WAITING Times for GP andNurse Appointments

Gwyneth as I and others have repeatedly pointed out on this and other threads, there is a massive shortage of GPs in this country. This in itself causes long waits for appointments, and huge stress for both GPs and their staff. Many staff who work in GP surgeries have to self isolate as they’ve been in contact with Covid or they catch Covid like my son in law did (he then infected our daughter) and so they have to be at home. I know of one GP who was hospitalised with Covid. You’re right in saying that more GPs need to be trained, but given the bad press, including multiple threads on Gransnet about this, it’s not surprising that the 5000 new GPs we were promised some time ago have failed to materialise. What do people not understand about not enough GPs?

As far as I can tell, The Telegraph, The Daily Mail, and many Gransnetters (which we can take to be representative of the general public) are constantly complaining and moaning about GPs. I’ll say it again.

There are not enough GPs.That’s why it’s difficult to see one of the ones we have got.

VioletSky Thank you ..I did and GP referred me to A&E because of new symptoms ..always feel grateful for GP support ..

Yes I think everyone agrees that there is a shortage of GPS maddy but what is your solution to the fact that so many work part time? Surely this is causing more work and stress for colleagues who are full time as well as there not being enough GPS to deal with patients. To reiterate my point again no matter how many GPS are recruited and if they all opt for part time work there will never be enough to meet the needs of patients. So again what solution would you suggest. I am genuinely interested.

Gwyneth : I have looked on my surgery website at the staffing facility, we have six GPs that work part-time four of them work
Monday, Wednesday and Friday and the other two work Tuesday and Friday. We have two other GPs that do alternate
sessions when needed. There is a G.P. that does a diabetic clinic Friday mornings.

That means all the G.P.s work part-time which obviously has negative impact on enough G.P.s to the ratio of patients, That
as well as a shortage of G.P.s is stretching all resources to meet the need of patients. I also would like to know what solution could we come to so that this could be improved.
During the lockdown and the worst time of Covid I did not ever contact the surgery and just followed all rules we were given about masks, sanitizer distancing and everything else so was fortunate enough not to have been hospitalized or had any Covid related illness. There was e-mails sent from the G.Ps not to contact them about any vaccinations for Covid as they were not doing them also anything related to Covid they told patients call an ambulance if necessary and if okay stay at home and isolate. My G.Ps are still only semi up and running and appointments have not returned to pre Covid time as yet.

I’m sure we all accept that there aren’t enough GPS but why is that? Yes probably a lot have retired recently but this shortage has been going on for years hasn’t it?

I do wonder why training to become a GP appeals to so few medical students.
They are well paid, and as has been pointed out many times on here, virtually all of them work part time. Yes I accept that there is a lot of ‘behind the scenes’ work and paperwork, but isn’t that the case in whichever line of medicine a medic works?

I’m sure on here we can all remember years ago when our children were small, that GPS worked full time, five, sometimes six days a week.
In fact our surgery was open for a couple of hours on Sunday mornings.
Yes obviously the population has grown hugely, and until the immigration problem is sorted, will continue to grow, but surely we need our GPS to work full time?

No matter how much money is thrown at it by successive governments, the GP situation never seems to get better.

What is the answer?

Gwyneth I’m pretty sure that I’ve already explained this to you on a different GP thread, but I’ll say it again. Many GPs are women. Women have babies and take maternity leave. When they return to work, they have the right, like all other women on this country, to opt to work part time. They often choose to work two or three days a week. This right to the mothers of young children is given to all women in this country, regardless of their job. You see to be suggesting that women who are GPs should not be allowed to do this. Can you give me a valid reason why young women who are GPs and who have young children should not be allowed to work part time.

My daughter is a mother. When her twins were twelve months old she returned to work as a GP. She worked part time, three days a week. Are you suggesting that with twins of twelve months old, my daughter should have been forced to work either full time or not at all?

My daughter had her third baby nearly four years ago. When he was nine months old, she returned to work three days a week. She then had a nine month old baby and four year old twins, none of whom attended school at that point. Are you suggesting that with three children below school age, my daughter should have forced to either work full time or not at all?

