GPs do not want to see patients in person

[Lily7050]

Apologies, if there might have been similar thread already.
Just trying to understand why it is ok for supermarket staff or hairdressers to work all day among many customers, dentists treat patients, and GPs still refuse to see patients?
I got 15 months old DS and ended up in A&E each time he was unwell because GPs refuse to examine him. A&E doctors laughed at "telephone examinations" of such a young child done by GPs.
Where do NHS GPs get instructions that they should not be seeing patients face-to-face and create more workload for A&E?
I hope there might be GPs reading this thread and explain their mysterious behaviour.

Working with customers sucks, so they want to avoid it, I guess.

My GP saw my 14 month old and one of his symptoms was a high temperature, so I suppose it just depends on your individual GP

When my dc were little, I phoned the gp on a few occasions when there was something I was concerned about. Each time, the gp asked me to go to the surgery, as they said with a young child they really needed to make an assessment in person, so yes, I agree. Telephone diagnosis must miss things - and with children it's often important to act fast.

Our GP is seeing people face to face. We filled in a form on the website, which is seen the same day and they ring you back to say whether they are happy to give advice over the phone/bring you in to see a nurse/send you to pharmacy/ bring you in to see the GP.

I filled in the form one morning about concerns I had about DD, got an email saying please phone for an appointment and we were seen by 11am.

Prefer it to the normal way to be honest. I certainly felt like filling in the form gave me the opportunity to describe her symptoms in detail and check I hadn't forgotten anything.

Most people won't (shouldn't?) go to the hairdresser if they have a cough or fever. People with severe immunocompromise won't (shouldn't?) be going to the hairdresser either.
Both of these groups will likely still go to the doctor.
Therefore GPs are more likely to encounter people with covid and risk spreading it to very vulnerable people (or their families).

I think it's reasonable to see emergency cases only at the moment. What was the emergency that you went to A&E for?

(For the record, I have been seen by my GP for pregnancy related issues, not life threatening but deemed 'important').

I called the surgery this morning for my DD, got a call back from a GP within 15 minutes and an appointment later this morning for her at the surgery. It's not urgent but something they'd rather check out in person.

I think it's about time the current GP system was scrapped. It's been unfit for purpose for many years and Covid has highlighted the fundamental flaws. It's crazy that you need a GP appointment to refer you for an NHS hearing aid, or physiotherapy or podiatry. GP surgeries used to actually do things, like dressing wounds, ear syringing, minor injuries etc. Go back a few decades and GPs actually went out to emergencies, road accidents, etc.

Dentists and opticians and pharmacies provide NHS services without GP referral - they manage to weed out those entitled against those not entitled. Why can't more NHS services do the same, such as podiatry, physiotherapy, etc?

GP's have made themselves important via their "gate-keeping" role but they're a very expensive gate-keeper. GPs have apparently become the "centre" of the NHS service for individuals, yet they actually do very little themselves beyond referring you elsewhere.

When it comes to dealing with longer term illnesses, it seems to be a wholly inadequate mix of what the GP deals with as opposed to what the hospital consultant deals with. My OH has cancer. The oncologist constantly refers him back to the GP for things like calcium/iron tablets but the GP won't prescribe them without a letter from the consultant which takes weeks. Same with blood tests, both the oncology dept and the GP surgery think it's the others' job to do the monthly blood tests. When he has a new ailment and goes to the GP, they won't prescribe anything because they say they can't see the blood test results (despite them being taken in the surgery), so they just fob him off to the oncologist who fobs him back to the GP and writes a letter to the GP with the blood test results. It's an absolute nightmare dealing between them. The whole idea of the GP is someone who takes responsibility, but they simply don't.

I think it's reasonable to see emergency cases only at the moment.

But what about things that aren't "emergencies" as such but still need regular monitoring and attention, such as cancers, diabetes, heart conditions, etc. You can't just ignore them for over 6 months and hope for the best. Do you really think people should just be ignored until they collapse and it becomes an emergency?

In the news today that GPs have been written to by the NHS reminding them that they should be offering face to face appointments, so you are right, it is not ok OP.

(Incidentally this made the news because GPs complained that receiving the letter was insulting to those who are already doing this, which I found a petty complaint. Fine- some GPs are doing it, great, but clearly some are not, so the letter was needed, get over it)

@Lifeaintalwaysempty

In the news today that GPs have been written to by the NHS reminding them that they should be offering face to face appointments, so you are right, it is not ok OP.

(Incidentally this made the news because GPs complained that receiving the letter was insulting to those who are already doing this, which I found a petty complaint. Fine- some GPs are doing it, great, but clearly some are not, so the letter was needed, get over it)

About bloody time too. Our GP branch practice still has signs all over the door and windows instructing patients not to enter. Apparently you've to shout through the letterbox if you don't have a mobile phone! There's also a box of urine sample bottles left on the doorstep to help yourself if you need one - very hygienic!

