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?

I've had several nurse appointments face to face, and about to restart my hospital rheumatology appointments face to face again after over a year.

I don't mine the GP telephone triage but our surgery's system needs to change before I'd be happy with it being a permanent fixture.

I want to be able to book the appointments via the app again, like I could with face to face - I can't do the 8:30am telephone hold thing easily as need to be in class.

I want to be able to select an appointment time, within reason, that suits me. I can't have my phone on me in class, I want have the 'we will call anytime between 9am and 5pm' system we currently have. I want a time slot. That should be easy to arrange and I don't understand why it hasn't been sorted.

For certain things I want the option to send a photographs perhaps - non suspect rashs or psoriasis outbreaks, blood pressure readings, etc.

For some things I want the option to click 'need face to face to discuss this' too.

At present our surgery's system isn't fit for purpose for most working people.

More people with mental illnesses are going to die. I would bet money on it. I have had anorexia since I was thirteen and have suffered with substance abuse in the past to the point I have been in a coma. On a day to day level I'm highly functional, have a 'good' job, plenty of important-sounding letters around my name, keep a nice house, social life and so on. When I'm well I can navigate the phone triage system no problem. Even got my regular medications much more promptly than usual and with less fuss via the phone. But I've been in crisis twice in the past year. and I absolutely could not have done it. I was not capable. Don't even get me started on the issues getting followup blood tests after an incident. If I didn't have a family member advocating for me I'd probably just have died. Its all very survival of the fittest, which is ironic, because if you saw me on a regular day you'd think that was me.

I think people are missing the point. This system is not being designed by GP's. GP's are private businesses, and they are contracted to provide certain services, in certain ways, in accordance with contracts and "guidelines" (many of which are nigh on compulsory) which are laid down by NHS contracts. What people need to be really thinking about is why NHS contracts are being driven in this way - and the roots of these developments go back long before the pandemic.

Some aspects are actually sensible and good. I understand the arguments about the needing to see doctors; and I am going to assume that everyone on these threads are reasonable people who only ever go to the GP with real concerns and issues. But that does not mean everyone is the same, and some practices are swamped with people who, frankly, turn up regularly for mild conditions that can be self-treated - you would be surprised how adept some of them are at getting the appointments that you think are so elusive. I am seriously not joking - people are known to go to the GP because they get headaches and want headache tablets, often when they can get free medication and won't even pay the 19p for generic tablets at the supermarket. Time wasting takes up enormous amounts of GP time, and triage filters that out so that GP time is reserved for those who need it.

Or at least, it should be, but then you are hit by the chronic shortage of GP's in practice. There simply aren't enough doctors in GP practice, and it is proving incredibly difficult to recruit new ones. By far the majority of practices are under par for the number of patients they are trying to manage. This is not their fault - you cannot provide what you do not have.

But then you have to ask, why are the NHS asking doctors to practice in this way (because you'll find that many GP's agree with you about this, and that is fuelling doctors leaving, which just adds to the problem)? Because it is cheaper. You see many more people in much less time, meaning that contract costs are more "efficient". Remember, these "improvements" are brought to you by the same people who, a couple of years ago, where suggesting the NHS scrap most elective surgery as too expensive - you know, things like the hip replacements that enable people to carry on walking instead of being crippled.

So if you are angry about your NHS services, don't take it out on GP's - and as some have pointed out, other services are being pushed in the same direction. Take it out on those responsible for funding and managing the NHS.

BTW - I am not a GP, so I am not defending them out of a sense of belonging, but because people need to understand that they are between a rock and a hard place, and this level of vitriol directed at them now will simply mean that more and more will leave (or not join GP practice at all), either for other specialisms, or the NHS altogether. That will make things even worse.

And I know they've been open. I don't dispute that and don't dispute they are working hard. I know a GP who's mental health dived during the crisis and she has lost her life. I am in no way disputing that many GPS are working harder than ever right now and throughout this year.

Ive also had f2f appointments - but only after dealing with an insufficient phone system.

Sort the system out and address my booking and receiving calls time slots out and I'm happy for phone triage to stay.

I was refused a life-essential medication repeat prescription because I hadn’t had a blood test. Despite the fact that I have repeatedly asked to have my bloods checked over a 9 month period and been shouted at that ‘don’t you know there’s a pandemic’. Had to go to hospital to get it done in the end. Because there’s no COVID risk there.

