Bonkers new rule at our GP surgery

growstuff
You ask about when I was seriously ill with Covid. I didn’t at any point see or hear from my GP. My husband became so concerned about my breathing that he phoned 111 because it was out of hours. It was the evening of New Years Day. Initially I was put into the Covid Virtual ward and my son had to collect the little oxygen measuring thing from the Covid Hub. It rapidly became apparent that my oxygen levels were so low that I needed immediate transfer into hospital. I was only in the virtual ward for about half an hour. The staff at the Covid Hub called the ambulance and it arrived in about 15 minutes. I was then in hospital for the following twelve days. I think I would probably have died without the care and treatment that I received. I couldn’t fault it and that’s one reason why I don’t like the GP bashing threads. I have always received treatment whenever I’ve really needed it. This wasn’t the first time I have received life saving care and therefore I will not criticise doctors. It’s fair enough to complain about lack of funding but not about the staff in my opinion.

Many GPs are already retiring or are approaching retirement and many young doctors just do not want to become GPs.

Yes, I had heard that maddyone.

Our original GPs retired some years ago, we still see a couple of them sometimes; they say glad they retired when they did.
All the present ones are part-time.
The population here has expanded and we need more GPs.

I don't know the answers.

maddyone Well, stop defending your daughter and accept that they need to understand patients. I know I don't waste GPs' time and I'm very pro-active about my own health - and so are many other people. My GP friend has also told me about a few people who are the "worried well" and factors them in. According to her, they make up a very small percent. Your daughter chose to become a doctor; ill people don't choose to be ill!

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.

growstuff
There is absolutely nothing in your posts that I disagree with apart from one thing. There are definitely time wasters who make appointments to see/speak to their doctor and don’t turn up. It is actually known about by the Health Service. Some people will be so ill that they end up in hospital first but it would be disingenuous to pretend that is the case for every missed appointment. And not every appointment is for serious illness ie I referenced my daughter being asked for nit lotion and sun lotion.
Your GP practice has sent out a document that lists the difficulties that GPs are working under and that pretty much applies to all GP practices across the land. They are asking for their patients understanding. That’s exactly what I was saying. People need to understand the difficulties rather than complain and show disinterest in the problems. The facts are that the vast majority of GPs are trying their best to deliver the best service, but when they read a lot of criticism in the press or on social media, it can be very demotivating for them. That’s my point. And sadly historically Gransnet has been a place where GP bashing has become something of a pastime for some posters. Whenever that happens I will defend the GPs because they do not deserve the contempt voiced by some people, and you growstuff and others are certainly not guilty of that, but sadly some people are.

On a positive note our GP practice is excellent you always get a call back from a GP or nurse and an appointment is booked if necessary. The reception staff are very helpful and understanding.
I do not have much experience as I only visit a GP very rarely but when I was ill the the GP booked me in within hours (probably surprised to hear from me )
My daughter has had problems with appointments by her consultants as she is a type 1 diabetic and her care is not usually done by our GP practice. She did see a GP on a other matter and he pushed successfully for her to have a blood monitor which she
wears on her arm on prescription. We did previously pay for this whilst she was pregnant as her hypo symptoms disappeared but it is expensive at £60 every two weeks.

This is the beginning of a document, I have recently received from my GP:

"This is now a uniquely challenging time, and the practice is currently seeing levels of demand that we have never seen before, as well as dealing with the effect of pressures and backlogs throughout every aspect of the health service. We are dealing with nearly double the amount of workload that would be considered normal for what was already an extremely busy practice. This effect has been seen across the UK and is not a problem unique to XXX Medical Practice. We thank you for your patience with us and beg of you to be kind and understanding.
Staff at the practice are quite routinely working, well over 12-hour days, and it is not unusual for an individual clinician to face nearly 100 patient contacts in a single day. This does mean that staff are fatigued and are at serious risk of burnout. We are sorry that this means that we are not able to give each and every one of you the time that you would like and are forced to prioritise and work in ways that may not always seem as caring and as personal as we would like.
We also understand there has been a lot of frustration recently regarding access to the practice for booking appointments, including prolonged periods of time for your calls to be answered by one of the care navigation team. We do strongly sympathise with all our patients on this matter. We continue to monitor the impact of increased pressure and demand on patient experience and review what measures we can implement to try and mitigate the challenges. To that end, and as a result of your recent feedback, we have implemented the following:
·We are moving to a brand-new clinical system provider, which goes live on Wednesday 30th November which will benefit patients and clinicians alike, resulting in an increasingly joined-up and comprehensive approach to healthcare "

