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?

My gp was doing phone triage 3 years prior to covid, very useful. You can still book an in person consultation for specific reasons etc on going medical issues

also

• GPs have been open throughout

• there's been an INCREASE in demand for GP appointments in recent years and this is one way to manage it sensibly.

• even before the pandemic people were being asked to go directly to the local pharmacy for very minor things to try to manage demand

• GPs (using telephone triage as well as face to face) have apparently been seeing an INCREASE of a MILLION extra patients per WEEK this year. They are a bit overwhelmed. I think we should be cutting them some slack (before we lose more of them)

from here www.pulsetoday.co.uk/news/workload/one-million-more-gp-appointments-taking-place-per-week-than-before-pandemic/

#I am not a GP

@herecomesthsun

So the telephone appointments are triage.

If the GP needs to see you they can decide to.

Skin lesions/dermatology lends itself very well to this in that you can send in a pic.

This has worked very well in our GP practice and I got a triage, a review by the GP and a specialist referral very quickly for a cancer assessment

From an article in the Telegraph today

"Proponents of the system say that it helps GPs to identify and focus on the most urgent and serious cases and ensure that those who need them get face-to-face consultations.

The guidance also suggests that online consultations can be carried out “very quickly”, recommending “quick wins” such as using preset messages.

When the NHS first issued guidance recommending use of “total triage”, it said that such measures were necessary to “protect patients and staff from avoidable risks of infection”.

This is pure propaganda straight from the Conservatives press office.

I worry what kind of world we're going to end up in- it's already the case that people live through their screens, often not physically speaking to another person for days on end. Humans need human contact and this trend for taking out all f2f communication is depressing. It could all become so isolated and disconnected.

I understand phone appointments can be really handy, but they should never replace the choice to speak to your GP f2f.

And we also know for a fact that women are far more likely to have their symptoms dismissed, and that we present differently to men on any number of conditions.

Men are hailed as heroes for contacting their doctor. Women are regarded as a nuisance.

It really pisses me off.

Me? Never voted Tory in my life. I read the Telegraph and the Guardian. I like the balance of opinions and the recipes.

FWIW lots of Telegraph readers want GPs seeing more people face to face as well.

I completely agree! It’s ridiculous that they’re wasting so much of the emergency services time. I contacted my GP as I was having some spotting in early pregnancy, I’ve had a miscarriage before and it was the exact same type of spotting until I had a medical management in 2019. My GP’s responce to me requesting a Early Pregnancy referral to confirm was ‘you will need to visit A&E urgently and have it confirmed that you are not having an Ectopic Pregnancy before we will contact you in regards to your spotting and a potential referral’ Now in my message I stated I had no pain, no shoulder tip pain, etc Had to go to A&E who where rammed with similar non-emergency issues sent by the GP. Luckily A&E were lovely and made the referral for me then and there.

I had a great experience with telephone consulting with my GP. Filled in a form on the website, got a call from the GP the same day. Telephone consultation, asked to send a photo of my DS's relatively minor but persistent rash. Asked if I was in any way worried about him - was he unwell? No. All good.

BUT, this doesn't work if the GP doesn't ask that question, doesn't trust the answer, or the parent isn't really able to tell whether their kid is unwell or not. Something could easily be missed.

Telephone consultations are a skill. They're easy to do with a patient who is quite 'with it', but much more difficult with a patient who is confused, poorly educated, doesn't speak English well etc. So basically, the new system works brilliantly for middle-class professionals like Matt Hancock...

I don't have a major concern with the triage idea. I've rung the GP just for advice prior to Covid. What infuriates me is the time table ours seem to work to. I've had an ongoing back problem. I was called in to see the GP earlier in the year after a number of phone calls. I had to call her back this month with an update on whether the treatment she'd organised was working. I had to ring at 11am for an afternoon telephone conversation. 'Doctor will call you back between 1pm and 6pm'. Absolutely ridiculous. If I were working (I work part time so I rang on a day off), how on earth can I ensure I'm free to take that call? How do teachers cope (who may be teaching so can't exactly leave a class of 30 kids on the whim of a GP calling back)? What about shop workers who may be on the tills (you can't exactly discuss your intimate rash in front of a customer and we've all been there when a cashier tries to get a supervisor over for help - it takes a while). Is a bus driver expected to pull over and discuss his or her private medical history during their shift? I tried asking if the GP could call before 3pm - just to see what the answer was. Nope, they can try to request it but the GP will call when they're able. At least with a face to face you can accept an appointment time.

If they are going to continue with this, slightly farcical, way of doing things then they should be held to an appointment time (give or take 15 minutes for a tricky patient holding them up). After all, we have 10 GPs in our practice. If they're all calling patients instead of seeing them they don't need a 5 hour time slot for the calls. They just work through them like they used to see them - by appointment times.

Phone triage is ok, but I think that there does need to be a system where you can have a face to face appointment on request. So standard would be phone triage, with the doctor calling you in if they felt it necessary (it's not always, I had a very helpful conversation with my doctor over the phone the other day as all I needed to know was what painkillers I could take for back pain while breastfeeding - he didn't need to see me for that). But alongside that I think there should be an ability for the patient to say that they want a F2F appointment, not a phone one. Some people are not happy or comfortable talking on the phone, some don't have a private place to do it.

Also, they need to get better at giving timed appointments for phone calls with doctors. I was just told that the doctor would ring me, "Sometime this morning," which was fine for me on maternity leave! Not (I imagine) suitable if you're working the tills in Tesco, you'd need a time so you can tell your manager that you have a medical appointment at such and such a time.

