What to GPs actually DO?

There's an astonishing discrepancy between surgeries around the country it seems. And between the health care professionals. The nurses at mine have carried on as usual in the last two years - always pleasant and cheerful (and there!) And the receptionists as helpful and sympathetic as always - not easy when patients are clearly desperate and sometimes abusive. The doctors? They weren't in at all throughout the pandemic and are only just attending the surgery now. You could, if you could wait for three weeks+ have a phone appointment, but no face to face. Apparently they are more precious than nurses or receptionists (or transport and supermarket workers.)

My son’s surgery is appalling. It would be easier to break into Fort Knox. I had every sympathy with them in the early stages of the pandemic and with the problems that a national shortage of GPS bring, but enough is enough.
Hospital and community staff/carers had no option but to provide face-to-face care.

Our GP practice has provided an excellent, responsive service. It has managed to recruit new GP partners and nurses, which makes a huge difference. We seem to forget that in order to have GP practices we need to train and recruit doctors. We also forget that these practices are, in fact, businesses. The doctors have shares in the business. I can imagine that in some parts of the country it is difficult to keep practices open. Several have closed near us and this is a pretty prosperous part of the UK

We have mixed experiences with our GP practice. I have had the benefit of a phone consultation with a GP. Pros were not having to get to the surgery and sit in a waiting room full of people coughing and sniffing (as in pre covid days). Cons were not knowning when the call would be and therefore having to make sure I was at home as the conversation was about problems with my ladybits - not something to be talking about while going round the supermarket! Personally I've always found the medical staff to be excellent once you can get past the receptionist. The receptionists at the practice are variable, some friendly and efficient, others rude. Yesterday my DH had to go for clip removal from recent surgery and fresh wound dressing. The appt was somewhat grudgingly given I felt, then when we arrived my DH, whose mobility is still very shaky, wanted me as his carer, to accompany him. The receptionist was very terse to the point of rudeness and tried to refuse, but he insisted. The surgery is somewhat like the example in the piece which sparked the article in the Mail: it is still operating exactly as it did at the start of the pandemic - doors locked, a queue outside and no one allowed in unless for a visit to the treatment room. The GP I spoke to for the appt I have mentioned, was working from home, and the building yesterday appeared to only have the treatment room in use, none of the consulting rooms.
My husband's surgery (knee replacement) only happened because of follow up care from the hospital following admission for covid. He had been fobbed off 8 years ago by the GP (a locum) and told they would not refer him for surgery and instead put him on high strength ibuprofen, unmonitored use (which apparently was wrong) and which has led to other health problems. The covid discharge team looked at the x-rays for his knees back from when he was fobbed off and were appalled at the degeneration in his knees even then. It is fair to say that he had been contemplating not continuing to live because of the incessant pain and no quality of life because of his inability to work or pursue his normal activities. The hospital wrote to the GP in no uncertain terms regarding the need for his surgery to be progressed through referral, and now thankfully his first knee has been replaced.
I have looked at the practice's own website, and the NHS website for reviews of this practice, and all bar an isolated review, it is receiving only 1 star reviews, with many reviewers saying they wish they could award a negative star rating. This has been the case from before the pandemic and I doubt anything will change for the better.

Doodle

Tea3 I bet they don’t. ?.
I imagine like most GP surgeries the rules they work to are set out quite clearly by the GPS. If they made up their own the GPS would be in trouble.
What usually happens is the ogre on the reception desk tells the patient the GP has no appointments or can’t fit them in. Patient eventually gets to speak to GP who says of course I will see you. Patient glares at receptionist as they go into the GP ‘S room. GP is nice as pie to patient. GP then rages at the receptionist for not telling the patient they couldn’t be seen.
You have no idea how many times that happens. ?

Our surgery is like Fort Knox but my DD’s less than 2 miles away, has been open for appointments for everyday ailments. They work out of a scrubby portakabin type building and our surgery is purpose built all singing, all dancing but unavailable to patients. Not difficult to work out which ones have a true vocation and which are greedy money grabbers.

It used to happen daily when I worked as a receptionist! Plus the patients who are rude and abusive to the receptionists then sugary sweet to the GPs.

