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?

[quote ConfusedAdultFemale]@BuggerBognor if your employer won’t allow you to take a phone call from your GP I assume you’re not allowed to go in for a face to face appointment either, which is illegal. They are not allowed to deny you time for medical appointments whether that’s a telephone consultation or a face to face appointment.[/quote]
That’s not very realistic though, when you don’t know when the call will happen. Should a bus driver, for example, just pull the bus over and park if the Dr rings while they’re driving? Should a teacher leave a class alone? Should a nurse step out mid smear test?

I had a major spinal injury last June. Have been in severe pain every day since. Have been prescribed drug dealing quantities of painkillers..She's never seen me. She referred me for physio which was over the phone and utterly useless. I ended up seeing the spinal surgeon privately who recommended surgery. When I spoke to my GP about this she said she was surprised by his advice. But he saw me and assessed me and knows how much pain I'm in and how disabled by it I am. I honestly feel utterly uncared for by her. I'm paying for private osteo and acupuncture and these are face to face.

There's been lots of threads like this and GPs come on saying how overwhelmed they are and that the system is broken. I don't disagree but I'm not sure many are aware how devastating the phone only approach is for some patients. I'm now having some significant mental health difficulties but have no inclination to contact the GP.

All part of the Tory plan. Proving we dont need our GPs. People that are desperate will pay for private treatment. Same with Dentists - all part of the Tory wind down of NHS services.

I'm just off the phone to my GP. It's taken me from 12.30 to through. Nearly five minutes listening to a recorded message advising they have a closed door policy, if you have Covid symptoms you should book a test, then another message regarding the flu vaccine. Are they even still doing those?! Then I had to press '1'. Another long winded recorded message about something I cant even remember before I eventually got through. Wanted blood test results from last week, which receptionist gave me. When I asked to see a Doctor about the constant heart palpitations I have been having since my Pfizer vaccine a month ago, I was given one on the 27th May. I told her I didnt want to wait that long (just in case I died), and she has told me to phone back in the morning between 8 and 9. I know how that's going to go. I also have a 'female' complaint I would like to speak to a doctor about, but I am certainly not explaining that to the girl on reception. Will have to put up with that one. I managed an appointment 3 weeks ago re. my palpitations and got seen by a nurse practitioner. There didn't seem to be any doctors on the premises that day, just lots of nurses rushing in and out of the waiting room. What I'd like to know is what are all the doctors actually doing. Are they only working part time now and are the accepting a pay cut?

My ds (19) has been off work with tonsillitis all week. Last night, he couldn't even swallow, can't drink a glass of water, ibuprofen not taking the pain away. He got through this morning and was allocated a callback.
He's been dropping off all day but has fought to stay awake in order to answer his phone.
He can barely talk now.
About an hour ago, he received a text message from the surgery saying he hasn't answered his call. Checked his phone records and there has definitely been no call.
I've phoned up and been told that if he can be fit in, he'll get a callback soon. No apology or explanation given. He's now nodded off with exhaustion. He's taken to spitting in a bucket because he can't swallow and I'm worried if he's okay going to sleep.

Telephone triage would work if you were triaged by someone with medical qualifications but that isn't the case at our surgery. DP was told that sudden onset, painless jaundice isn't a medical emergency and that he could wait over a week for a telephone appointment. We will never know if his life expectancy would be longer if he had developed his cancer in non covid times.

@Pet8

My ds (19) has been off work with tonsillitis all week. Last night, he couldn't even swallow, can't drink a glass of water, ibuprofen not taking the pain away. He got through this morning and was allocated a callback. He's been dropping off all day but has fought to stay awake in order to answer his phone. He can barely talk now. About an hour ago, he received a text message from the surgery saying he hasn't answered his call. Checked his phone records and there has definitely been no call. I've phoned up and been told that if he can be fit in, he'll get a callback soon. No apology or explanation given. He's now nodded off with exhaustion. He's taken to spitting in a bucket because he can't swallow and I'm worried if he's okay going to sleep.

