Why are GPs so protected?

[BiggerBoat1]

Can anyone explain to me why GPs still aren't seeing patients face to face.? All other services seem to be back up and running and in my doctor's surgery the Practice Nurse and Midwife are seeing people as normal.

Dentists are back up and running as are opticians etc. I am a teacher so I have been expected to be in a classroom with 30 children at a time for months.

I asked the receptionist today at my GP surgery when they would be back to normal and she looked at me like I'd grown two heads and said "Not any time soon. We still have the Covid". Is it just me or are GPs being protected to a ridiculous extent?

@Fancymice makes a very good point , people like teachers can’t access GP care at all really now , they are closed at weekends and you can’t specify what time you can take a phone call at least you can’t at our surgery .

There have also been other incidences of medical manslaughter

publishing.rcseng.ac.uk/doi/pdf/10.1308/rcsbull.2014.96.4.118#:~:text=Medical%20manslaughter%20is%20legally%20no,the%20part%20of%20the%20defendant.

This explains what it is and how cases proceed. From my understanding once the autopsy was done it had to be reported and was.

www.cps.gov.uk/legal-guidance/gross-negligence-manslaughter

@canigooutyet

I don't see any GP bashing just people like myself who are bemused about the lack of access to what should be front line basic care.

Gp's were told earlier this year to start seeing patients again.

Have you seen the figures reported with regards to the huge increase of deaths in peoples homes?

It's also not necessarily down to them seeing more patients, but more appointments given to the same patient. Four appointments for an asthma review over the phone and counting is crazy when normally this would be one f2f and a possible follow up over the phone.

Imagine if A&E also said fuck it, we are going to offer triage only over the phone.

I've also had a lump that needed to be seen. Saying over the phone it's the size of my hand doesn't really work does it?

I record all these phone appointments, which they know, and it's shocking to hear them saying you need to be seen, but we aren't doing f2f. I started doing this as A&E and Consultants were questioning why I'm not seeing the GP and I was getting fed up of the implications that I am not doing enough and leaving it until I need a hospital bed.

Actually, that exact thing is being piloted in a few areas with needing to phone rather than present at an emergency department.Not ambulances bringing major trauma, obviously but most other things are required to phone ahead and are offered a slot or advised to go elsewhere.

It's not only Gp surgeries, the dental surgery we are registered at is still doing emergencies only. I've had an abcess which started over the weekend, I couldn't get an appointment until tomorrow. Ds has ended up ringing 111 this morning as I have symptoms of sepsis, am now on massive doses of antibiotics with instructions of if my temperature goes up or I get any worse to dial 999. Thankfully it has burst so at least the pain has reduced.

Just pointing out that albeit rare, she and the nurses involved weren't the only ones who have been prosecuted for medical manslaughter, and for the layperson to have an idea of what is involved for this to happen.

The timeline of everything that happened that day is appalling, and mistakes happened via the trust, the Dr and nurses from what has been reported. A further investigation was also done and a considerable number of damning failures were highlighted against the hospital.

Everyone mentions the Dr but no one really speaks up for the agency nurse Isabel Amaro who was also struck off and also thrown under the bus.

This was on Twitter and I think it's really useful, I do appreciate everyone has different experiences though.

Why people can't get a GP appointment: A thread.
Everyone who has been waiting for hospital outpatients, elective surgery, etc, has been pushed back on the waiting list because of covid. All of those people are going to their GP asking for meds, updates, and extra help...

At the same time, a lot of people who held on to their minor problems last year are pitching up at their GP
At the same time, a lot of people who held on to their suspicious of cancer symptoms are pitching up at their GP.

Most of whom require a referral, which is often delayed, due to the hospital backlog. So they come back to the GP again panicking that they can't get their appointment/scan/tests etc.

111 is RAMMED. A+E is RAMMED. So those people pitch up back at the GP.
Meanwhile, the GP surgery, which was built pre-covid, has a waiting room that can only accommodate a dozen bubbles at best.

Which means only a couple of GPs and a nurse can see face to face at any time of the day, otherwise you have to make people wait either in a crowd or outside. So telephone triage is used to make sure only those who need to come down come down.

Potential covid patients can't be put in the same waiting room as non covid patients. Most surgeries only have one waiting room, so a lot of respiratory clinics are done at hubs. This allows the most vulnerable to come into the GP surgery for appointments, nurse checks etc.

So in summary: Demand is massively increased. Face to face facilities are substantially decreased because you can't physically get the same number of patients in the building. Telephone appointments are massively increased.

GPs aren't 'hiding'. They're holding up the shield in front of the elderly, the cancer patient, the kid with no immune system, against the person who is screaming abuse at their receptionists.