OP I agree. I have a mole on my neck that is now actually 2 moles.

The desk dragons think they know better, just keep repeating the same mantra that it's telephone only and when you absolutely insist they tell you you're going round in circles and they just hang up.

No other GP in my catchment area, and don't even have a tenner to my name at this time of month so can't afford to go private.

Agree it’s terrible at the moment (at least where I am, though accept this may not be the case everywhere). Before being triaged by a GP, you’re effectively ‘triaged’ by a receptionist with no medical training. My mum phoned up the GP for a consultation as she was in pain and paracetamol was not working. GP prescribed morphine patches without seeing her or identifying a cause for the pain. She had no history of illness, but because she is elderly, it seems they can’t be bothered.

@whiteblinds

We have telephone triage and then the doctor decides if we need to come in. My son has been seen face to face twice this year.

I like the telephone triage. Much better idea

I have no issue with telephone triage in principle, for me and those in a similar situation to me. I wfh and can generally pick up my phone whenever and a quick call rather than a f2f appointment with travel time, time in the waiting room etc is so much more convenient. Many people do not have jobs like that - DM is a teacher, so unless she’s so ill she’s off work, or it’s half term, she cannot speak to a GP because the surgery refuse to allow her to request a call back later in the afternoon after school finishes. She is literally asking to be put at the back of the queue for a call, and they won’t. Students presumably have the same issue, they can’t answer the phone in lessons. And they shouldn’t be expected to hope the GP calls during break time, and then discuss potentially sensitive medical issues in the playground.
Telephone triage is fine as a general default, but there must be some understanding that it is just not possible for everyone. Especially if they don’t provide even a vague time slot.

I really do think some GP surgeries are taking the absolute piss. I have a chronic illness and dealt with the GP over phone call until around June where I saw one for a gynaecological exam and I’ve seen a GP in person around 6 times since then. Each one has been triaged by phone and then I’ve been invited in. So clearly they can see people in person, different surgeries have just decided not to and it’s absolutely shocking. I’ve also had bloods done 4 times, a laparoscopy and seen the pain clinic in person.

I think each practise is just inventing their own guidelines and it’s shocking because there are people out there who really just need to see a GP in person. I agree A&E are taking the brunt in some towns and it’s ridiculous.

Diagnosis's are being missed because people can't see their GP face-to-face and people are dying as a result.

Would love to see the statistics on that.

I feel very lucky with my surgery seeing all these posts. My surgery does face to face appointments and telephone appointments. I’ve never had a problem getting either. They also let you send in pics to use to show them something during a telephone consultation. It’s worrying to see what a terrible service some patients are receiving.

I like telephone triage, but then we get a call back that morning if required and in recent months following triage I've taken DS in and DH has been in. Neither case was urgent, they were just things that needed to be done in person. What it sounds like is that some particular GPs are shit. Complain to the practice manager and if you get nowhere then complain to the CCG, and consider moving to a different GP. No need to suggest all GPs are like this when it's just yours and you could complain to those who can actually fix the problem.

Telephone triage is fine as a general default, but there must be some understanding that it is just not possible for everyone.

For years we have begged for telephone consultations from GPs and consultants because dragging our daughter out of school (again) for a three hour round trip to have a ten minute conversation with her consultant is incredibly inconvenient. Nobody cared that it didn’t suit and refused to do phone consults. People with disabilities have been asking for this for a long time but the fact the original system was “just not possible” for quite a lot of people was soundly ignored.

But I guess now that non disabled people are having a taste of that, we really need to do something about it, eh?

It's shocking. I know the NHS is held up a the pinnacle of health care but it really isn't.

I have family in France. the GPs are working as normal, and health care is amazing, far far superior to what we have here. If I was ill I know which country I'd rather be in. Before anyone starts, I am fully aware of the political issues.

Elderly DM can't access her online only GP independently anymore. It all has to be done through DB's computer. Disgusting.
The irony is that he's literally across the road from the place!

Mine has done phone triage for years and it usually works well. Some straightforward issues are appropriate for it. But there have been appointments in the background. Some things really do need to be seen in person and it's a balance of efficiently deciding the best method of patient care, not multiple hoop jumping to get to the right stage with wasted time on both sides.