At least the practice has acknowledged that it's struggling to provide what people need and do not always appear caring or personal. They are not accusing us of wasting their time, which is what you're doing maddyone.

Granmarderby10

Yes growstuff it was Blair who paid the GPs “handsomely” but it soon became evident that the handsome pay rise had strings attached and these were, an exponential rise in the number of duties they had to perform.
They could not just simply “stand still” and enjoy their well paid status but would need to take on the responsibility for several other roles.
And so this is we’re it all began really. Then more and more GPs started to do part time hours due to the stress and exhaustion from it all.

I know. It was a repeat of the tactic which had worked with teachers in 1988.

Rather than moaning about how awful patients are (wrong type of patient?), maybe people should think about how they vote. If they continue to vote Conservative, they're voting for all this to get even worse.

maddyone

GPs are not actually employed by the NHS like hospital doctors are, they are self employed. So they cannot be privatised, because they’re already private. They ‘buy in’ to a Practice and so they own it collectively with the other GPs in the Practice. The government gives the practice money, but they don’t employ the doctors or own the premises.

Yes, they can be privatised. An increasing number of practices are run by profit-making chains.

Not only that, but there are now a number of private GP practices in my area. They're owned and run by GPs who sometimes still work in the "normal" practices, but for fewer hours.

Now do you really think a person who makes an appointment and then doesn’t go is ill?

Yes! The only time I've not turned up for an appointment is when I ended up in A & E and was admitted!

I also know that I've been recorded as "not attended" when I missed a telephone call from the GP.

maddyone When you were ill with Covid, how would it have been if you couldn't have been seen for a few days? Would you have thought "That's OK! I'll stay in my bed at home and be seriously ill with no treatment and maybe I'll die, but I understand"?

That's what you're expecting people to do.

People will die because they're not being seen by GPs. I'm certainly not bashing them because I know they work hard. However, when people are already down, the last thing they need is to be told to "understand". How about understanding patients? They're the ones not being treated.

Given that it seems impossible to recruit and retain GPs, solutions include recruiting more nurse practitioners, who can be trained more cheaply, scrapping some of the bureaucracy and targets, issuing repeat prescriptions for two months instead of one, giving patients more control over their health records, encourage people to be more pro-active about preventative medicine, allow direct access to mental health services, allow some medicines to be prescribed by pharmacists. There's more but I've forgotten. All of those suggestions were given to me by a friend who is a GP.

I don't know enough about the system Maddy to make suggestions, but perhaps you could show some understanding too.

Good post Granmarderby.
But another reason for part time work is the number of women who work in general practice. Of course they negotiate part time hours after they have a baby, just like many other women in work do.
And yes! For example GPs practices get paid per flu vaccination given. But many Gransnetters choose to go to the pharmacy because it’s more convenient.

It was Blair who paid GPs handsomely.

Yes you’re right growstuff. But do you remember the complaints about that from the general public? There were frequent complaints about it on all the media outlets. I remember that very well indeed. The public don’t want GPs to be paid handsomely, but you’re right in that it is necessary to pay them well. Look what happens when they’re not paid well. There aren’t enough of them. The public can’t have it both ways, either pay the GPs ‘handsomely’ or have too few GPs.

Yes growstuff it was Blair who paid the GPs “handsomely” but it soon became evident that the handsome pay rise had strings attached and these were, an exponential rise in the number of duties they had to perform.
They could not just simply “stand still” and enjoy their well paid status but would need to take on the responsibility for several other roles.
And so this is we’re it all began really. Then more and more GPs started to do part time hours due to the stress and exhaustion from it all.