To say that GPs haven't been seeing patients during covid is like saying armed forces veterans didn't actually serve in a war just because you didn't see it or they didn't win.

It's not only untrue, it's massively disrespectful not just to the doctors, but also to the nurses, pharmacists, HCAs, receptionists, surgery cleaners, admin even who put their lives at risk serving through the pandemic.

And if you're a hospital specialist spreading these untruths, shame on you! Do you want your most vulnerable patients to sit crammed in a room of forty people? You aren't doing it in your outpatient clinics for the exact same reason.

@andthelaw_won

@itbemay1

This was on Twitter and I think it's really useful, I do appreciate everyone has different experiences though.

Why people can't get a GP appointment: A thread.
Everyone who has been waiting for hospital outpatients, elective surgery, etc, has been pushed back on the waiting list because of covid. All of those people are going to their GP asking for meds, updates, and extra help...

At the same time, a lot of people who held on to their minor problems last year are pitching up at their GP
At the same time, a lot of people who held on to their suspicious of cancer symptoms are pitching up at their GP.

Most of whom require a referral, which is often delayed, due to the hospital backlog. So they come back to the GP again panicking that they can't get their appointment/scan/tests etc.

111 is RAMMED. A+E is RAMMED. So those people pitch up back at the GP.
Meanwhile, the GP surgery, which was built pre-covid, has a waiting room that can only accommodate a dozen bubbles at best.

Which means only a couple of GPs and a nurse can see face to face at any time of the day, otherwise you have to make people wait either in a crowd or outside. So telephone triage is used to make sure only those who need to come down come down.

Potential covid patients can't be put in the same waiting room as non covid patients. Most surgeries only have one waiting room, so a lot of respiratory clinics are done at hubs. This allows the most vulnerable to come into the GP surgery for appointments, nurse checks etc.

So in summary: Demand is massively increased. Face to face facilities are substantially decreased because you can't physically get the same number of patients in the building. Telephone appointments are massively increased.

GPs aren't 'hiding'. They're holding up the shield in front of the elderly, the cancer patient, the kid with no immune system, against the person who is screaming abuse at their receptionists.

To say that GPs haven't been seeing patients during covid is like saying armed forces veterans didn't actually serve in a war just because you didn't see it or they didn't win.

It's not only untrue, it's massively disrespectful not just to the doctors, but also to the nurses, pharmacists, HCAs, receptionists, surgery cleaners, admin even who put their lives at risk serving through the pandemic.

And if you're a hospital specialist spreading these untruths, shame on you! Do you want your most vulnerable patients to sit crammed in a room of forty people? You aren't doing it in your outpatient clinics for the exact same reason.

@andthelaw_won

Absolute bollocks 🙄

My mums gp isn't "holding up a shield" in front of her or anyone else for that matter.

They are refusing to see an elderly, frail woman with multiple co morbidities which means she gets systemically very unwell and ends up in hospital.

Who patch her up, send her home, and the whole fucking thing starts again.

She NEEDS f2f appointments and timely antibiotics/medication not the fuckwittery above ^

Burntoutbarbara I hope you are OK despite the free rein that people are lashing GPs with on this thread.

Itbemay1 very clear explanation, but people don’t like hearing.

I wish GPs were protected. My daughter is just leaving work now. She arrived at 6:45 am to try and get test results reviewed and start ensure patients didn’t miss treatment. This afternoon she had to do text consultations.

This wasn’t because she was refusing face to face appointments. She fitted an extra four people onto her morning list and went without lunch. It was because she’d been allocated half hour to join a child protection conference that took three hours. She was the professional who knew the family best, so needed to be there.

Did anyone say thank you for trying to juggle everyone’s needs? Of course not, they moaned at her and told her she was lazy and needed to see more patients instead of hiding away. After the conference and afternoon list she had to go to a nursing home as they had two new admissions who needed reviewing.

Not exactly an easy day spent hiding away looking at Line of Duty on her laptop.

@canigooutyet spot on and to be fair, I've pushed back about the treatment of Dr Bawa Gerber because of the nature of this thread though IME NMC and RCN seem too eager to throw nurses under a bus for the good of the appearance of the profession, even more eagerly even than than the the GMC treat doctors though I think the GMC's record on the treatment of Black and female doctors is adverse relative to white male doctors. Still let's hope the criminal justice system is free of misogyny and racism and that didn't influence Dr Bawa Gerber's judgment.

Potential covid patients can't be put in the same waiting room as non covid patients.

