Bonkers new rule at our GP surgery

I attended our fantastic GP surgery on Monday morning. It was a routine, pre-arranged monthly visit with the Advanced Nurse Practitioner - who is allowed the prescribe medications and refer patients to hospital for tests, appointments etc if she deems it appropriate. She’s fab and I appreciate the continuity of care.

I noticed however in the waiting room (no masks worn any more by anyone) that the monthly ‘tally board’ indicated that last month there were 72 ‘no shows’ (dna’s - did not attend) which is shocking when you think about it. A receptionist said ‘that’s by no means the highest monthly figure we get’.

I’m glad I take the staff a box of biscuits each time I attend. They all work so hard at our group practice. Friendly staff, no ‘dragons’ and a really accessible and well run practice. We are very lucky.

It’s interesting maddyone that your GP daughter has emigrated to NZ for better life/work balance and yet is encountering similar problems there to here in the UK. Covid world-wide with restrictions, lockdowns and backlogs has a lot to answer for. Didn’t Ardern the NZ PM enforce some of the harshest conditions and yet, still they have similar difficulties it appears. Maybe your daughter might think of returning as the grass wasn’t greener after all?

Yes, I think that people who work p/t often put a better shift in too.
Less burnout

What happens when a teacher goes part time?

Its ridiculous to suggest the gps shouldn't be allowed autonomy over their own work/life balance.

The system can’t function properly MissA because there simply aren’t enough doctors who choose to be GPs. We have a huge shortage of doctors across all specialities but it’s acute in general practice. The government have tried to encourage more doctors to train as GPs but doctors don’t want to. The reasons for that are obvious, as growstuff’s own practice pointed out in the letter she received. Frankly, if I was a doctor, given the amount of criticism in the press and on social media, I wouldn’t want to become a GP either.

MissA
I don’t want to derail the thread, but a quick word about part time teachers. When a teacher went part time, there would usually be a job share arranged, so two teachers had one class between them. It actually worked really well.

Next door neighbours son is a GP and he is only working 3days a week. He is mid 30s with young family. He doesn’t need the money. His parents say he should be working a “proper” week. Their daughter is also a GP who only does an occasional shift for 111 service she is married to a GP. I don’t know what the answer is. My surgery is ok nurse wise and paramedic wise but how anyone ever gets a face to face is like winning the lottery. My dogs receive better treatment.

Yes, that’s what I did too Maddy
They advertised for a job share.
In fact, my school bent over backwards to allow me to go part time, which was wonderful.
And then I had to leave

Fanny
Glad your part time appointment worked for you. I think it suits many women, whatever their job.

Well these days are gone for sure, never to return.

Blair set out new T&C for GPs.
No more ‘out of hours’ doctoring. No evenings. No weekends. No home visits. They were sourced out long ago to agencies.

The job a GP does is nothing like it once was. Pluses and minuses both ways. More complex. More government tick boxes. Less continuity of care, even for the elderly, by a designated doctor.
We have gained in some things - routine checks for example - monitoring of blood pressure, diabetes checks etc - but also we have lost out on so many aspects in the family doctor and patient relationship.

No single handed GPs (since Shipton). Practices are now ‘business models’ with a practice manager who balances the books.

I don’t know the answer.
All I do know is the NHS has eye watering costs yet some little children have never, for instance, seen an NHS dentist as again ‘there aren’t enough of them’.

What will it take I wonder to sort out this behemoth?

In my surgery the receptionists are triaging any request for an appointment. That’s if you can get through at 8am.
Any request for a routine appointment the same but appointments are next month.

Oldbat (I bet you’re not really an old bat )

A full working week for a GP is normally four full days because they work about ten to twelve hours per day. My daughter often worked twelve or more hours on her days ‘on.’ She was doing paperwork and referrals after she saw her patients. She often didn’t leave her surgery until after eight at night, despite having arrived before eight in the morning.
Some GPs choose to work say, three days a week, and spent one or two days working in hospitals or doing locum work.

Sparklygrandma
I find it more productive to phone the practice in the afternoon to be honest, so long as it’s not an emergency, or make an appointment online. The NHS App is brilliant. I use that.

maddyone that sounds logical but here I would be told to ring the next morning at 8 am. NHS app either not here in Wales or not applicable locally.

Personally with a GP payrise should come a requirement that all U.K. trained GPS and funded for same, they work at least 10 years full time in the NHS. The NHS trains them and it’s putting extra pressure on primary care for GPS to choose to see it only as a part time job.

The info on the app is supplied by each gp practice individually, I think.