I’m sure everyone can understand the difficulties with women GPs who are mothers of small children. It would take a superhuman effort for them to attempt full time work, and would probably end up so utterly exhausted that they would have to give up.

However, the problem lies not just with women. Male GPs these days also are also only working part time
Not all of them have children, so why aren’t they working full time?

I think this dates back to the Blair government when they were effectively paid more for working fewer hours.

It’s a very worrying problem, and the result seems to be more patients pitching up at A and E out of pure frustration at being unable to get a face to face appointment at their surgery.

Maddy Firstly I didn’t say that most GPS who are part time are woman. Secondly, I have read somewhere, sorry I can’t give chapter and verse, that again well over 60% of medical students who are accepted into med school are women. I don’t know the reason for this. Perhaps one solution may be to encourage and accept at least an equal ratio of male students who are prepared and able to work full time. I have not suggested in any way that women GPS should not be allowed to work part time. You have brought up the question of gender. But logically if you have a particular profession that has a higher ratio of one gender and that gender choose to work part time there is going to be a shortage. This would happen in any profession. The other question is as you yourself point out that it is mainly female GPS who work part time so what is the percentage of them who return full time after their children are in school full time. I think most people accept that the shortage of GPS is only going to worsen but something has to done and solutions have to be found.

Another issue with the GP shortage is that many new doctors choose to specialize. If you choose to specialize, the pay is higher, and the setting is more hospital than clinic. They have no overhead for office space or staff (or it is much less).

A specialist that works in a hospital setting will sometimes have her office space paid for, and make almost twice as much as a GP, who has to pay rent and staff. I admit that I don't know how your system works, but I assume it is somewhat similar to ours.

To be honest when you watch programmes like "GPs behind closed doors" it does look like a lonely job, seeing patient after patient and trying to resolve their problems. Do full time GPs get a day a week say to further their knowledge in hospitals and to keep up to date? What support do they get within the practice? They seem very isolated in their consulting rooms and I am sure the responsibility weighs heavy. The job needs to be made more appealing especially to modern day doctors.

Josianne I record GPs behind closed doors as find it interesting especially the Hall Green Centre (live in same city) it enlightens/educates and amuses/irritates in equal parts as, the services they seem to offer their patients are far better than my present surgery ..perhaps it allocation of monies from different Health Trusts.

Last year on a few occasions I had pains in chest when walking, so in October when it happened for a fourth time I called GP. Triage system in use eventually Dr called back, listened to symptoms, said sounds like asthma I wasn’t convinced, could it be my heart ( having googled symptoms) unlikely but to be on safe side he agreed to me coming in & having an ECG. Heart problem discovered - Aortic Regurgitation - & from then on I honestly can’t fault the NHS. Seen several consultants, had various tests, now on 6 monthly checks.

Bea65

Josianne I record GPs behind closed doors as find it interesting especially the Hall Green Centre (live in same city) it enlightens/educates and amuses/irritates in equal parts as, the services they seem to offer their patients are far better than my present surgery ..perhaps it allocation of monies from different Health Trusts.

Yes all the patients seem to get referred very promptly, in fact the doctors are often filmed on the phone to the hospital departments during the consultation! I think it is because it is going on national TV.

We have a GP in the next village, but he will rarely see a patient face to face these days. There is no walk-in centre at all, the nearest A&E is 10 miles away, & we have to travel 14 miles for a ‘flu/covid jab. Our village has no bus service & many people have no car. There is a limited & expensive volunteer car service available, which has to be booked in advance, not always possible in an emergency. Ambulances have a long journey to get here and we often have to rely on an air ambulance (thank goodness for that wonderful service). Many of us are feeling that the NHS no longer exists for us.

Delila I’m sorry to hear that it’s difficult for you to access health care, but since you live in a village some ten miles away from the hospital, and fourteen miles from a vaccination centre, with no buses, and from what you say, possibly no car, you really need to consider whether living in an isolated village is the right place for you to be as you get older. Older people need services, and if they’re not in your village, perhaps a move to a sheltered apartment in a town near the hospital would be a wise move. Hospitals, vaccination centres, and GP surgeries are not going to be built in isolated villages.