I'd go to walk in or A&E.

Yes I'd get attention too.

Firstly, to anyone who is having problems getting an appointment, I'm sorry. But here are a few comments from someone working in a GP practice:

1. I work with several GPs who are towards the end of their careers - people who are very experienced and who, I would have said, are good are handling stress. They are breaking and plan to leave the profession.

1. We are a training practice - our current GP registrar will complete their training in August but does not plan to work as a GP

1. Our practice, like most, offers 'on the day' telephone appointments in the first instance. If a patient is working and needs a call at a certain time we will do our best to accommodate this, often calling several times.

1. At this practice poorly children are virtually always seen.

1. eConsults mean patients have almost instant access.

1. We may fill up our 'routine' telephone appointments quite quickly each day but our duty doctors list does not close.

1. The current system we are being told to use of 'triage first' is not perfect. No appointment system is perfect. Pre-pandemic we had patients complaining that they couldn't make an appointment for two weeks.

1. Our 'part time' GPs are working long into the evening and at weekends to keep on top of administration and referrals. I know this because as a Practice Manager they call or text me when they are having technical issues with their laptops!

1. We are often managing patients who are having hospital procedures delayed by many months.

10. Nearly 50% of telephone consultations here are converted to a further face to face consultation.

11. At the beginning of the pandemic our antiquated telephone system simply wasn't up to the job of moving to a telephone/remote service. It has taken us a year to get a new telephone system installed. Now, instead of getting and engaged tone, patients are placed in a queue. It's still not good enough, apparently.

12. Our doors are open and we are carrying out the vast majority of usual work, including smears, blood tests, minor operations, child immunisations, chronic disease management.

I could go on but, seriously, this is one GP Practice that is doing it's best to provide a responsive and safe service in very difficult circumstances.

To be fair my surgery was abysmal pre-covid so they can’t blame it all on the pandemic but they have now introduced a system of absolutely no bookings for appointments in advance, it’s phone at 8am on the morning and try your luck. Which would be fine if they had some sort of queuing system but no, if it’s engaged you have to call back then they don’t answer the phone if it does actually ring.

I emailed in desperation to ask for a prescription only to get a message back saying call at 8am. I’ve just sent them a screenshot of the 22 times I tried to call yesterday and the 35 times tried this morning!

With regard to point number 10, doesn't that mean you're seeing 50% of patients twice? Is that an effective use of time?

And after saying all that, what are patients actually expected to do? It's all well and good saying but but but... Most people aren't calling up to make your lives difficult, they are genuinely in need.

I was triaged and see same day by my Gp

With regard to point number 10, doesn't that mean you're seeing 50% of patients twice? Is that an effective use of time?

Well, yes - a history is taken over the phone and the patient then comes in for examination.

Pet8 I hope a&e are helpful. Sounds like a possible quinsy? If so, you need to get antibiotics prescribed. My husband had the same throat symptoms over the BH weekend 5 days after his Moderna jab. 111 and out of hours insisted it was a side effect and refused to examine him - (I even pcr tested him so they would let him in!) To cut a long story short, after 3 days of 111 he had a quinsy (throat abcess) which ended up rupturing in the out of hours GP car park - the GPs were still hiding in the building behind all the 'covid safe' measures. He eventually got antibiotics 6 hours after the abcess burst which was a huge sepsis risk. There is just no excuse for vaccinated GPs hiding from acutely unwell patients. If he had had it diagnosed before it burst he would have been admitted to hospital for intravenous antibiotics instead of being left sitting in the car until it burst!

Lucky you, I can’t see a fucking dentist

My DM has been suffering terribly with her ears and ended up with Labyrinthitis, she needs her ears syringing but GP practice won't do it now because 'covid' however they recommended she could contact a private audiologist who could do it for £55 per ear. Quite how the audiologist is safe from covid but the practice nurse isn't is beyond me. It's a complete joke and I'm sick of it all now, masks, distancing and being treat like a leper every time I go somewhere.

