Bonkers new rule at our GP surgery

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.

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.

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.

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.

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.

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?

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

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

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.

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.

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.

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.

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

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?

MissA sadly some people do GP bash about their own GP practices, rather than the system. That’s how the thread started. The system is struggling and it is fair enough for people to be very concerned about that. In fact, it’s a good thing if people are concerned about that and complain to their MP about it. Complaining on Gransnet will achieve nothing, but possibly make doctors feel more disillusioned.

My daughter is a GP. She lives and works in New Zealand at the moment. She thought she was escaping to a better health system where she would have time and facilities to really deliver her very best care, but has now discovered that the problems are much the same in NZ. Anyway this isn’t about NZ. The reason that many GPs are part time is mainly because they are women with young children. When I was teaching lots of our teachers had a baby and then went part time. It’s the same in medicine. Women make the same choices that women in other jobs make, and choose to work part time whilst their children are young. I’ve seen it suggested before that GPs shouldn’t be allowed this choice. Of course that would result in even fewer GPs as they would choose not to work for a few years, and anyway as a feminist I couldn’t support the legal rights that other women have being removed from doctors.

FannyCornforth

MissA I recently heard something (on R4, so it must be true) that the vast majority of female GP’s are (or want to be) part time.
I think that most, or a great deal, of GP’s are now women.
I know that our (excellent) GP surgery bares this out.

I would hope after years of study, that gps have the opportunity to work part time as and when it suits them.

I still can't grasp how that means that the service cant function properly, considering all parents of either sex may reduce their hours, or perhaps when older, have other more pressing family commitments.

People are talking about the system, not individual gps.

I don’t think I’ve asked people to be more understanding of doctors growstuff, I think I said, or was trying to say that patients should understand the situation. They should understand why there aren’t enough doctors and that’s why it’s difficult to get an appointment for some patients. And there are many reasons. As your surgery correctly pointed out. And as I also tried to point out.

growstuff
I am trying not to defend my daughter, I don’t think she needs defending because I know she works hard and is very professional. When a poster asked upthread if I had a doctor in my family, I deliberately didn’t respond to that as I didn’t really want this discussion to become about my daughter, who doesn’t even live in the UK at the moment and is actually living and working in New Zealand. Interestingly she says that many of the same problems in medicine exist over there too. And yes she chose to become a doctor, but that doesn’t mean it’s acceptable to criticise her and her colleagues just because there are insufficient doctors in the country. That’s not her fault and it’s not the fault of any other doctor in the country. They do not deserve the criticism that is frequently heaped upon them, when as your own surgery says, they are doing their best under difficult circumstances.

maddyone I'm not complaining about doctors either! I've had life-saving care more than once in my life. I am complaining about people who don't seem to recognise that most patients aren't time wasting hypochondriacs. The system is underfunded and needs some radical reform at all levels, but I'm sick to death of people who don't seem to realise that patients and doctors are on the same side. Patients do understand that doctors are overworked, but doctors (and their parents) need to understand that most people wanting appointments are ill and worried. They can't be fobbed off by telling them to have more understanding.

MissA I recently heard something (on R4, so it must be true) that the vast majority of female GP’s are (or want to be) part time.
I think that most, or a great deal, of GP’s are now women.
I know that our (excellent) GP surgery bares this out.

MissAdventure

I think people are interested in why things have changed so dramatically, hence them asking on here what is different now compared to pre covid.

To be honest, I haven't noticed many changes from pre-Covid. My practice started showing signs of stress about five years ago. I noticed it particularly with diabetic clinics, which no longer included the full range of checks. It was taken over by nurses, and doctors are rarely involved. My practice doesn't even have a doctor with diabetes as a specialism. After I had a heart attack in 2017, I couldn't get an appointment with a GP for five weeks, even though the hospital had told me I would need one within days to sort out prescriptions and a follow-up plan. That was five years ago.

What has happened during and since covid is that the NHS (in England, at least) has introduced new working practices, which include more telephone appointments and triaging. It's supposed to be more efficient (and it probably is for certain conditions) but it does mean that patients don't get face-to-face appointments very often - and many don't like that.

Doctor turnover is very high. There are two partners (one on the verge of retirement), but the other 8 doctors are salaried and don't seem to last for more than a few months, which affects continuity of care. I'm not sure what's going on with them. I know that the NHS would prefer more GPs to be salaried, so that they can be employed by large chains - maybe in preparation for take overs by large chains.

Too few.

Do people still job share?

Two part time workers to do the job of one full time, maybe?

Or are there literally two few candidates to fill the vacancies?

Our surgery does triage when you phone in, minor complaints they send to a pharmacist, or practice nurse, more serious they will see you same day, appointments with a specific doctor are going to take longer.
Went for a flu jab yesterday, communication by text, seemed like business as usual