MerylStreep

I phoned this morning at 9. Asked to see a doctor, told her what’s wrong; I’ll be seeing a doctor at 1.40 this afternoon.
Can’t knock that.

From my post above you will see that I was at the Drs at 1.40 ( Wednesday) from there I was sent to the hospital from where I didn’t get home until midday Thursday.
I told my doctor that if I was younger I would have his babies ?

Gwyneth

Maddy Firstly I didn’t say that most GPS who are part time are woman. Secondly, I have read somewhere, sorry I can’t give chapter and verse, that again well over 60% of medical students who are accepted into med school are women. I don’t know the reason for this. Perhaps one solution may be to encourage and accept at least an equal ratio of male students who are prepared and able to work full time. I have not suggested in any way that women GPS should not be allowed to work part time. You have brought up the question of gender. But logically if you have a particular profession that has a higher ratio of one gender and that gender choose to work part time there is going to be a shortage. This would happen in any profession. The other question is as you yourself point out that it is mainly female GPS who work part time so what is the percentage of them who return full time after their children are in school full time. I think most people accept that the shortage of GPS is only going to worsen but something has to done and solutions have to be found.

Gwyneth
Do you have a problem with over 60% of medical students being women? Your comments about female doctors are coming across as rather old fashioned really as you appear to believe that female doctors shouldn’t really be working part time, and that too many female medical students are doctors. You query why female doctors cannot work full time once their children are at school. You may not be aware but children in this country start school at four years old. Are you seriously suggesting that a busy doctor, working full time, usually in an evening surgery until between 6pm and 7pm, can somehow manage to collect and care for her children at 3.30pm, or that four year olds do not need the care of a mother at least some days in the week. Many grandparents take on the childcare, collecting and feeding the children, we did this ourselves till our daughter emigrated, but most grandparents would not want to do this five days a week, plus full time care in school holidays, because they are getting older and get tired. And most doctor mothers do not want to abdicate all childcare of their children, leaving them in the care of others every evening and every school holiday. Perhaps they actually want to do some hands on parenting with their own children! Plus male doctors are often involved in childcare of their own children these days and so work part time, juggling the childcare with their wives and the grandparents. Men are involved with bringing up their children these days Gwyneth, no longer do they leave all that to the women as it probably was in your time as a young mother.

Additionally both male and female doctors work part time in the GP surgery for a myriad of reasons, including they sometimes work in the local hospital as well as a GP, they have an additional job in area management (my daughter did this, one day per week working on the provision and delivery of services across the South Eastern Corridor, and she was heavily involved in this role in setting up vaccination centres across the south east) they also choose to work in the out of hours services as my son in law did. Who do you think the doctor is who rings you back if you ring 111? Yes, it’s a local GP! Out of hours also includes home visits where necessary.Who do you think does that? Yes, it’s a local GP! My son in law also worked in the local Covid Hub. He worked many hours there in addition to his not quite full time commitment in his GP surgery. In fact he usually worked appropriately 60 hours a week, at the surgery, at the Covid Cub, and doing out of hours services. But his patients might have said ‘Oh Dr M only works part time.’ But he did 60 hours a week delivering GP services in a variety of situations. So when you complain about part time GPs, perhaps you should have a think about why they may appear to be part time in your surgery. And instead of complaining think about what you’re saying, because in actual fact, you don’t know where your GPs are, or what they’re doing, when they’re not working in your surgery.

One place they are not, is on the golf course!

maddyone, your point is taken, but in this lovely place we overcome our transport/NHS shortcomings by helping each other out. We are resilient and largely self-sufficient. Before covid we had a perfectly good GP service albeit in the next village, the least any community should expect, in my opinion, That’s no longer the case. The GP is still there but the service provided is minimal. Of course we don’t expect a hospital in our village, but access to decent primary care would be a welcome starting point.
Should all small communities migrate to the towns - I don’t think so. Our quality of life here is wonderful in so many ways & I wouldn’t like to spend my “old age” anywhere else, but thankyou for your thoughtful suggestion.
We consider ourselves very lucky. However, I have an observation to make about the provision of NHS services in many rural areas.

