Fed up of GP surgery

[Trumpetpants]

Am fuming with GP surgery, very rarely go try to use Pharmacy. Tried to get a wound check appointment today for next week. It took over 2 hours just to get through, kept getting a recorded message stating that they can't place me in a queue as there are over a 100 people already in the queue. Finally got through only to be told sorry no appointments ring another number which is a city wide treatment room and they will see me.
Rang them only to be told that they don't do wound checks! This morning had lengthy surgery to remove cancerous growth and surrounding tissue and surgeon said must have wound checked by GP.
Our NHS is broken, I'm grateful for the surgery and the radiotherapy in hospital but appalled at the complete lack of care and concern by GP

Shouldn't the surgeon be providing the follow up of the operation they performed?

Why isn’t the surgeon providing their own surgical after care? This isn’t the role of the GP practice.

No, had surgery done by Plastics. Continuing care is under another speciality

The GP is unlikely to be the right service for routine post-op care, particularly not after 'lengthy' plastic surgery. The surgeons should really be organising that.

The reason it is like this is because demand is outstripping supply. GPs are leaving in droves because of these very issues - being expected to provide follow up care for other clinicians (your surgeon should be arranging this themselves) and then being slated when they can’t manage it. Not your fault I know OP - you shouldn’t have been told to see your GP for wound care.

It's just a wound check, no dressing or suture removal required.
I'm not Clinical so have no clue as to who should do what. Had a very long wait to see GP for referral and no appointments available for asthma or diabetic checks so shouldn't really have been surprised not to get in for a simple wound check.
Appointments for next week for the Nurse are not even on the system, may be released within the next few days but am extremely unlikely to happen to ring and get through at the point they become available.

I'm a GP. I have not the faintest idea what a wound should look like after lengthy plastic surgery for a cancer, or how what dressings etc to use. Your anger is misdirected at the GP, when actually it's the surgeon who has failed you.

A large part of the reason why it's hard to see a GP is that we are picking up a huge amount of work that should be done in hospital.

Sorry justabigdisco cross posted. Am just fed up with this GP surgery, would have more chance of an audience with the Pope than being physically seen by anyone there. Have had to have invasive treatment as a result of delay in being seen. But the sad thing is I am not on my own, am sure that there are many others.
Being advised to go to A&E for a UTI by GP surgery or to ring 111 after 6.30pm is to my mind passing the book. Rang 111 at 6.35pm and got callback at 4.20am, told to ring own GP after 8am...

Last time I had surgery, the post op would check had to be done in the hospital . A nurse in the relevant department did the check. Most my gp surgery would do was to change the bandage for me a few days after the op when it was starting to fall off.

It's just a wound check

Checking for what? Wounds vary massively. Unless you're a surgeon or a surgical nurse, you don't know what a wound is supposed to look like after a particular operation. It varies hugely, depending on the type of operation, the instrumentation, the closure method, the length of surgery, the underlying health of the patient, the patient's age and race. GPs will be familiar with certain common surgical wounds like a C section, but not some unusual and no doubt highly technical plastic surgery wound.

No doubt you would be running to MN to slag off your GP if s/he tried to wing it and got it wrong. But you're also slagging off the GP for declining to do something that s/he cannot safely do.

No clue, as I'm not Clinical but have a discharge letter stating that Practice Nurse can check wound, not GP. Which is just as well as I would absolutely zero chance of an apt with a GP, 100%chance of being redirected by Carenavigator to A&E or 111 who would undoubtedly bounce me straight back to GP and quite rightly so.
The issue for me is that it it virtually impossible to be seen in person since Covid and since surgery taken over by national company.
There are simply not enough apts available, the session times are significantly fewer too.
Until recently I hadn't needed to see a GP and was bemused by all the comments of how hard it is to get through to surgery let alone get an actual appointment.
I do support someone who is with a different surgery and she only had a 3 week wait to be seen and I was only on hold for just over an hour so not all surgeries are as bad.

Presumably if it is on the discharge letter as a direction for the GP then they should be contacting you with an appointment not the other way around? At least that’s how it happens where I work.

In an ideal world yes, but the receptionist said that they are weeks behind in scanning and tasks which I'm guessing includes discharge letters :(

@Haiyaa

Presumably if it is on the discharge letter as a direction for the GP then they should be contacting you with an appointment not the other way around? At least that’s how it happens where I work.

No, because it's not the GP's job or area of expertise, and putting it in a discharge summary doesn't magically change that.

I think the OP just wants a nice, cathartic slag off of GPs, so the facts don't really matter. Here are some anyway:

Excluding appointments for Covid vaccinations, GP practices in England delivered 26.9 million appointments in June 2021. This was 3.1 million more appointments than in June 2019. More than half (56%) of these appointments in June were face to face.

On top of that, GPs in England also delivered 4.2 million appointments for Covid vaccines in June alone.

The number of patients per practice is 22% higher in 2021 than it was in 2015 but that the GP workforce has not grown. As a result, there are now just 0.46 fully qualified GPs per 1000 patients in England, down from 0.52 in 2015. France has about 3 per 1000 - so over 6 times as many. The average full-time French GP has 900 patients. The average UK GP has 2000.

