GPs and opening times, whats going on

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]

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.

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.

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.

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

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.

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

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?

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.

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.

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.

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?

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.

"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.

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.

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).

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.

But why are doctors leaving? It’s not to do with funding or Practice Managers, I’ve said repeatedly that doctors are leaving. Why will no one deal with that issue? No one thinks there’s enough money going into the health service, but these doctors are already employed. Why are they choosing to leave? And why is it difficult to recruit more doctors? That is the question that I’d like answering, but no one will even try to grapple with that issue. It’s just the old not enough money or it’s the Practice Managers, and neither explain why doctors are leaving.

I don't know if you have classified me as a dissatisfied poster, maddyone, but those are all questions for NHS managers and funders to answer, not patients. I suppose I would say that the answer is to vote for a party who will guarantee to ensure the funding of the NHS to a decent standard, and to vote for a party who will agree to there being sanctions if their guarantees are not met.

As there is no such party, the only solution I can think of is to make it clear on the doorstep and by making one's feelings clear in other ways, (such as marching, letter writing or whatever way is most comfortable for each of us) that this is what we want. We are supposed to live in a democracy after all.

The thread, however, is not about these more complex issues, but about the difficulty in getting a confidential consultation with a GP.

Did you miss my reply to you above about the problem not being with people living in one room or without mobile phone access (although I am sure such situations exist) but with people in workplaces being unable to make private calls, and for people sharing houses with others who may not respect their right to privacy?

I was listening to the radio this morning whilst I was in the car, and a news item came on which stated that the BMA has surveyed thousands of doctors and found that the level of strain suffered by doctors during the Covid crisis could have a lasting impact on workforce numbers in the wake of the pandemic with 47% of doctors telling the ......BMA survey that they are now more likely to work fewer hours in the future.............27% of doctors are likely to take early retirement and another 27% are likely to take a career break. In addition These further reductions to the workforce can sorely be afforded with an existing shortage of more than 8,000 consultants and the number of fully qualified GPs continuing to fall.

Given these findings by the BMA perhaps some of our dissatisfied posters could explain why,
a) so many doctors are so unhappy with their working situation that they wish to leave
b) how we can recruit more doctors quickly to fill the current vacancies and predicted future vacancies
c) how it can be ensured that all patients who would wish to have a face to face consultation on the day of request are given one given the current shortage of GPs
d) why doctors prefer to work abroad and we are losing doctors to other countries

growstuff
Don’t read my posts as you don’t find them to your liking. That will solve your problem.

grandmajet

We are lucky in our country to get our medical care free - national insurance is a very small contribution for what we get. See nanna8’s post from Australia - they have to pay for appointments, as do most other countries in the world, even Sweden! No wonder these countries can afford to pay doctors more - and have the cheek to lure our nhs trained staff away! It’s annoying when people who complain about the American system then go to work there for the higher wages!
Our surgery has done its best throughout the pandemic. It was a new situation for them, as well as for everyone else and they had to adapt quickly. I’ve been treated for advanced cancer throughout the pandemic and don’t feel that my treatment has been affected. I’ve always had a call back the same day from a gp if I’ve asked - which hasn’t been often as I’m seen in hospital mostly. We expect more and more from our nhs, but would be horrified if asked to pay a bit more for it.

Maybe everybody should pay some form of National Insurance, including the retired.

maddyone Until you stop blaming patients for the shortfalls in funding of the GP service, I'm afraid I find it difficult even to read your posts. You really do not seem to accept that there are times when GPs will not see patients even when a condition requires it. I know, because it happened to me. I have complained to the Practice Manager, but she's part of the problem and can't even be bothered to reply. How do you think teachers should take phone calls in front of a whole classroom of pupils?

Apparently everyone lives in a house with only one room! And young people don’t have personal mobile phones! I’m obviously out of touch with these latest developments.

I didn't say that. I said that there were numerous situations where it would be difficult to take a call in private. Leaving a room to take a personal call could easily result in someone being asked who is calling, and if the call is confidential, could be awkward to explain. Also, in workplaces, not everyone has their own office, or is able to take personal calls.

Thank you for the information about the requirement for a GP to be in attendance at vaccination centres. I didn't know that, which is why I asked.

There is really no need to get snippy. My point of view is perfectly valid, whether you share it or not.

I am on immunosuppressive drugs and got a urinary infection, so took a sample into the surgery which was reluctantly accepted. The receptionist took my mobile phone number and put me on a triage list. Later, there was I standing in the post office queue when my phone went and the practice nurse asked me to describe my symptoms. She was so insistent that I had to blurt them out in front of a shop full of people. Embarrassing, but at the age of 77, should I be bothered?