November Lockdown: Mibbes Aye Mibbes Naw

[BlueThursday]

Thread 3!!!!

My DD (1) had a face to face appointment in July for a rash and the DDs and I have all had dental check ups, a few weeks ago. We just asked them to put us on the list so they called when they reopened.

I separate out some amazing individuals from systemic failures with the nhs. The example where your son wax had to be referred again, that's crazy.

My GP practice is excellent, I've never had a bad experience with them (except when they put on the trainee doctors as they know I will accept talking to them!). My dd has seen a wonderful OT (in fact both of them were great) and paediatrician. It's the hospital care that's scary mostly!

@Judystilldreamsofhorses not smug! It’s good to hear positive news.

That's one of the problems isn't it, there's a standard set centrally and then huge variation in interpretation and delivery on the ground.

I had a telephone appointment back in the hardcore lockdown. It did work for me as it was a low level issue- I really liked the 2 minute phone appointment, prescription sent to my local pharmacy for collection. However, GP could only diagnose as I had previously had longer appointment and confirmed condition via tests etc. I can’t see those appointments returning to in-surgery checks e.g. a flare up of a diagnosed condition, or say an obvious UTI type issue.

Need to amend what pharmacies can sell. We previously had to get doctors appointment just for an infected cut from a fall, as no antibiotic cream without prescription. That seems crazy now🤷‍♀️

You can get an antibiotic prescription at the chemist in Turkey. One year DH had an infected toe just before we went on holiday. It was easier just to wait until we got there to get treatment via the local chemist.

I’m quite happy with phone GP appointments but some kind of online booking system would be good, not the Million calls to get one!

I was at an appointment with DS shortly after a bad bout of snow meaning that no one was really able to travel to the surgery, it has about 5 or 6 GPs in the practice.

GP was saying they'd called round everyone due to come in and did telephone consultation where possible and they found that less than a quarter of the people actually needed a f2f gp appointment, most of which were OK to reschedule and they ended up with a handful of people that they had to visit at home by Land rover.

They said they were hoping to alter the way they worked to do more telephone calls where appropriate.

I haven't needed to visit gp in many years so not sure how much this now happens.

The concern is that people will say they don't need an appointment because they don't want to be a nuisance, and things will be missed. The only reason I go to my GP is for the pill so I've not been at all during lockdown and I imagine my next call to the receptionist will just lead to another prescription being written with no contact with a GP at all. Fine. So why was it needed before? Why did the GP take my BP before prescribing the pill, when that apparently is no longer clinically necessary?

My DD had a hospital appointment cancelled as it's not deemed 'clinically necessary'. But why was it clinically necessary when the appointment was made, and it's not now? If it's just that they're prioritising other things, fine, but say that.

I quite like the initial phone triaging, but I guess I've not been in the situation where a physical follow up is required.

For the pill I actually buy that from Lloyds pharmacy for years since the NHS changed from branded to an allegedly identical non branded and I started getting Endometrial pain after being pain free for years. I fill in my details and haven't seen or talked to a doctor about it for over 3 years now.

I hope they keep some of the things that covid has forced on it. I've read about mobile breast screening clinics and that sounds like a marvellous idea.

I also think pre covid a lot of these things like a face to face for regular contraception were genuinely a bit OTT so now they'll need to be rationalised a bit anyway. Ironically by taking a risk free attitude to covid we are essentially forcing a more risk based approach on other medical services - but in some cases this might be sensible anyway

I don't have a problem with proper phone triaging either - there's definitely a place for that. But it seems like a lot of areas aren't even getting that, or not in any decent standard

My DD had a hospital appointment cancelled as it's not deemed 'clinically necessary'. But why was it clinically necessary when the appointment was made, and it's not now? If it's just that they're prioritising other things, fine, but say that.

Ds was discharged from the hospital eye clinic...apparently their concerns in March disappeared over lockdown without seeing him and we should just take him to the optician at some point.

I think telephone triage is dreadful for mental health issues. My psychiatrist appointments will be via the phone for the foreseeable future. That doesn't work for me for a couple of reasons so they are now pointless. That's ignoring the fact that I haven't spoken to him since July because despite me telling him we don't get mobile reception at home (huge stone walls/cliff behind the house), he insists on phoning my mobile.

Dc2 had her hv 27 to 32 month check up the other week. It was an 8 minute phonecall. I expected a video call so she could at least see dd but no. Again what's going to be missed?

I think lots of things are going to be missed. Crucial early diagnosis of illnesses and cancers and also, the opportunity to identify abuse etc.

