41 gp surgeries

I know the GPs at our surgery are all part-time, just checked to see how many there are.

The one thing that struck me is that every single member of staff in the practice is female.

My mother's uncle was a GP in the 'good old days' then his son joined him in the practice years later.

The surgery and waiting room was part of their house, there was a receptionist but his wife (unpaid) answered the phone at other times and he got called out at any time.

maddyone

Another thread to complain about GPs.
When you’ve done the job yourself, then complain!

maddyone it’s far better to lodge a formal complaint via the Practice Manager when misdiagnosis and mistreatment has occurred. Then there’s a chance that other patients will not suffer in the same way and that gps will learn from their mistakes.
I don’t think though that it’s right to claim financial compensation for shortcomings unless severe consequences are involved.

But that is not what your OP was about!

It’s an evolving learning experience on Gnet maddyone ….. at least am clearer now as to possible way ahead.

petra

Lucky you. 41 Drs for 33,000 patients. We have 10 ( all part time) serving 23,000 patients.
We can usually get an appointment for same day ( or next day)

With respect you didn’t mention your health issues in the OP.
Your gripe was the number of Drs/ working part time.

ronib, its clear from this and other posts that you are dissatisfied with GP practices generally and that you have a formal complaint about misdiagnosis.

SueDonim and maddyone are two regular posters who have first hand experience of the pressures A and E and GP doctors experience every day. If so many doctors are leaving, going part time (how very dare they) or during training, many deciding against General Practice, surely that suggests the problem is with work expectations not individuals.

I also haven’t had the best experience this last year myself with the NHS. I actually made a thread about my experiences but I haven’t at any time criticised the NHS staff. However I did comment on the thread about the pathways devised by management to prevent patients reaching either a diagnosis, or treatment, in my case it was both. The doctors I have seen have been exemplary in their care, indeed the physiotherapists have been responsible too. None of it was their fault, it was the fault of the decision makers, those in management who want to keep people off waiting lists. I am finally to get my first treatment next week, following more than a year of trying to get a diagnosis. It’s a long story and it’s under the Health forum if you fancy a read. The point is, we are all frustrated by the situation in the health service, but it is not usually the doctors who are at fault. The people responsible are managers and behind them, the government, who are simply not willing to put enough money into the NHS in order for it to function as it should.

I was seen at my local GP practice by a paramedic who misdiagnosed my problem. I asked to see a GP to review the diagnosis and was re-directed to the same paramedic. When the case was eventually reviewed by a GP he changed the diagnosis which was later confirmed by a consultant.

The paramedic was polite and considerate but was clearly at the limit of competence. The practice was clearly under pressure. I think the direction of travel needs looking at and that includes finding and training places.

funding not finding

None of it was their fault, it was the fault of the decision makers, those in management who want to keep people off waiting lists
Oh yes! They keep finding new ways of massaging the figures to make waiting lists seem shorter than they actually are.
I've just experienced a new wheeze!

Okay my gripe is how do I cope with past misdiagnosis and mistreatment plus recovery from major surgery in a gp practice with so many unknown new faces?
In my case, there’s no point blaming a NHS manager for poor clinical outcomes.
Also even the doctor handling my complaint was trying to make sense of how my ovarian cyst had grown to 20 cms/8 inches without being picked up. Probably over 25 years or so.
I am very lucky so far and am probably coming out from the trauma of it all. I think to calm down, stay put for the time being and possibly change practices and/or pay for a second opinion if it’s needed.
Hopefully no more medical interventions for quite some time ….

I’m sorry you have had difficulties with getting a diagnosis ronib and from my own experience it is frustrating to say the least. I imagine you have been in pain. I also have daily pain, take painkillers all day and every day, and have tried to get on with living my life whilst trying to manage the pain.
I realise it must be difficult to see a different doctor every time. I’m in the lucky position of being able to see or speak to my own GP usually, unless she is not there, as our surgery tries to maintain the doctor/patient relationship wherever possible. I know many surgeries don’t or can’t do that.

It does sound rather like the system in other countries is being introduced here, ronib and I agree that it could be impersonal. Someone I now went to work in New Zealand years ago as a GP but didn't like the system there as she did not have her own list of patients. I realise even in a small practice the GP may not have seen you previously but there could be more liaison.
I'm sorry your problem has been overlooked.

I’m sorry you’ve had such problems, Ronib and hope you’re on the road to recovery.

If your concern now is about ongoing care, I think you need to ask yourself exactly what it is you are expecting from your surgery. Do you have dressings that need care, ongoing medications or just someone to talk to? Those are just a few thoughts, I’m sure you have other expectations.

Medical practise today is very much about what the patient indicates they are concerned about/want, not what the doctor sees fit to provide so I hope you feel able to voice what you require to the surgery.

I think it depends how efficient communications and pathways within the GP practice are.

I have annual (sometimes six monthly) diabetic checks, which also check my heart and general health. Sometimes those checks trigger appointments with all sorts of other people, such as the practice pharmacist, GP, podiatrist, nurse for ECG and/or brachial blood pressure test. I've also been referred to the practice physio because I have ongoing problems with my spine/hip, which affects how much I can walk and, therefore, my blood sugar. I could see a counsellor and/or dietician if I wanted (I don't). I feel that everybody knows their role and it's quite efficient. My notes seem to be accurate, so I don't wast time explaining what's wrong each time.