A private audiologist would use microsuction not syringing. Ear syringing is an outdated, dangerous activity which is not in the GP contract or commissioned. Many practices were doing it for free but have thankfully stopped now. You can buy ear irrigation kits from Boots. Using drops regularly for a couple of weeks would do the same job but without the risk of perforating an ear drum.

@Shannith

Just to see it from a GP point of view. 57 million in person visits a year are unnecessary.

www.google.co.uk/amp/s/amp.theguardian.com/society/2016/nov/05/millions-of-patients-putting-strain-on-nhs-with-minor-ailments

These are the reasons GPS get swamped and miss serious illnesses/can't give enough time to people who are really ill.

It's also why pre-covid it was so bloody hard to get a GP appointment within 2 weeks unless you had an arm hanging off. Because there were hundreds of people having appointments about colds.

I suspect GPs have welcomed the fact that covid has given them a reason to use telephone/email triage. Which they would loved to have done but would have taken years and endless terrible PR to do in normal times.

Just like millions of people and businesses have realised that they can do their jobs in more efficient ways - from home/digitally.

Yes it's different but it's possibly a much better way of managing the process.

And remember - although GPs are paid by the NHS each practice is actually running a private business.

So how exactly is it better or easier to get an appointment now? People above have given examples of their GP not even seeing them when they needed urgent antibiotics, suffering from undiagnosed diabetes type I (there was a lady on here recently who went to A&E based on Mumsnetters' advice because her GP wouldn't let her come in) and such like. Yes, some people visit the doctor more than necessary; but there might be a reason for this, too (such as mental illness, loneliness, domestic violence), with which the GP is in a good position to help.

@littlepeas

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.

This is me. 90% of the time I am adamant that I am not going to seek help for my mental health, don't need to and can't face it for various reasons, but occasionally I think I maybe should. However, I can't talk to people on the phone, I struggle with a normal everyday conversation with someone I know, I also can't easily talk about my mental health when face to face with someone so the combination of talking about my mental health on the phone is going to be literally impossible. This is potentially life-threatening for some people.

its a good question that begs a reasonable answer , but sadly i think all we the patients will ever get are excuses , my elderly mum who is 84 is now put off totally with all the arsing about trying to get through , waiting for the doctor to ring back which means she has to stay in and cant leave her flat, she and i both agree the whole lot of them will be looking to implement this on a permenant basis going forward , it only benefits people who dont work , and the really really infirm who never leave their houses , everybody else finds it a royal pain id wager , i need to phone for my 12 yr dd .but il have to wait until my day off , as the phone lines open at 8 am and are promptly engaged for about the next hour , by that time iv dropped her at school on my way to work and by the time they are free iv started , even if i happened to get through i cannot take a call back as we arent allowed mobiles on the shop floor and giving the no of the store wont help as if im busy serving customers i can hardly just drop them to go off and talk on the phone for how many minutes while the poor sods wait for me to come back to serve them . its a shit system ,sadly i think its here to stay

Phone triage has worked well for me. I have a flexible job so can just stop working for 5 minutes to take the call, rather than getting myself to the GPs then during in the waiting room. Recently I was called in by the doctor after he looked at a photo. I actually felt more comfortable "bothering him" with the photo than with going in initially: I'd worried i was wasting his time.

BUT it needs to be a choice. There are so many circumstances where an in-person appointment is necessary.

@BuggerBognor

And remember - although GPs are paid by the NHS each practice is actually running a private business.

This is such a contrived and ridiculous statement. It’s a “business” with guaranteed income, one customer and fuck-all risk. About 75% of the people using the post-pandemic GP “service” (arf) thinks it’s a bag of shit, but GP’s get paid anyway (£70k for a 2 day week according to my practice website). Hardly captains of industry, are you? 🙄

GPs are not salaried. Every practice is a partnership. GPs do not just get paid anyway.

www.drneilpaul.blog/how-gps-are-paid/