The Surgery's Gone Down the Plughole

In yesterday's Observer.

www.theguardian.com/society/2015/mar/21/ow-lucrative--deals-go-to-firms-that-use-tax-havens

https://clivepeedellnha.wordpress.com/2015/03/20/press-release-cancer-specialist-challenges-david-cameron-to-a-debate-on-the-nhs-in-witney/

Sorry, Pittcity, I realised you mentioned that further up the thread.
Our local surgery has just moved into new premises, leased to them by Virgincare. When it was built, they wanted the pharmacy to move in as well, but it meant it would be further away from the village centre. Fortunately the pharmacy declined. Okay for those who wanted to drive, there but not those who walked.

This is the latest wheeze.

nhap.org/using-pharmacists-to-ease-gp-pressure-is-a-sticking-plaster-to-help-a-stem-haemorrhage/

Have been warning about this for years.

www.pulsetoday.co.uk/home/finance-and-practice-life-news/gp-practices-in-one-borough-to-lose-20m-over-seven-years/20009497.article#.VQvaOOFRI80

This is one of the reasons the NHA was set up, to protect our GP surgeries, as well as our hospitals.

The reason it's easier to get an appointment with a nurse rather than a GP, Deedaa, is because nurse practitioners are being given more responsibility, as it's cheaper.

For the first time since we moved here (16 years ago) our surgery has a notice up warning that it might be difficult to get an appointment because they are short of doctors. Oddly, at the moment, it is easier to get an appointment with the nurse than it has been for ages. You used to need a real emergency to see one of them.

You aren't living somewhere beginning with a 'T', are you? Only I am in East Angular too, and there is a clinic/practice further out of town, and the main surgery in in the centre. The Drs from my surgery man the clinic aka Healthy Living Centre on a rotation, it's actually used as the emergency visits place plus minor surgeries and nurse things like blood tests. Half of the Drs live in my village which is the only way I get to find out how the system works. None of them are what I would call exactly computer literate - I doubt they get the time to be. I suspect they rarely update their details.

Not Leomin't'ster. Leominster.

I watched that program too. I think it was Leomintster, I remember thinking it was possibly a place on the English/Welsh border????

It certainly looked a lovely area and I wondered why anybody wouldn't want to work in a practice there.

As the program progressed you heard from a doctor who had left the NHS to work in Australia. The program was trying to show how the NHS was nose diving but the point they missed was the doctor they were interviewing left England in 2008!!!. Whoops.

Then they showed a woman who had to catch a bus to the 'bigger' surgery as their village surgery had closed due to the lack of hiring a new doctor . She had to catch the bus to drop off a repeat prescription. A week later she had to make a return bus journey to pick the prescription up! At that point I thought I'm not surprised they are struggling to sign up a new doctor the whole system they were working with is antiquated. I could see the scenario the doctors they had either left through retirement because the package is so good or they were frustrated with trying to get the surgery into the 21st century.

If I need a repeat prescription or an appointment I can either order/make it via my personal surgery computer number or I ring the surgery and I am told when it will be ready! I live in a small village and it is a satellite for the larger surgery. It has it's own dispensary and is not the only one in the area.

I honestly am shocked how poorly some areas are run and I can't understand how the NHS, past and present governments cannot decide what works and what doesn't and attain good practice for everybody.

Well that's interesting. I don't know whether the NHS Choices website is out of date, but according to them, all the GPs I thought had left the practice haven't actually left at all, they're working at the other branch of the same practice in a village 5 miles down the road.

There are a total of 9 GPs, out of which four are timesharing between the two practices, 5 are working full time in the village and none are working full time here. If that's the case it makes you wonder why the NHS haven't told the practice manager to deploy her staff where they're needed.

Counting the timeshare GPs as a half, that makes seven GPs for a village of 3800, and for all practices, a total of 22 GPs for a town of 53000.

There's a fifth surgery listed on an estate on the far side of town which according to NHS Choices has "GPs at this practice: 0 male and 0 female GP". The link to their website brings up a page of adverts for everything from guitars to CCTV, but no mention of the surgery other than in the title.

jr I'm in East Anglia, it not exactly the Lake District, but it's not an inner city sink estate either. vq I don't know what they'll do, but there was a practice (Manchester maybe?) on TV recently which was closed because they couldn't recruit the staff.

Not sure this will make it any better, but it is happening all over. We have exactly the same here in rural Switzerland- we have 2 GPs that committed suicide a few years ago in our valley (1 depression, 1 due to motor neurone disease) who were never replaced - and now we have 5 baby boomers coming up to retirement next year- with no replacement in sight- despite the Council offering incentives, accommodation, money for setting up with modern services and equipment!

That's terrible. How do they expect the remaining surgeries to deal with the sudden influx of new patients? If they're already struggling it will just make things worse. Will you have a choice or will they simply allocate you to a surgery?

Our surgery is just about getting back to something resembling normal, after nearly a year of doctor shortages. We had 5 doctors in the practice, and 2 decided to retire at the same time, and it was several months before new GPs were appointed, nobody seemed to want to come here. It was impossible to get an appointment, we had to ring in the morning, first thing, and hope against hope that they could fit you in that day.

Whereabouts are you, crun? That's horrific. I've lived here for almost eight years now and not yet managed to see my own doctor once - apart from as a friend! He is booked up by his old regulars weeks in advance. I always see a locum. I don't actually mind, but it does seem strange.

Two of the females in the practice are also friends and they have both left recently due to the stressful lifestyle, such long hours and no breaks, holidays cancelled due to staff shortages at the last moment. I read somewhere that Drs now only want to do private work, they can have shorter hours. They are also scared stiff of being sued. They try to save people, but aren't gods.

This new initiative to make more use of pharmacists should help ease the pressure.
I worked in a pharmacy for several years and was surprised as to what a pharmacist is qualified to do.
I should think that if the NHS funding was available that a pharmacist could do your INR crun. I visit mine for general checks like blood sugar, pressure etc.
They certainly are the best person to help with medication questions.
Apparently there is an excess of pharmacists. All that is needed is a joined up system of patient records and you would not need a GP for repeat prescriptions, medication reviews, simple tests and diagnosis etc.

Oh dear I worked in a town like this which had difficulty attracting GPs because of the high cost of housing and lack of good schools. It meant lots of locum cover unfortunately. You are right the good GPs can pick an choose because we simply don't have enough of them and we aren't training enough.
I still think that the traditional general practice could do with having a range of practitioners as well as nurses and pharmacists as per recent news reports for example a full time counsellor as so many consultations are about mental health and emotional issues, physiotherapists, nutritionists would also be of enormous value but sadly GPs themselves wont make these people partners so its not attractive to them and GPs do not make the best of employers if you listen to practice nurses.