intensive care and very nearly died. She had a chest drain for a month.

If the GP had seen her & listened to her chest early on she would have realised how potentially severe the infection was, and we could have been sent to hospital then.

I'll never trust the GP again.

I'm so sorry Sipperskipper. That's just awful for your child and you. Some GPs have really let the public down. Well done for pursuing it and taking her to A&E.

I wonder how much GP time would be freed up if we were able to purchase more medication over the counter in England. I’m always amazed that I can go to the USA to visit family, go into a drug store and come away with a whole load of stuff I’d have to see a GP for over here. Antibiotic cream, decent pain relief, acne treatment, melatonin etc and I have a feeling a family member says you can buy HRT from a pharmacy as well. Go in, have a talk with a qualified pharmacist and they dispense what is appropriate. Makes much more sense to me. GP appointments should be for more complex issues not basic health care.

@cptartapp

Abraxan if it was a new machine it would more than likely be more accurate than that used in the surgery! Although calibrated once a year(!), ours are several years old. As you have proved, despite your initial reaction it is extremely reasonable to ask patients not to come into surgery for every little thing. Our receptionists get asked for hundreds of f2f appointments every day. Due to social distancing rules if these were all granted without triage you wouldn't be seen until Christmas.

When you're told by hospital consultants that you need regular monitoring then it is reasonable to expect that to happen.

As I sad, fortunately I can afford to buy my own device. Many people wouldn't have the spare £30+ to buy a cheap machine.

I just find it strange that I can see the nurse f2f, my hospital appointments are now starting f2f (first one today infact) but with my GP it isn't possible.

Despite this I'm fine with SOME telephone triage.

What I am not happy with is the current system we have in place.

If it is to continue changes must be made.

We need to be able to select appointment times.
We need an option to send images/pre information for the doctor,
We need the app to work again.

And tbh we need to know what actually constitutes a need to be seen and what can wait. So much can be discovered f2f that is missed when done over the phone. This also needs to be acknowledged.

@Parker231

GP’s are seeing patients daily - DH has never seen so many.

F2f, online or over the phone?

And if f2f, all of the, or only some? When compared with 18 months ago how many are now f2f?

Until last week it was predominantly online with f2f if required- this followed the NHS England guidelines. As from last week when the guidelines changed, it is more f2f but patients are complaining as it can be up to three weeks for f2f appointment whereas many more can be’seen’ online.

My Gp is also relying on me to record and take the BP accurately myself. It's not being checked and I am taking two different fairly heavy duty medication for it. I believe I'm taking it correctly and recording it properly, but I can imagine this might be more difficult for some patients. The GP just has me read the readings to him and takes my word for it, and prescribes accordingly.

What happens if a patient wasn't doing the readings properly or wasn't taking the BP correctly? They'd be given the wrong medication - what affect might that have after 6, 7, 8 months or more>

The GP surgery here has been dire since covid.
They finally got a new phone system - a year after the pandemic started. Sadly its rather temperamental and regularly cuts people off.
They are "looking at" an online triage system.
They have shortened their opening hours.
My mother has what I suspect could be a serious bowel issue.
She phoned at 8.30am yesterday.
A Dr phoned her back at 5pm and gave her an appointment for 10am today as its clear she needs a physical exam.
We could well end up at a&e later.
They have done a handful (yes I mean a handful) of covid vaccinations and their passive aggressive messages on their website are pathetic.
They are the only surgery in the locality so they don't have to be better.
I'm sure some GPs are working hard. But not all of them.

@Sipperskipper

My usually wonderful GP really, really let us down with this. My 3 year old was unwell with temperatures over 40 and a cough for 10 days. No improvement despite 3 different antibiotics. They would not see her. I spoke to the GP 4 times. Despite having a negative covid test they would not see her 'due to covid concerns'.

I ended up taking her to a&e as she just wasn't getting better. She had a collapsed lung, with a hole in as the infection had progressed so much. She ended up in intensive care and very nearly died. She had a chest drain for a month.

If the GP had seen her & listened to her chest early on she would have realised how potentially severe the infection was, and we could have been sent to hospital then.

I'll never trust the GP again.

I'm so sorry. Please report them to the CCG and GMC.

The CCGs are still paying these surgeries to provide services they are not providing.
My mum has copd. She hasn't been seen f2f for nearly 2 years now ....

Social distancing??
Have you been into a school or shop lately??
🙄

Thanks for the information @Nobble that's quite an increase. Surely it must be linked to lack of access to GPs.

To all of you including @Jenthefredo @Abraxan and @Sipperskipper whose experiences are really serious so sorry to hear this happened.

I think the public will be suffering from Covid unintended consequences for years now. The need for properly funded and properly managed primary health care services will only increase now. I just hope GP surgeries will consider who gets missed when they don't offer face to face appointments and it will probably be the young, the old and the most vulnerable people.

GP's receptionist told me yesterday to take wheezy coughing 2yr old to pharmacist , and ring the practice again if he got 'much worse'.
Are pharmacists paid for consultations?
Sorry haven't read full thread, this may have been covered

So first f2f with hospital dept today for rheumatology. Two blood pressure readings done within 5 minutes and both two high (top number at 167 abd 170) despite medication.

Again flagged for gp monitoring so let's see. Last monitoring by phone was stopped a while back and never been done with a gp f2f since being in hospitals 🤷🏻‍♀️

Video or telephone appointments are fine if they actually happen and the patient wants them.

But it should be at the patient's preference. For example, many elderly people can't use systems like e-consult, but the surgeries don't care. There is no differentiating the service for different needs.

If I eg had a mole I was worried about, I could quite easily take a photo and send it to the surgery. But a lot of people would struggle to do that and have nobody to ask. Even if you can't see the GP you should be able to see a practice nurse in that instance. Or even the receptionist, who can take the photo for you!