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GPs and opening times, whats going on

(193 Posts)
earnshaw Fri 09-Apr-21 16:16:21

we have been with our local GPs for many years, quite a small practise ,they have , most of the time, been excellent but since the pandemic started, like other practises i suppose, have changed, not for the better, trying to get in is like trying to get into fort knox, we have to ring first, then, if we are lucky, we get a phone appointment sometime, maybe next week, then the doctor, whoever he might be, will decide whether he needs to see you or not ,if he does then you have to make an appointment for whenever, this is not new , with our practise there has always been phone appointments if the problem is treatable without seeing the patient but surely, at this stage , we should be able to see our GP at their surgery , it worries me that this will be the future, not happy

maddyone Mon 03-May-21 19:35:40

And it is for people/posters to consider why it’s difficult to get a face to face, or even a phone consultation the same day. Of course it’s for people to consider, rather than complaining that they can’t get an appointment. In actual fact, far more consultations took place in March if this year, than ever before in a single month. This is a fact, not an opinion, and it’s been pointed out by myself and another poster. It was ignored because people don’t want to know that, especially since so many doctors are leaving and there are currently over 8000 vaccines for doctors not filled right now. The least doctors should be able to expect is some consideration and understanding from their patients and the realisation that if there are 8000 missing doctors, that inevitably there will be fewer appointments available. We need to consider why 8000 posts have not been filled. But people would rather complain and blame others than think about why.

growstuff Mon 03-May-21 21:50:23

And there we have it, folks! Don't forget to bow and doff your cap if your GP condescends to give you an appointment (within weeks not on the same day).

Doodledog Tue 04-May-21 00:48:08

Ok then. A solution would be to say that trainee doctors sign a contract to say that they will work exclusively in the NHS for a period of, say, ten years, after graduating, and if they leave either the NHS or take their expertise elsewhere, they pay back all of the subsidy (estimated at £200,000 on top of the money paid by the students themselves) that they have had to pay for their education.

Figures from 2016, so they will have increased

This system works when people have their education subsidised by the armed forces, for instance, and it could be extended to medics, as, I believe, was suggested by Jeremy Hunt at some point.

It is rarely that I am to be found quoting Conservative policy with any sort of approval, but it does seem to me unreasonable that the taxpayer should pay so much towards educating each doctor in the system, only to have them not only, as you point out, leave in their droves to take that expertise elsewhere, but also to spend a chunk of their time whist they are here seeing private patients in NHS hospitals, and in lecturing the next generation of medics at grossly inflated Clinical Lecturer rates, both of which are 'nice little earners'.

If doctors still insist upon leaving before they have repaid their subsidies, at least there would be some money in the kitty to train more, or to invest in other areas of the NHS.

I am not a complainer, incidentally. I can see how telephone consultations can sometimes be useful, and have sometimes found them more convenient than face to face appointments. At other times, however (eg speaking to hospital consultants about concerns that can not be properly assessed over the phone) I find the system unsatisfactory, so do not think it should be a one size fits all approach.

I can also well imagine that the default telephone appointment will result in many people not being able to seek advice or medical help, however, if they are unable to be guaranteed a confidential consultation, or to take a call at a specified time so that they can make arrangements to be somewhere on their own - a point which you seem unable to acknowledge, much less answer. A pregnant schoolgirl, a young mother with gynaecological problems and children under her feet, someone in a busy office, a schoolteacher, a bus driver, a woman with a controlling husband or father who wants to discuss a personal matter - all of these people and more might find it impossible to speak privately to a GP outside of a surgery.

And you are not the only person on here to know people in the medical profession, you know? I'm sure that many other posters do too, and that not all medics feel the same the ones you quote. I know doctors who bemoan the passing of the old 'family doctor' system, and say that they would much prefer to see their patients and get to know them, rather then read emails or online forms from 'service users' and then pass them to nurses or other medical specialists. In fact, I know people who say that it is this - the erosion of job satisfaction - that is making people want to leave the profession that they used to love.

As in any profession, I am sure that there will be any number of different points of view amongst practitioners, but please don't assume that just because you have pointed something out that we should all take it as gospel.

foxie48 Tue 04-May-21 09:59:34

"A solution would be to say that trainee doctors sign a contract to say that they will work exclusively in the NHS for a period of, say, ten years, after graduating, and if they leave either the NHS or take their expertise elsewhere, they pay back all of the subsidy (estimated at £200,000 on top of the money paid by the students themselves) that they have had to pay for their education."

Doodledog, Actually most doctors spend 10 years (if not longer) in training after qualifying. During that time they are chasing suitable training posts and studying and taking exams in their own time. Junior doctors work very hard and take on a lot of responsibility very early in their careers. It's actually a very stressful job and the training system is not family friendly as after the first two years of foundation training, they have to apply for training places which may mean they move from one end of the country to the other and then to continue their training they have to move again and then to move on they have to move again. I think the way to retain doctors is not to start treating them like the valuable assets that most of them are rather than putting punitive restrictions in place.