My surgery have just gone back to pre Covid method of booking appointments - early each day for emergency appointments and non urgent ones can be booked up to two weeks ahead again. They are still using phone consultations and I had a lovely conversation with a doctor this afternoon about my diagnosis of having a TIA. I was referred by my optician after she identified some problems in my right eye and was seen by the consultant ten days later. I am now on blood thinners. At the appointment my blood pressure was far too high and I requested the gp appointment to discuss that.

The lovely doctor wants me to see a nurse next week to get a base line bp ( he felt that a one off reading at the hospital when I was under a lot of stress needs more in depth investigation before changing my medication) He agreed that I should take my own bp machines ( an upper cuff one and a wrist one) to the nurse so we can check their accuracy and make sure I am using them correctly.

This doctor took his time to listen to all my questions, did not rush me and made me feel valued - I think I love him!

I’m so relieved it seems easier to get an appointment as it was almost impossible a few months ago.

maddy with the greatest of respect instead of repeating the same thing over and over again why don’t you answer the question I have asked you several times. What is your solution to the difficulties that many posters are having in accessing healthcare? Solutions are needed not excuses. I just give up.

Delia, thank you for your lovely message. I understand completely that you are very happy in your present home and that your friends and neighbours are helpful and kind. Obviously I don’t know your age, but as you get older and need more hospital visits it may be an idea to consider a sheltered apartment nearer to the hospital. My mother moved into a sheltered apartment when she was ninety and was very happy there, with (pre Covid) a lot of social activities. However she’s now in a nursing home as she can no longer manage in her apartment. Carry on enjoying living in your lovely village, but do remember that there are other options available if it does become too difficult to access health care.

Gwyneth the solution obviously is that we need more GPs, but I don’t have a magic wand and cannot provide that solution. However complaining on Gransnet, when the vast majority of GPs are doing their level best to provide a good service, is not only not going to help, but is likely to put potential GPs off. This is the World Wide Web and GPs know that there is a lot of negative press about them, which is very demotivating for those trying their best. There are people who perform badly in every walk of life, but the majority of GPs are actually performing very well, and seeing more patients than ever before. In March this year it was reported that GPs consulted a record number of patients, more than ever before in one month. Inews:Heath reported that GPs are consulting 70 patients a day, which is apparently three times as many as is considered safe.

There is much in the press about the shortage of GPs if you care to look. The BBC reported six days ago that the shortage of GPs is putting safe care at risk. The BMA has reported on the pressures in General Practice. But some posters on Gransnet prefer to complain than actually have any real understanding of the pressures GPs are working under and to ask me, another Gransnetter, to provide a solution is ridiculous, just as it would be if I asked you to provide a solution. Whatever the solution is, it won’t come from me. Perhaps you can suggest how we can recruit more GPs. Complaining on social media and the constant negative headlines in The Telegraph or The Daily Mail isn’t going to make the job more appealing to young doctors just about to specialise. My own GP has left, she was made ill with the constant pressure from government and patients. She was replaced by another who has also left already. My Practice continues to look after me, even though I don’t have a named doctor now, and I consulted by phone with a GP today about an ongoing illness.

Gwyneth saying I’m giving excuses simply tells me that you are disinterested in the stress of working in General Practice. Telling you why many GPs opt for part time work, whilst working in other areas of the NHS is not an excuse, it is one of the reasons why some GPs work part time in their Practice. You are not interested at all in understanding anything about the health service, over and above your own need to get a face to face appointment.
There have been a number of complimentary posts on this thread saying that they are happy with the good service they have received from their GPs. Including mine.

Maddyone, you are making too many assumptions and your advice may be well-meant but be careful not to be patronising. People of all ages and means have many reason for choosing where they live and, who knows, may be just as capable as you of recognising when things might or might not need to change as they age.

You know, we have all sorts of people here and many and varied opinions on a multitude of issues affecting us, but most of us agree that we are not well-served here in respect of health-care from our GP practice, that the service has declined markedly since Covid resulted in lockdown.

Yes, distances to hospitals and the absence of walk-in centres are a disadvantage of rural life, but the lack of GP care gives the biggest cause for concern, and that seems to be almost universal these days, so I don’t think the solution is to up-sticks and move into town.