Video call physio with an autistic, dyspraxic 9yo was err... interesting...

At least I will get my overdue smear test in the near future, and credit to my practice, they approached me (are trying to put on catch-up clinics), I explained the logistics causing me concern and they are accomodating that.

@GreenLemons

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 was told exactly the same when I turned up at the EPU for spotting for the second time in early pregnancy.

They told me to go to A&E.

Pre covid, you could turn up at the EPU to be checked over if you'd already been seen there for current pregnancy.

Now you need a new referral for every visit and if you turn up in person you're turned away.

Shocking practice.

@Marcia1989

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...

This is the issue I think. Telephone triage works really well for some patients and conditions, not for others.

I'd hope that they're considering this if it's going to be a permanent feature going forward. They've introduced it in an emergency, now they need a review to make sure that however they change things for the future doesn't cause risks to health.

MY GP surgery is GENERALLY fantastic (but of course all GPs vary - there are good and bad) and I have been seen in person in the past year, including for my DD2s preschool booster which was bang on time.

In the past I had to go in for things like weird rashes on my child - now I can send a photo if it's not urgent, which saves everyone time and frees up GP time for other patients.

I agree that phone and email consult works for many in certain circumstances, and it’s a good use of GP’s time. But like pp’s have said, it’s difficult not knowing when the GP will ring. Even if people are at home and not at work, it can be difficult to have a private conversation.

I want to discuss something with my GP, but do not want my husband (we are both retired) to know. I have been unable to get a f2f appointment for over a year now, without first having a telephone triage, which is impossible with him here all the time. I despair.

There's soooooo many threads about this. It depends on the GP practice. I've seen mine multiple times

My relative was telephone triaged by her gp, symptoms dismissed and told she was suffering from an eating disorder when she lost significant amounts of weight. After months of this she was as in such pain that she had to go to A&E. Of course she has cancer, of course it is terminal. Maybe if the gp had agreed to see her, he might have realised that she was very ill and there might have been a treatment that could have given her more time. But we will never know.

Telephone appointments can work, but not if they are used by gps as an excuse not to help very sick patients.

@MintyMabel

Telephone triage is fine as a general default, but there must be some understanding that it is just not possible for everyone.

For years we have begged for telephone consultations from GPs and consultants because dragging our daughter out of school (again) for a three hour round trip to have a ten minute conversation with her consultant is incredibly inconvenient. Nobody cared that it didn’t suit and refused to do phone consults. People with disabilities have been asking for this for a long time but the fact the original system was “just not possible” for quite a lot of people was soundly ignored.

But I guess now that non disabled people are having a taste of that, we really need to do something about it, eh?

I can assure you that there are disabled people posting on this thread.

E-consult triage works really well at my surgery, they see you in Preston where required, and they give you a one/hour time slot for a call-back which is more convenient than a trip to the GP for most people and equally convenient for most of the remainder. Some GP surgeries are doing very well under the new regime, some are implementing it very poorly indeed and some are so understaffed that no matter how hard they try they’re never going to be able to give a decent service.

We need a national review of GP functioning to spread best practice and get rid of some manifestly inappropriate activities like the 8am Fastest Finger First triage and sending people to A & E unnecessarily.

That’s separate from the need for more funding and the shortage of GPs.

I don't think this is true; plenty of people here are saying that in certain circumstances they'd be quite happy with a remote consultation because it's an ongoing issue for example. But at the end of the day the NHS is there to serve patients. That is the whole point of its existence. How many elderly / disabled / mentally ill people would go without seeing a GP even though they should because of the obstacles that are currently in place? Restricting access to GPs will lead to higher mortality rates and rising costs for treating problems that were spotted late. It's a false economy (unless it's a deliberate step towards privatizing healthcare in the UK completely).

Moondust

I get the GPs are being told to act this way

But what is the penalty if they say "actually I need to do in person with some of these patients"?

Have just had to go to the Gp surgery to book an appointment as the phones are constantly engaged.
I need a smear test as my last one had anomalies. I’ve been told they are not booking them at the moment and I’m on a waiting list.

I’ve also been given a phone consultation with the Gp on 27th May as I need a coil check. Not sure how they will do that by phone ! 🙄