Doodledog Tue 04-May-21 10:11:25

I never said that I was an expert, on NHS financing or the psychology of doctors in training ?. I agree that medical staff are assets, but arguably that is more of a reason for the country to try to hang onto them? They are very expensive to train, and are aware of the training system (which I agree is punishing) when they sign up, but there are always far more applicants for medical training than there are places. Maybe asking for a commitment to the NHS would be a way of deciding which applicants to accept?

It's just a suggestion, really, as Marydoll has repeatedly asked anyone who feels that telephone appointments are not ideal to explain why doctors are leaving the NHS and asked what can be done about it. As she points out, there is not enough money in the system, with the thinly veiled implication that we are being grasping for expecting a decent service, as our NI contributions are not enough. My response was an attempt to come up with a solution as demanded.

Rosie51 Tue 04-May-21 10:42:30

Summerlove As far as not being triaged by the receptionist, I’ve said it before and I will say it again, no one’s health issues are so complex that the receptionist hasn’t heard it before. Their job is to figure out who needs appointments most desperately. If you can’t trust the receptionist, then you can’t trust the doctor in my opinion.

Really, you honestly believe that a receptionist is able to diagnose complex health issues with total accuracy? In hospital A&E triage was always done (in my experience) by a qualified nurse, have they too taken to asking the receptionist to take on this role? And why does my desire to disclose what might be an intimate problem only with a qualified medical practitioner not matter?

Gwyneth Tue 04-May-21 10:58:09

According to the Telegraph in 2019 I can’t find any more up to date figures 46% of GPS are contracted to work part-time including 61% of female GPS. This is not a criticism but clearly if just under 50% are working part time this can only be adding to the problem. Also it is very difficult if you are not at home to speak confidentially to a doctor. Teachers in particular have difficulty as they cannot leave the classroom. In the past I have had to speak to a doctor with one foot in the classroom whilst a year 11 class has been listening attentively to what I was saying but I had no choice. So whilst telephone appointments are fine for some people for others they simply do not work. One size does not fit all and I think that this is what many posters have been trying to say but have been ‘shot down in flames’ for daring to criticise the system.

foxie48 Tue 04-May-21 12:04:29

Gwyneth I wouldn't be surprised if the percentage was higher now. It seems that a lot of women doctors swap to being a GP as it's actually more family friendly than being a hospital doctor and then the switch to PT fits in better with children. This is anecdotal I can't provide evidence for this! You can train to be a GP in 3 years and doctors who have done specialism training in other areas but not progressed up the greasy pole to consultant level will bring a great deal to a practice. As I said in a previous post you can't force doctors to work in certain areas it's better to try to find ways of making the work more attractive and tbh on the basis of what I've been told, not many newly qualified doctors aspire to be GPs.

Summerlove Wed 05-May-21 14:46:54

Rosie51

Summerlove As far as not being triaged by the receptionist, I’ve said it before and I will say it again, no one’s health issues are so complex that the receptionist hasn’t heard it before. Their job is to figure out who needs appointments most desperately. If you can’t trust the receptionist, then you can’t trust the doctor in my opinion.

Really, you honestly believe that a receptionist is able to diagnose complex health issues with total accuracy? In hospital A&E triage was always done (in my experience) by a qualified nurse, have they too taken to asking the receptionist to take on this role? And why does my desire to disclose what might be an intimate problem only with a qualified medical practitioner not matter?

Why tell them?

Because if two people say they have a problem they don’t want to discuss, one could be a scratch on the arm and the other could be something serious. And the receptionist isn’t to know. If she knows that something is serious versus a scratch on the arm she can get that patient in sooner instead of randomly doing it the opposite way around.

People who work at doctors offices aren’t idiots. The majority of people who say they don’t want to tell the receptionist what their issue is say it’s because of privacy reasons. they are afraid the receptionist is going to blab to everybody.

You are certainly in your rights, but you have to understand that that makes everyone’s jobs harder.

Rosie51 Wed 05-May-21 14:58:20

Summerlove

Rosie51

Summerlove As far as not being triaged by the receptionist, I’ve said it before and I will say it again, no one’s health issues are so complex that the receptionist hasn’t heard it before. Their job is to figure out who needs appointments most desperately. If you can’t trust the receptionist, then you can’t trust the doctor in my opinion.

Really, you honestly believe that a receptionist is able to diagnose complex health issues with total accuracy? In hospital A&E triage was always done (in my experience) by a qualified nurse, have they too taken to asking the receptionist to take on this role? And why does my desire to disclose what might be an intimate problem only with a qualified medical practitioner not matter?

Why tell them?

Because if two people say they have a problem they don’t want to discuss, one could be a scratch on the arm and the other could be something serious. And the receptionist isn’t to know. If she knows that something is serious versus a scratch on the arm she can get that patient in sooner instead of randomly doing it the opposite way around.