Just imagine! 95% of patients were seen on the day they called! Occasionally evening surgery would run an hour over time but it didn’t allow a back log to build up that started as days, then weeks and now even months.

The first seven years were hectic but rewarding then, when the younger doctors came on board they, often their wives, wanted 9-5 hours with no pesky patients interfering after hours.

The day started at 8am for phone calls and paperwork, surgery from 8.30 til 11ish. Usually 1/2 home visits which the receptionist was blamed for, then they went home til 3.30-3.45 then back for evening surgery. Home again normally by about 6. They did a four day week and had massively generous annual leave and still complained they were hard done by.

What does AC mean, please?

In answer to the OP, nothing.

GPs do absolutely nothing.

They sit in their surgeries from 7.30 am to 9.00 pm (or later) doing nothing.

Of course, they may gleefully have a thought or two about the £350,000+ salary that is accruing in the bank whilst they sit and... do nothing.

Perhaps they may occasionally raise their legs from desks to stroll to the coffee machine to have another cafe latte but generally, they do... nothing.

Not.

Apart from running a 'normal' surgery, GPs have other responsibilities too. Paperwork has increased vastly in the bureaucratic nightmare that the NHS has become. There are clinics and small surgeries, previously undertaken by the local hospital. There are vaccinations, plus operating a hot or vaccination hubs. How about committee meetings to arrange the above? Have you considered all the ongoing (almost 24/7) 7-days a week telephone calls regarding patients from other offices, mental health consultations and on and on?

When will people realise that there is a crisis but this is not of GPs making. This has been coming for years and GP organisations have been warning the Government that there is a real crisis point coming and have been ignored.

GPs are leaving in droves because they cannot sustain the pressure. Their job, as with any doctor is making decisions, day in and day out. Theirs are crucial decisions. Could any of you sustain this pressure day in and out? I couldn't.

Replacement GPs cannot be plucked out of thin air. A current GP has undertaken eleven years of training and now GP training schemes are being developed with a shorter training period and only time will tell if these will be successful.

Of course it is more than frustrating not to be able to obtain the service one expects but please do not blame the GP. Write in the first instance to the Practice Manager and secondly to your MP.

Incidentally, I do understand the frustration of some posters who are not offered a decent GP service. I was once in tears, not being able to get through to my surgery ('you are first in the queue' after twenty-five minutes of holding on followed by a click and a dead 'phone) and can well remember how I felt. Since then I have joined the Patient Participation Group at my surgery and matters have improved immensely.

My surgery will see patients face to face (if deemed necessary - they have the right to decide and I agree with them).

I have posted before that I have an interest in this topic as my daughter is a GP. Her surgery is offering face-to face appointments now and..... only 50% of patients choose to be seen this way. The other 50% are happy with telephone appointments.

So, if you are unhappy with your practice, write to your Practice Manager, write to your MP, join your Patient Participation Group but do something! Moaning is cheap but ultimately pointless. Make your voice heard.

I really think GP's need to get back to seeing there patients properly. It is OK if you are happy to do remote appointments but a lot of older people are uncomfortable with this and they could be suffering without anyone knowing if they can't easily make a doctors appointment.

Candelle - great post.

Ours is For Knox as well
Everything on line only, haven't managed to see an actual Dr for about 4 years.
Had to turn up to A&E 20 miles away for antibiotics for a bite on my hand - it looked like a boxing glove - worth the the 6 hour wait.

Ali08

What does AC mean, please?

Adult Children.

(There’s an Acronyms list, see bottom of this page)

'I think that variation around the country is huge. My GP, apart from the receptionists border guards is fine'
As a recently retired (early due to long covid) GP's receptionist I bristle at comments such as this.
But then I realised it's pretty accurate. They're there to do the doctor's bidding. If they appear to be a brick wall between you and the GP then consider that they are doing exactly what the GP has told them to. Granted, some of them do it better than others but they can't make appointments that aren't available. They can't do a lot of things as their hands are tied.
And they can't answer the phone any quicker than they already do!

Candelle - well said.

The receptionists can only act as border guards when they are told in no uncertain terms, to do so by the GPs. The receptionist I spoke to, after spending a whole morning trying to get through, was polite and apologetic. The Practice Manager was extremely rude and offensive. They’ve taken off their feedback section on their website! Can’t have patients telling the true story!