Is everyone getting routine dentist appointments? Misses the point

We haven't had our check-ups. My DD(3) had been going every three months to get her used to the dentist and as I was pregnant and on maternity leave, I was having more regular check-ups - my teeth aren't great and I suspect I need a few fillings. I can't get appointments though.

Our doctor has seen my DD and DS for vaccinations and I've had a smear test (oh joy). I think you can get a face to face if needed.

Thanks ladies. I guess I need to look around and find a decent GP practice.
Our current GP practice has git its metal doors permanently shut. If you buzz the receptionist tells you to phone them. Telephone line does not work: I spent half an hour trying to book telephone appointment with any GP but in the end got disconnected.
I think NHS GPs forget that they are funded by taxpayers', i.e. patients' money. They are paid salaries in return for the service to patients.
I pay higher rate tax and expect at least half-decent service.

@Rigamorph: DS had a high temperature (over 39 degrees) for over week. We did COVID test which came back negative. The nursery management recommended to show DS to a GP but our then (different) GP would only agree to speak over phone even though she was free (I saw her wondering around practice). Then we went to A&E where the doctors laughed, examined DS and took his blood tests and in the end said it was a viral infection, one of the many, children usually get in nurseries.

There’s very mixed guidance. I think it’s fine to offer video appointments as default, as long as the possibility is there to offer face-to-face if you have to.

Look at it this way: spending 15 minutes in close proximity to a covid case means you can get infected, or at least get a 2 week quarantine. Now extend that out to all the patients you could see in person. And consider the impact of losing all those community-based doctors, either to quarantine or illness. Think it’s worth it?

I work as a doctor in CAMHS. After a “honeymoon period” over the summer months when I felt it was ok to do face-to-face as default, I’m now moving back to videocall by default. This is in line with current guidance. I’m far more useful if I avoid a call from Test and Protect telling me to go home for 2 weeks. And I can still offer a face-face appointment if absolutely necessary.

All the GPs I know are doing face to face appointments where it is required. And thanks to improvements that other methods of engagement have brought, they are seeing more people in the short term.

I accept that some people may not have the GP service that they personally want, and that may or may not be a reasonable ask. But damning all GPs for the perceived faults of a few is no better than me pointing out that patients are flaky, never turning up for appointments, and when they do turn up they have insignificant complaints that don't need a doctors appointment anyway.

My GP's are usually fantastic. Had a phone appointment on Friday as I need a sick note. Said it would be ready to collect today. The GP hasn't signed it, so will have to make another trip to get it. Arghh! If I'd seen them face to face it would have taken less than five minutes.

Our GP has been great, telephone triage and face to face appointments if needed.

Prescription done over the phone.

Seems the way forward to me. So much more efficient.

Only problem is getting through to reception!

They get paid anyway, so they're happy to not see patients for as long as they can get away with it. My DH is a health professional in the private sector and is seeing patients, with appropriate safety measures in place, all day every day.

At our dental practice regulations from the NHS means that we must contact all patients who call us by phone first, then decide if it’s something that can be managed without coming in, or whether it needs a face to face appointment. So urgent cases only. We’ve gone from 25 appointments per dentist per day to five, so there is no way we can see the same number of patients as previously. (Due to extended cleaning procedures, enabling distancing in the waiting room, taking ten minutes to actually put all the PPE on etc...! )
Unfortunately something has to give so we have to prioritise who we need to see and who can wait.
It’s not the way I want to work, but there’s not much way round it at the moment.
(Private dentists are different as they fund themselves so don’t have to take notice of NHS rules! You will get a check up there!)

Above post for @BlackKittyKat

But I expect most GP surgeries are working under similar instructions.

DD has a rash recently so I called for an appointment and got a video call with the duty GP within an hour who quite sensibly said he had to see her in person and we were there within 10 minutes - thankfully live a short drive away. The surgery is locked and you have to call reception when you arrive but they’ve been pretty good. I’ve been going regularly for jabs I have done by the nurse, the in-house pharmacy has been quicker than ever. They had a delivery service in place during proper lockdown and it’s collection from the surgery again now but if you ring ahead they get it ready and someone hands it over at the door.

@AbulaConundrum

No need for that. It’s unfair to view pandemic precautions as laziness.

And bully for your husband. I do private work as well as NHS. If I’m seeing NHS patients virtually, then I’m doing the same for private patients.

@AbulaConundrum
They are getting paid by the NHS so they have to do things the way they’ve been told to by the NHS. The NHS wants to reduce COVID transmission. Doctors do not want to abandon their patients. Conflict of interest and everyone doing their best to meet in the middle.

I ended up much unweller than I needed to be last week because my gp insisted on consulting three times via an online form that has automated questions and twice the week before. I really needed examining so that they could see the problem was as I said and not what they thought. It would have saved them time too if I had just been seen. Im going to write to the practice manager when I feel up to it.

Now I cant get hold of my specialist nurse either for urgent advice. Ive been trying since Friday, but instead of their answer phone it just rings out. With my hospital consultants also insisting on telephone consultations, I feel pretty abandoned.