I dont mind the telephone triage but my bugbear is the amount of time it takes to get through. I rang my surgery at 8am (when they open ) and i was 9th in the queue and was on the phone for 35 minutes. I’m signed off sick at the minute so i could wait for that amount of time. Not everybody has the time to wait for 35 minutes on a call. If they are going to go down this route more permanently then they seriously need to think about having more people answering the telephone calls as i can see a lot of people not even bothering to try with potentially life changing missed illnesses.

@110APiccadilly

Phone triage is ok, but I think that there does need to be a system where you can have a face to face appointment on request. So standard would be phone triage, with the doctor calling you in if they felt it necessary (it's not always, I had a very helpful conversation with my doctor over the phone the other day as all I needed to know was what painkillers I could take for back pain while breastfeeding - he didn't need to see me for that). But alongside that I think there should be an ability for the patient to say that they want a F2F appointment, not a phone one. Some people are not happy or comfortable talking on the phone, some don't have a private place to do it.

Also, they need to get better at giving timed appointments for phone calls with doctors. I was just told that the doctor would ring me, "Sometime this morning," which was fine for me on maternity leave! Not (I imagine) suitable if you're working the tills in Tesco, you'd need a time so you can tell your manager that you have a medical appointment at such and such a time.

Presumably a lot of people would then say, oh if I can choose I'll just have a face to face appointment.

I think people don't realise how overburdened the system is and that the GPs are actually dealing with a lot more requests for help and that this is a way of managing it.

I agree that finding a way to get back to people around the requirements of work is important.

Some very interesting points raised here.

Also - I expect lots of us are unable to discuss an issue openly with the doctor because of other people hanging around. My DH is one of those men who can't cope with the thought of his wife being unwell. He is retired so here all the time. I don't want him hearing my private health-related conversations.

I cannot bear phone appointments. I have needed to speak to a GP twice over this time and both times it was rubbish. the second time she wrote an incredibly crap referral letter that did not reflect what I had said at all.

My DD has had face to face consults 2 during lockdown (she is a teen not a young child) following telephone triage, and one issue that was sorted over the phone. It seems to work very well with our practice, but they have always been excellent. My bugbear is that you don't have a time for when the

GP will ring you back, which isn't ideal if you need to go to work or school where you can't access your phone and/or get any privacy.

Same. I have had so many issues with ongoing health but never have they once asked me to go in. Yet I've had several dentist appointments and had constant letters and texts telling me to go for an eye test.

I like telephone triage. There, I said it. And I like the email with a question even better.

And I've been seen F2F this year, as has my DM - 2 different surgeries.

Took my elderly DM a while to get her head around that she has a GP that she didn't know what he looked like, but he's actually been about a zillion times better than her previous GP who saw her F2F all the time but made a point of misdiagnosing her and seeing her as a fussy old lady.

I was diagnosed with shingles through telephone triage and a photo. I was told (by the nurse practitioner) that it was too late for anti-viral meds. After two more days of being in absolute agony with the pain and being worried it could result in long term neuralgia, I had another telephone appointment with a GP and was prescribed anti-viral meds. The two appointments instead of one was a waste of NHS resources imo.

I’ve also had a video physio appointment for tendonitis in my ankle - I had to prop my iPad on the floor against the armchair so the physio could try to see what my ankle looked like when I did certain movements of my ankle. Most of the time was taken up by me trying to get the angle right on the iPad screen.

Last week, the receptionist at my GP surgery said "we're not booking face to face appointments" and I thought it was pretty shocking that it was a black and white scenario. I know they'll get people in for certain things once triage is complete but I just don't understand why they're still flat out refusing to go back to normal. Everyone else has been expected to go back to normal. Masks aren't being mandated in schools anymore from next week, leisure is reopening, we can go and sit in a bingo hall but can't see our GP face to face. To put it bluntly - it's fucking ridiculous.

Also, it should be noted that many people who suffer from anxiety and depression are phone phobic. This will definitely mean that people may not seek help for their mental health, but also other health issues. I tend towards being a little anxious but function perfectly well day to day. I cannot bear speaking on the phone and will put off making phone calls for days on end.

My DD24 was not offered a f2f appointment for a lump in her breast, nothing except "keep an eye on it''. Luckily I'm able to get her on my work's private healthcare to be seen soon, but so many are with this privilege an may miss life-saving early diagnoses.

@Seeline

My DD has had face to face consults 2 during lockdown (she is a teen not a young child) following telephone triage, and one issue that was sorted over the phone. It seems to work very well with our practice, but they have always been excellent. My bugbear is that you don't have a time for when the

GP will ring you back, which isn't ideal if you need to go to work or school where you can't access your phone and/or get any privacy.

This is the other thing that's shit about it - they won't give you a time for your phone appointment other than morning or afternoon. They expect you to be available to answer their call at the drop of a hat. They want the public to work around them and it's not right.

I do quite like the e-consults though, sorting prescriptions etc is just a 5 minute phone call rather than the trouble of travel and a f2f appointment just to iron out dosage or change a medication.

I think they will use this to never go back to how it was. OK some things needed changing but not like this. They have no way of seeing change in vulnerable patients because they are not seeing them
I work in an NHS community team and we have continued all through covid. Why is it safe for us and not GPs and we are going into patients houses so it's a much harder environment to control
We may as well just Google our own symptoms at this rate

I am thinking that too about googling.