They treat us like charity cases yet it’s our taxes that pay their wages.

Excellent post, Candelle.

The UK has a population of around 67 million. Around 20% of the population is age 65 or older. Most people that age have one or more chronic (i.e. incurable but treatable) conditions that need regular medical attention to a greater or lesser degree. That’s over over 13 million people needing regular monitoring whether it’s for a blood test or a drug review and repeat. It's all work on top of patients presenting with new concerns.

Also bear in mind that around a million people age 65 or older have still not been vaccinated against Covid. Surgeries continue to call and call and call these and others to persuade them to get their jabs. That’s one or more staff members who might otherwise be answering calls and attending to other admininstratives tasks.

There’s another 54 million people under the age of 65 needing attention to a greater or lesser degree.

67 million people and over a year of diverted resources and having to work around Covid. There’s bound to be a queue.

Our surgery is ‘the pits’ and I too agree this will be the norm.

I had excruciating stomach pain that lasted a month. I asked if the Rapid Access Clinic at the surgery was open and they said Yes, however no one would examine me even though my maternal grandmother and sister had bowel cancer. So I had to go private.

What a total disgrace and to top it all I’m told they have won an award. No doubt it was ‘The total incompetence award 2020’.

Interesting reading.
I can only say our surgery have been pretty good with telephone appointments and getting one to go into the surgery if necessary.
Our dentist has been very good.

Grim reading...

Work more hours than they are contracted to do. Try to guide, advise and help people who are too ignorant to look after themselves. Get criticised and moaned about constantly, oh and try to diagnose and treat or signpost to specialists when they can't.
The majority of people in this country don't know how lucky we are to have the NHS that works its butt off for very little or no thanks

I have been trying to see a doctor now face to face since January. Keep being told, no appointments, try again in two weeks time. Finally got a cancellation this week after refusing to leave the surgery until I had an appointment. What is going so wrong? My surgery used to be brilliant.

I was told recently that at my surgery there was one duty doctor working, two nurses and a paramedic.

Some doctors were either isolating or doing other things.

I recently had a large boil that decided to erupt.
Rang surgery only to be told to consult the pharmacist.

Pharmacist didn’t want to know and suggested I see GP.
Eventually spoke to a paramedic at practice and needed antibiotics. I treated the boil myself with saline solutions and dressings.

I think the Government has to review the GP pay etc. asap, of course that won`t happen

I heard/saw on tv, very recently
what to do if in need of medical advice/assistance

in this order

don`t go to A&E!

call 111, ,

can`t recall if anything in between
but finally
oh yes, your local pharmacy was in between

if really need help
finally, and as a last resort
call your GP

truly, that is what was on tv. BBC!

back in the day it was
GP first and foremost
wicked waste of NHS money imo

The GP who has treated me for the last 20 odd years retired this summer. Two months later he was back doing 2 or 3 days a week because they are so short staffed.

It’s impossible to see a GP at our surgery. Our adult son has been in pain and quite unwell over the last week with a sore throat, coughing and uncomfortable breathing. Negative Covid test. Despite calls to the surgery, NHS 111 several times, he has been diagnosed with viral bronchitis, no medicine to help. How is it possible to diagnose something like this over the phone? It’s been so painful at times he says he has felt like crying. I feel helpless not being able to help him and thoroughly annoyed and disgusted with these procedures in place at surgeries. Husband went through the same when it was thought he’d had a stroke. Told to take a photo!! Luckily he hadn’t. What are Drs doing when they aren’t seeing patients? I myself phoned to see a doctor for a hearing problem and told I need to make a telephone appointment first. I asked the receptionist how was I supposed to be diagnosed from a phone call. The answer was that all patients have to go through triage first and the doctor will then decide whether to see you. I find this totally inappropriate and hope that this isn’t the way forward. Sorry about long message, totally annoyed and disgusted with these procedures and hope the Health Secretary and NHS will order surgeries back to normal soon.

Goodness, Caro57! I would never categorize anyone as being ignorant because they couldn't look after themselves. Fortunately, most people are kinder and know that life can be harder for some, or maybe they were just brought up differently.