There is no option on my app to book appointments, and it no longer shows any upcoming hospital appointments, which it used to.

I think they model themselves on Dickens' Circumlocution Office.... round and round getting nowhere... I had a letter from our Surgery to book a Hypertension review... Went to desk with letter. 'Can you prove your address?' I was asked. - Showed letter from them to me at my address with request to come in. No, they said - it has to be a bill for gas, electricity or rates! 'But here I am standing in front of you so I must have received your letter at where I live' I said. They wouldn't accept it. So I left feeling like a non-person, with my Hypertension at top rate and without the review!

Sparklygrandma I think you’ll find most doctors complete ten years or more very easily in the NHS already, so such a rule wouldn’t really help. I don’t agree with such a rule anyway, because student doctors pay university tuition fees exactly the same as other students. That means they pay £9000 a year for th3 first four years of their training, so it’s not the situation that the NHS trains them entirely. They then move into clinical practice for one or two years where they are working for no pay in the NHS.

My daughter, after spending three years attending lectures and hospital clinics, did:

A further three years clinical practice whilst training. She was not paid for this work and in fact one year we paid the university even though she was engaged in clinical practice.

She then did F1 and F2 (two years) working in a hospital on different rotations. She was paid for this because she was qualified.

She then worked for one year at the Psychiatric Hospital. She was paid.

She then worked at a variety of GP practices for three years as a trainee GP. She was paid.

This makes a total of nine years as you can see. She then went on to work for several years as a GP before going to work in New Zealand. As you can see, doctors will easily clock up ten years without any such ruling, but unfortunately people don’t actually understand the process and therefore think they can offer a solution, which actually isn’t a solution at all.

Dandylion
What a strange situation! I wonder why they wanted a bill when they already sent the letter to you at your address. My practice text me if they want me to make an appointment ie flu vaccine, and I can make the appointment on the NHS App.

MissAdventure

What happens when a teacher goes part time?

Its ridiculous to suggest the gps shouldn't be allowed autonomy over their own work/life balance.

Well yes, but there are consequences. The Government has calculated the number of GPs currently required based on them working full time. Not that long ago, that meant working 1 night in 3 or 4 on call, and 1 week-end in 3 or 4, doing home visits, etc, ON TOP of their normal working hours, which were much longer than today.

Now GPs don't work nights or week-ends- and do much shorter hours, and then this part-time. The results- a massive shortage. The reality.

Our doctors have sealed up their letter box. 😡

Fleurpepper
It’s donkeys years since GPs did overnight and weekend surgeries, or went out to visit patients in their own homes. How do you know their hours were much longer then than today? Have you got any proof of that? And how do you think that GPs could manage to home visit patients when there are so many more patients to oversee now? Have you actually read the thread?

NanKate
That suggests they want you to use the online facility then.

I don't believe gps have a moral obligation to work themselves into the ground.

If times have changed, and both gps and patients (some) are finding things are no longer workable, then a solution needs to be found.

Since I'm pretty sure we all want the same results, that's at least a starting point.

Good post MissA.
Surely (in time) “things can only get better”? 🎵 🎶

maddyone

Fleurpepper
It’s donkeys years since GPs did overnight and weekend surgeries, or went out to visit patients in their own homes. How do you know their hours were much longer then than today? Have you got any proof of that? And how do you think that GPs could manage to home visit patients when there are so many more patients to oversee now? Have you actually read the thread?

I can assure you, I know. The night and week-ends were always on top of a full week. So 11 to 12 hours a day PLUS 1 night in 3 or 4, and 1 week-end in 2 or 4, + all th admin, insurance reports, monitoring of younger doctors, and more. What was a 4.5 wo/man practice, with the same list, is now 11.

As for Junior Doctors, do you think it would be allowed for the to work 140 to 145 hrs per week as they did in the 70s!?

MissAdventure

The info on the app is supplied by each gp practice individually, I think.

There is no option on my app to book appointments, and it no longer shows any upcoming hospital appointments, which it used to.

I don't think it is supplied by the GP.

My NHS app has details of my Covid jabs, but my GP app doesn't.

I haven't been able to book appointments directly with either system since the start of Covid. I have to use another app, which brings up an online form to connect me to the triage system. The GP then replies to my message with an appointment, which appears in the GP app.

I've never had hospital appointments on the NHS or GP app. They appear on yet another app, called "My Chart", which is the online system for Addenbrooke's Hospital. Bizarrely, blood test results (even those done by the GP) appear on the Addenbrooke's app, but not the GP or NHS app.