It's probably crucial to be seeing young children even if there aren't any already flagged issues.

Mental health issues are increasing due to the current situation so just because all has been well before, that doesn't mean all is well now. Not that I'm blaming mental health for child abuse and neglect, but for some it's a factor no matter how much a child is loved.

It's probably crucial to be seeing young children even if there aren't any already flagged issues

I would have thought so too. Plus if I'm being honest, I'm hardly the poster woman for motherhood. I had postpartum psychosis with dc1, I have ptsd plus an interesting childhood myself. I nearly got sectioned in lockdown. They are aware of all this as I first met said hv when dc1 was 10 days old and I thought he was a doll plus she definitely knows about the ptsd because she kindly informed a trainee hv about the trauma behind the diagnosis in front of me once. I'm trying as hard as I can, we're doing playdates, online groups and hopefully next week an in person one and obviously dh is working from home but I found the lack of concern rather terrifying.

Oh absolutely - I've not seen numbers for Scotland but child abuse incidents 20 percent up in England this year.

My lovely mum had pp psychosis and mh issues when we were young (at one point she wouldn't leave the house and my grandparent had to take us to school for several months) and she is a great mum, as I'm sure you are @Dinosauratemydaffodils - she is so supportive and kind and always there to listen to us moan endlessly about lockdown, children not sleeping etc.

I know the GPs love the phone appointments as it takes so much pressure off them and it was fine for me with a minor but irritating issue but actually, so much more can be picked up from a face-to-face appointment than over the phone, body language, memory problems, you can gauge how much pain or movement someone has etc etc.

I also dislike the triage system - I dislike telling the receptionists what is wrong because they usually try and prevent an appointment with things like ' do you know you can see a pharmacist about that?'. Yes I bloody well do because they told me they weren't confident prescribing and I needed to see a GP. Then everytime I asked for a follow-up appointment the comment 'you don't need to see the GP for that' or wanting to know a description of the issue which they would try to summarise (usually wrongly) so i would spend the first 5 minutes correcting the GP if I actually got to see one. I started saying 'please write that it is an ongoing issue and to refer to my notes of date/ dates'. They didn't like that either

To be fair on the triage and telephone appointment system, ds WhatsApped us a few weeks ago at about 8.45 saying he needed help as he wasn't feeling well (my dad, my best friend and her dh and our neighbours are all GPs, so he thinks we can diagnose at a distance ). It took us over 2 hours to persuade him to ring the GP and was told he would be rung back in the afternoon. She rang at 3.30, asked him to get to the surgery by 4.20 (fortunately a friend with a car had just moved into a neighbouring flat). By 5pm he was at Foresterhill and he had his appendix taken out at midnight.

Yikes @prettybird that is my fear during all of this, that people won’t want to bother the GP, especially those who previously didn’t have multiple appointments. BC (before covid) I would hardly visit the GP for me, but it was ironic that the last time I went BC was for a nasty lingering cough, I assumed it was bronchitis...in and out in 5 minutes, discharged with ‘just a nasty virus’ (would you like an inhaler?) just need to rest. 🤷‍♀️ Come back BC appointment days, all is forgiven.

Actually it was exactly the fact that ds is not a regular visitor to the GP (he's in 3rd year and only been once before this) that meant that the GP took him seriously when he said he was in pain over the phone. He had all the classic symptoms We did however end up having to suggest to him that it might be appendicitis and that he might need surgery to get him to ring for an appointment ("I don't want surgery" ).

From Scottish hospitality below. Does the SG even know why numbers are still rising ?

“Tomorrow some places rise to tier 3, and no areas dropping a tier. This is into the 5th week now and numbers are still rising in areas. This begs the question, what is the excuse for closing hospitality, it isnt us that’s the problem @ScotGovFM #SHG #”

It’s very clearly not hospitality.

Much better that people socialise there safely in my view.

I think the main sources of cases are care homes and hospitals, followed by workplaces such as warehouses.

Yes business have spent fortunes in making their places safe.

And yet no end to their lockdown

Stobo castle has closed down

Absolutely agree @WouldBeGood. I think there are a lot of pious people on Twitter etc and it became a bit of a witch hunt. They seem to need to blame someone. First the footballers, then the students, now the pubs. The new government advert really got my goat, saying it was all of us to blame for closing businesses for twisting the rules.

Yep. It’s like when AIDS started .. big blame culture. Really unpleasant and destroying lives and livelihoods.