Nearly 1000 GPs have left the NHS in the last 2 months alone.

The GP suicide rate is 4 times that of the general population.

Hmmm and the % of private work done by GPs is?
And the % of missed diagnosis due to unavailability of apts. It's all part of a wider problem, underfunding of services etc
We had become used to a free NHS service that offered care at point of need, not one that generates income for businesses and thus is driven by something other than need

No, because it's not the GP's job or area of expertise, and putting it in a discharge summary doesn't magically change that.

Ummmm no not quite, the GP or another clinician - such as myself will review the discharge letter. Letter states under heading “action for GP” please arrange for wound check. Clinician sends task for reception to book with relevant clinician in this case a nurse based in the practice will be more than capable and can refer to the wound clinic if needed. A wound check is just that - checking the wound is healing appropriately. They aren’t going to do anything to it other than perhaps redress it. Again something that a practice nurse will be very experienced in.

And OP, I can guarantee that our waiting rooms aren’t stacked with private patients whilst they all laugh at the “silly little NHS patients” waiting for treatment. The truth is that there are delays to services everywhere, staff isolating with covid - you may think this is only important if staff are clinical but everyone has an important job to do and it impacts on the whole service. In addition to this trying to roll out flu jabs and Covid boosters and staff just completely worn down by the constant barrage of abuse going sick with stress. Just because you can’t “see” them working doesn’t mean they aren’t. My appointment lists are rammed as are everyone else’s.

Haiyaa, I'm not saying that you are prioritising private patients over NHS ones. But it is frustrating when there is no surgery session within own practice but one of the GPs is working privately for an Out of Hours service.
That is their choice though and until recently hasn't overly bothered me. It's just the realisation that surgeries being run as businesses do not have at their heart patient care in the same way it used to be. By its nature as a business it is about generating income and if that happens to coincide with patient care fab but if not the system falls down.
I used to have an expectation that if I was ill and it was clinically appropriate I would be seen or given a prescription not redirected to A&E or 111. I get that the system is stretched nearly to breaking point and that there are no easy answers.

So not private work then? But locum work for another NHS service. So long as they are not taking time off from their regular practice then I’m not sure what the issue is? They are entitled to do what they like in their free time same as everyone else.

Yes the GP contract means that they are essentially private contractors delivering NHS services but the patients are still at the heart of what they do and unfortunately (seeing as this is the way the government has chosen to remunerate primary care) then if they are not making money then there is no service to be had. Practices would be closing up and down the country. It’s sad but that is how this country seems to operate; and blame can be laid squarely on the government’s doorstep.

When my DS had surgery for a broken elbow, we were sent off to the GP to have his dressing changed and wound checked so many days after surgery. I think two of the nurses did it and the GP prescribed him some paracetamol on the spot as was so painful.

Honestly I love my local GP surgery, can always get an appointment within a reasonable period and they prioritise sick kids. It's such a shame it's such a postcode lottery. My previous GP had a ring endlessly first thing, finally get through to be told all appointments were gone for next 3 days and to call tomorrow. Rinse and repeat till you recovered or get sick enough to need hospital treatment. I was hospitalised more than once to get IV antibiotics for tonsillitus (sp) that could/should of been dealt with earlier.

@justabigdisco

The reason it is like this is because demand is outstripping supply. GPs are leaving in droves because of these very issues - being expected to provide follow up care for other clinicians (your surgeon should be arranging this themselves) and then being slated when they can’t manage it. Not your fault I know OP - you shouldn’t have been told to see your GP for wound care.

Exactly! OP even admitted she was in a queue of over a hundred people and still she's fuming with the surgery! You're directing your anger at the wrong people, OP.

I wasn't in a queue because they said that there was already a 100 people waiting so I couldn't be placed in queue. I did get through after 2 and a half hours though but no apts available. Don't know why I thought there would be really, but it is what it is and earlier I was tired and emotional. Expect nothing and then anything is a bonus

Nearly 1000 GPs have left the NHS in the last 2 months alone.

The GP suicide rate is 4 times that of the general population.

Do you have a source for these stats?

@Trumpetpants

I wasn't in a queue because they said that there was already a 100 people waiting so I couldn't be placed in queue. I did get through after 2 and a half hours though but no apts available. Don't know why I thought there would be really, but it is what it is and earlier I was tired and emotional. Expect nothing and then anything is a bonus

That's what I mean. Your surgery is extremely in demand. Im sure they don't love the situation either.

YANBU to be fed up at the situation. It's awful and I can't see it getting better any time soon.

@MissLucyEyelesbarrow

I'm a GP. I have not the faintest idea what a wound should look like after lengthy plastic surgery for a cancer, or how what dressings etc to use. Your anger is misdirected at the GP, when actually it's the surgeon who has failed you.

A large part of the reason why it's hard to see a GP is that we are picking up a huge amount of work that should be done in hospital.

Do you not have local health scrutiny panels and CCG/Trust board arrangements that oversee, discuss and make agreements between primary and secondary care?

It's very unfair for patients to be discharged into an unclear service agreement.