People who work at doctors offices aren’t idiots. The majority of people who say they don’t want to tell the receptionist what their issue is say it’s because of privacy reasons. they are afraid the receptionist is going to blab to everybody.

You are certainly in your rights, but you have to understand that that makes everyone’s jobs harder.

You stand by your assertion that the receptionist is able to diagnose complex health problems? I'm not convinced.

I doubt very much that anybody with a scratch on their arm is going to be going to the doctor in the first place (unless it was very infected, swollen, weeping pus), and secondly would object to telling the receptionist about the problem. On the other hand someone with a foul smelling discharge from their vagina might not want to tell an unqualified receptionist the details. Maybe if a patient just says it's an intimate problem they could be transferred to a practice nurse, who would be qualified to triage their need?

Doodledog Wed 05-May-21 16:57:04

I still maintain that patients are entitled to a confidential consultation with a qualified doctor, and believe that without this being sacrosanct there will be a lot of people with problems that go undiagnosed, potentially until it is too late for them to be treated.

Health issues cover such a wide range of areas that nobody can know why someone else wants to keep something private.

With some issues it can take someone a long time to pluck up the courage to approach a doctor in the first place, and if they are then told that they have to discuss it with the receptionist who will arrange a callback at an unspecified time if she thinks the problem warrants it could be the final straw - particularly if the patient knows that the call could come when they are at work or surrounded by family.

It's not unreasonable to be concerned about receptionists gossiping, either, even if they would never dream of discussing confidential information. Anyone who lives in a village or small town knows that keeping your business to yourself can be a challenge at the best of times. There is no central receptionist register, so a gossiping receptionist might eventually get sacked, but would be able to find a new job much more easily than a doctor or nurse who did the same.

Summerlove Wed 05-May-21 21:00:01

You stand by your assertion that the receptionist is able to diagnose complex health problems? I'm not convinced.

I stand by knowing that a receptionist will know how to triage (for example) a cut vs something needing stitches. However, if you refuse to tell them, they won’t know. The the cut could be booked in sooner than the deep laceration.

I know when I’ve called for something that seemed minor, But with more information my appt time would go from two weeks, to the next day.

They need the proper information to help you.

If you choose not to give it to them, it’s hard to blame the practice for not prioritizing you.

Summerlove Wed 05-May-21 21:06:59

It's not unreasonable to be concerned about receptionists gossiping, either, even if they would never dream of discussing confidential information.

They are bound by confidentiality. So, I do think it’s unreasonable. If you don’t trust the staff to follow confidentiality, I can’t understand how you would trust the dr.

www.bbc.com/news/av/health-37616633

Doodledog Wed 05-May-21 21:19:36

Summerlove

*It's not unreasonable to be concerned about receptionists gossiping, either, even if they would never dream of discussing confidential information.*

They are bound by confidentiality. So, I do think it’s unreasonable. If you don’t trust the staff to follow confidentiality, I can’t understand how you would trust the dr.

www.bbc.com/news/av/health-37616633

I explained my reasoning in my post above. I said, with the caveat that most receptionists would not dream of discussing confidential information, to be concerned about it is not unreasonable because doctors are subject to the rules of their professional body, and being struck off that register would be professional suicide, in a way that would not be true of a receptionist losing their job.

growstuff Wed 05-May-21 23:58:06

Summerlove

*You stand by your assertion that the receptionist is able to diagnose complex health problems? I'm not convinced.*

I stand by knowing that a receptionist will know how to triage (for example) a cut vs something needing stitches. However, if you refuse to tell them, they won’t know. The the cut could be booked in sooner than the deep laceration.

I know when I’ve called for something that seemed minor, But with more information my appt time would go from two weeks, to the next day.

They need the proper information to help you.

If you choose not to give it to them, it’s hard to blame the practice for not prioritizing you.

So how come it took me four weeks to see a doctor for an infection which urgently needed antibiotics? As a diabetic, infections often take a long time to clear and I told the receptionist that. The GP was furious when I told him how long I'd waited. Even then, I had to have a swab taken to confirm which antibiotic would work best. The GP told me that I should ring 111 if that ever happens again because it most certainly was urgent. The infection had spread and I'm still taking antibiotics 8 months later. If treatment had started earlier, it would have gone by now.

growstuff Thu 06-May-21 00:00:20

PS. Serious infections like the one I had can bring on heart attacks. As I've already had one heart attack, the chances of my having another one are higher anyway.

Magrithea Wed 12-May-21 09:47:24

Our surgery is the same but I have got a face to face appointment - finally having waited for 2 weeks for a phone appointment and another week (from yesterday) for the face to face. good job it's probably not something urgent!

My 96 year old Mum has shingles and managed to get a course of antivirals but still feels unwell. she called her surgery and was told they weren't seeing anyone but doctor would call tomorrow (today). I hope she's just got the wrong end of the stick and that she will get a face to face. [fingers crossed]