Moreover, my patient record is available online, so I feel more in control of my own health.

It wasn't always like this.

I read a report recently that acknowledged that patients who regularly saw the same GP for continuity of care had much better clinical outcomes and quality of life. They felt safer and more reassured. Sadly those days are long gone. I think there was a drive a while back to give all elderly patients (I was taking of my stepfather) a designated doctor at the surgery. A good idea I thought but this never happened.

It’s one of those obvious truths isn’t it. We bumped into our retired GP out walking. He referred to that research, laughing “well who knew continuity of care especially as we age could be beneficial “ 😳🙈

I'm absolutely sure it's true, but it's not going to happen. Nobody can force GPs to stay in the same practice and the government itself is encouraging the salaried doctor rather than partner model, which means that GPs have more flexibility to move around.

As it's not going to happen, I think the next best thing is to make sure that available scarce resources (ie staff) are used efficiently.

maddyone

I also haven’t had the best experience this last year myself with the NHS. I actually made a thread about my experiences but I haven’t at any time criticised the NHS staff. However I did comment on the thread about the pathways devised by management to prevent patients reaching either a diagnosis, or treatment, in my case it was both. The doctors I have seen have been exemplary in their care, indeed the physiotherapists have been responsible too. None of it was their fault, it was the fault of the decision makers, those in management who want to keep people off waiting lists. I am finally to get my first treatment next week, following more than a year of trying to get a diagnosis. It’s a long story and it’s under the Health forum if you fancy a read. The point is, we are all frustrated by the situation in the health service, but it is not usually the doctors who are at fault. The people responsible are managers and behind them, the government, who are simply not willing to put enough money into the NHS in order for it to function as it should.

Just to clarify maddyone, no clinical pathways are ever devised ‘by management’. They have always been, and remain the responsibility of clinicians themselves. The development of NICE and other guidelines is done by clinicians who are nominated by their peers, not by faceless bureaucrats.

Casdon

maddyone

I also haven’t had the best experience this last year myself with the NHS. I actually made a thread about my experiences but I haven’t at any time criticised the NHS staff. However I did comment on the thread about the pathways devised by management to prevent patients reaching either a diagnosis, or treatment, in my case it was both. The doctors I have seen have been exemplary in their care, indeed the physiotherapists have been responsible too. None of it was their fault, it was the fault of the decision makers, those in management who want to keep people off waiting lists. I am finally to get my first treatment next week, following more than a year of trying to get a diagnosis. It’s a long story and it’s under the Health forum if you fancy a read. The point is, we are all frustrated by the situation in the health service, but it is not usually the doctors who are at fault. The people responsible are managers and behind them, the government, who are simply not willing to put enough money into the NHS in order for it to function as it should.

Just to clarify maddyone, no clinical pathways are ever devised ‘by management’. They have always been, and remain the responsibility of clinicians themselves. The development of NICE and other guidelines is done by clinicians who are nominated by their peers, not by faceless bureaucrats.

Perhaps maddyone meant administrative pathways.
I think many of us have been the victim of errors and omissions.

Maybe, the management of the waiting lists and appointments is an administrative function, but administrators don’t have any involvement in deciding clinical pathways, quite rightly.

ronib

TinSoldier and as one young gp once said - I don’t stop learning. The idea that ten years of training makes for a fully competent professional is debatable given the changes in medical research and practice.

In my town (where they cannot recruit GP's) I know of 2 misdiagnosed patients by the same GP practice where you are lucky to get an appointment within weeks, or you can get an appointment with the nurse prescriber or paramedic. One patient had a cough for 18 months (despite the surgery putting out adverts saying 'if you have a cough for more than 6 weeks see your GP) but you can't! She was given loads of anti-biotics, an inhaler to no avail - eventually because she pestered they let her have see the GP and have ,an x-ray, by which time it was too late. She died in December as the cancer had spread from her lungs to her brain and spine. The other did see a GP who fobbed him off as did the nurse several times before things got so bad he attended A&E where he was scanned. He died in October of a brain tumour.

The introduction of these nurses, pharmacists and paramedics are because they are CHEAPER but they don't have as much experience. Because of that there will be a lot of things that are missed. They are trialling it in London - you will be seen, but at a surgery with just one GP 'just in case something dodgy crops up', but I suspect that these cheaper members of staff will be reluctant to escalate things anyway, as it doesn't look good on them?

Another thread maybe if the result of failings in the NHS led to admissions of failure and the death of a loved one due to gross errors /negligence/failure to follow protocols and procedures/unqualified staff etc .
Thank goodness people like the parents of young Martha fight for changes such as Martha's Law to try to make a difference to other people where it's clear that improvements - urgent improvements - are needed. Martha's Law will enable families to escalate their concerns if they feel something isn't quite right in the treatment being given - and to access an urgent second opinion/another clinical team. It can make all the difference. Everyone makes mistakes - but there are way too many.