They can actually! DS was told to take DGD to A & E a few weeks ago, by the GP as antibiotics didn't seem to be working for a throat infection. DS got to A & E, where there was a temporary screening station outside. People, who had any of the Covid symptoms got a red card, everybody else got green. However, they all have to wait in the same waiting room. It was a hot night, the room was so packed people were sitting on the floor or standing up. Ventilation was poor, so people waiting a long time took their masks off.

We have also been told by a HCP in our district, that the assumption is that everybody going to hospital has Covid. If its decided to admit somebody from A & E, the patient is put in a ward with other people, who may have Covid, until a negative test comes back - then they are sent to a non-Covid ward. I would have thought, that maybe after waiting 4 hours in a waiting room with people with Covid; and then hours on a ward with people with Covid, that anybody might have caught it by then, even if they didn't have it when they went?

Certainly, after that trip to A & E, DS was ill for 2 weeks with chills, fevers, headaches, sore throat, fatigue....He said it was the most ill he's ever been apart from the norovirus. DGS, who didn't go, also got it.

Hospital clinics are being protected as well, I saw my Neurology consultant face to face in July last year, ever since then it has been telephone appointments. At my last appointment in March he said my next appointment would be in 3 months, it's now August & still no appointment. My referral got pushed back 3 months because of Covid initially, the longer I am going, there has been no improvement in my condition & I'm not getting the support I need to learn to live with how I am, I need a referral to wheelchair services just to get me on the waiting list which will be 3-6 months. While I am waiting I am housebound, I also need rehousing but until I get a wheelchair I don't know what accommodation is suitable, all of this should have been done last year but due to Covid it never was.

[quote NotPersephone]@LemonRoses the fact that your daughter (or the PP for that matter) is overworked does not negate the basic premise of this thread: that primary care is failing people horribly and telephone appointments make the system completely inaccessible to certain people (like teachers, bus drivers, shop workers) and harder to navigate for others (the elderly and disabled). These facts seem to be completely ignored - including by GP’s posting on the thread.

It’s unsustainable for everyone.[/quote]
I agree access for some is a challenge and with ever increasing demand it’s unsustainable in current iteration.
My point is that GPs are far from protected. If only.

They do not deserve the abuse they get from those with no real understanding and who continue to believe tabloid reports of nurses pay rises, £350 million a week, and 40 new hospitals. It’s most definitely a political decision coupled with Brexit that is at root, not work-shy GPs.

My gp practice has partly worked remotely for years.
We always get a call-back on the same day and are always seen on the same day if needed.

I live in a charming town with great countryside. It’s where GPs want to live.

My mum has a totally dysfunctional GP practice however. It’s so variable.

Lack of F2F GP appointments Christmas 2020 nearly left me with sepsis.

I suffer with tonsillitis on a regularish basis about 3 times a year. I generally never take antibiotics and let it go on its own. I've never had a problem.

Week 1 of tonsillitis was the usual and I was waiting for it to pass.

Week 2 still hadn't gone and was getting visibly worse. Rang GP. Receptionist said no F2F appointment and GP would phone me back. GP phoned back no F2F appointment offered prescribed antibiotics.

Half way through course of antibiotics December 23rd phoned GP to say this wasn't helping and my jaw was aching, my throat was horrific and puss filled, I was pooling saliva in my mouth. No F2F appointment offered, told to continue with antibiotics.

Boxing day woke up in excruciating pain, unable to swallow saliva, Clamy skin, low temp. Phoned 111 - advice given get to a and e immediately. Offered an ambulance but said no it's ok I can get there myself.

Arrived at A and E. Poor triage nurse, asked what the problem was I managed to get out 111 throat, pain, saliva. He rolled his eyes (probably thinking oh great come to a and e with a sore throat - can't blame them, people probably do and I felt a bit of a lemon being there) he said "open your mouth please?" I did, he shon his little torch and physically recoiled and said "my god I've never seen anything that bad" (cheers mate 😳)

I kid you not the next happened within minutes. I was taken by the arm to sit on a little chair in the next room, a HCP came in straight away and took bloods, she then walked me to a bed in a and e and said wait here. A and E Dr then popped his head in just as my ass was touching the trolley and said ENT consultants had been paged and were on their way. They then arrived within 3 minutes and said "don't panic, but you may have septic tonsillitis/septicemia"

You fucking what....don't panic?!?!?!

They looked, came back and made a care plan. They were absolutely shocked the GP had refused to see me when I reported jaw pain and worsening symptoms even on antibiotics.

Luckily the morphine, steroid shots and horse dosages of antibiotics I then had cleared it up and I dodged septicemia by a few hours apparently.

But I have to be honest scared the shit out of me 😳