GPs are not actually employed by the NHS like hospital doctors are, they are self employed. So they cannot be privatised, because they’re already private. They ‘buy in’ to a Practice and so they own it collectively with the other GPs in the Practice. The government gives the practice money, but they don’t employ the doctors or own the premises.

It is difficult to understand why things have changed so much . I have been with the same practice for 50 years . Doctors have changed but the numbers remain the same and no changes since Covid . So shortages cannot be the reason for not being able to get face to face appointments. We had a lovely GP for a while, but she returned to hospital working as she told me she didn’t want to work on the phone all day and wanted to “see patients” I have tried to join our patient participation panel but it seems it no longer exists. We have some private hospitals now providing Private GP appointments . Wondering if all these NHS GP access issues are a deliberate plan to privatise GP’s as have so many other areas . Breast and bowel screening are now run by private companies, so much planned surgery is done in private hospitals on NHS .

Good for you growstuff. I agree that it pays to be persistent if the problem is real. However we have many appointments where patients have simply not turned up, a poster upthread pointed this out. Now do you really think a person who makes an appointment and then doesn’t go is ill? They can’t be otherwise they’d turn up. This reduces the numbers of available appointments for people who are ill. There are also patients who turn up to request sun lotion or nit lotion on prescription. This is true because my daughter GP has had such patients. She refused to prescribe these items but no doubt the patients who had requested them would have then complained vehemently about her. Or as she said, gone to another GP who will prescribe them for a quiet life. Both of these examples show misuse of the health service, and both reduce the number of available appointments for the people who really need them.
Unfortunately people often don’t want to acknowledge this misuse of the health service.

VioletSky

Diabeties is such a serious and worrying condition to live with

It's awful the amount of hoops he was forced to jump through

Hope it all gets sorted out

I'm diabetic, so I know. I'm amazed that he should have been forced to go through those hoops. The government insists that diabetics have reviews. Otherwise the GPs aren't paid for their services.

maddyone

Thank you for your suggestion growstuff.
There is an ongoing issue of pay in general practice, not just now as there are issues of pay with many professions, but I’m aware that the issue of pay has been rumbling for about ten years or more. The level of pay has been seriously eroded over time and GPs are not happy about it. Maybe that needs to be looked at properly too.

It was Blair who paid GPs handsomely. Maybe people should vote Labour next time.

Diabeties is such a serious and worrying condition to live with

It's awful the amount of hoops he was forced to jump through

Hope it all gets sorted out

maddyone

Do you think complaining will make them better then? They should complain to their MP if they feel strongly enough. Understanding is important in my opinion. How do you suggest that the current GP shortage is solved? I would tentatively suggest fewer hours and fewer patients per doctor. But if we can’t attract sufficient doctors to train as GPs, that’s impossible. Any other suggestions?

People do understand!! It doesn't help them if they are seriously ill. Writing to MPs, if they're Conservative, won't do any good. Places for medical schools are oversubscribed. The problem is the government places unrealistic demands on GPs. It's not the patients' fault.

People should remember next time they put their X in a box.

Thank you for your suggestion growstuff.
There is an ongoing issue of pay in general practice, not just now as there are issues of pay with many professions, but I’m aware that the issue of pay has been rumbling for about ten years or more. The level of pay has been seriously eroded over time and GPs are not happy about it. Maybe that needs to be looked at properly too.

Maddyone I was persistent because an arrogant GP refused to believe me. My breast cancer was picked up six months later by a routine scan, even though I had known all along that something was wrong. With some difficulty, I contacted the GP practice manager, who initially tried to fob me off. It wasn't until the practice received a letter from me threatening legal action that I was finally granted an interview with the senior partner. There is now a note on my records (I've seen it) that I refuse to be seen by the partner who misdiagnosed me. I received an official apology, but decided not to sue.

Nobody should need to be as persistent as I was to receive basic care.

Do you think complaining will make them better then? They should complain to their MP if they feel strongly enough. Understanding is important in my opinion. How do you suggest that the current GP shortage is solved? I would tentatively suggest fewer hours and fewer patients per doctor. But if we can’t attract sufficient doctors to train as GPs, that’s impossible. Any other suggestions?