Are GPs as busy as they keep telling us they are?

SueDonim

My dd is on a GP training scheme. She is one of the Covid graduates. She had a breakdown a couple of years ago and now works PT. Her PT work consists of four 12 hours shifts a week plus weekend on call work. She is supposed to have regular paid study days but none has been forthcoming and she does that in her own time.

I wonder how many others jobs there are where 48+hrs a week is considered part time?

They know all this when they enter the profession.

Lisaangel10

SueDonim

My dd is on a GP training scheme. She is one of the Covid graduates. She had a breakdown a couple of years ago and now works PT. Her PT work consists of four 12 hours shifts a week plus weekend on call work. She is supposed to have regular paid study days but none has been forthcoming and she does that in her own time.

I wonder how many others jobs there are where 48+hrs a week is considered part time?

They know all this when they enter the profession.

With attitudes like that it’s no wonder so many doctors leave. Some people just have no idea at all.

I hope your daughter is managing okay SueDonim, that sounds very challenging.

SueDonim thank you for the update on your daughter. I hope she is managing now and manages to complete her training.

With attitudes like that of Lisaangel110it’s no wonder doctors leave the profession or the speciality.

Staggering view from Lisaangell110. Victim blaming is one way of responding

It prompted me to think about our police and military who can develop PTSD directly linked to their service to us. It’s like that awful old saying “if you can’t stand the heat stay out of the kitchen’. Or blaming miners whose lungs are wrecked - well they knew the risk etc

Employers have a duty of care. The rate at which we are losing doctors, police, teachers should be telling us something about how the duty of care is failing

The 1965/66 Family doctor charter put a limit of 2,000 registered patients per GP, it is now nearer 2,500 for most GPs. Add into that the increase of patients with co-morbidities, the change in the range of hospital tests and drugs that patients are having, the need to keep up to date with medical advances via publication like MIMs etc etc and it doesn't need a genius to see how the volume of work for a GP has increased yet they are seeing more patients.
I keep coming back to my earlier post about why so many doctors are leaving the profession. Doctors don't enter training thinking they'll pack it up if they don't like it. They wrack up huge debts whilst training and if they decide to leave it is a really hard decision to make. Yet, when doctors leave their training jobs it is rare for anyone to do an exit interview with them. DD has never had one despite working at three hospitals for a year each and several others for periods of 3/4 months. Surely stemming the flow of doctors leaving the NHS is important and it is most certainly not all about money
Casdon anaesthetics had nearly 5 applicants for each training place in 2023, it is not under subscribed there is, however, a shortage of training places to meet the demand of the NHS which is and will increasingly have, a negative impact on waiting lists.

I know two doctors who did the Anaesthetics rotation a few years ago though Foxie48, and neither of them stayed the course, both moved into surgical specialties after the first year, maybe it’s changed since then, but starting and not staying in Anaesthetics seems quite common. Do you know what the ratio of applicants to training posts is in other specialties now? I know a current junior who struggled to find a job on a Medicine rotation - he worked as a locum for a year before he was successful in getting a training post.

It's quite technical and the exams are reputed to be extremely difficult. Core surgical training was very slightly easier to get into in 2023, Internal medicine was a lot easier to access as was GP training. I'm attaching a link which shows all this. Core training 1 is the main access route to a specialism, ST4 and above are the next level training routes. To apply for ST4 anaesthetics the applicant had to have passed the stage 1 exams ie Primary OSCE/SOE (in May 2022 53% pass rate) out of 640 applicants only 390 got a training place. I obviously know quite a lot about this as DD is following this route. She took her part 2 exams in September and is awaiting her results! tbh all the medical routes are lengthy and difficult but it seems many don't appreciate this.

Training posts are limited in most, if not all, specialties. I don’t know why but I suspect government interference, the last government obviously, as the new government has not had time to do much except point in the direction of travel. I’m disappointed that hospitals have been told no more money, which may mean no in increase in training posts, I don’t know. The new government has indicated that they will be concentrating their efforts in the NHS to improvement in the GP service. It’s too soon to know what that means and how the service may improve. I hope there will be a substantial improvement in the NHS as a whole. Time will tell.

Not attached, but I found this.
medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2023-competition-ratios
Anaesthetics has obviously become more popular, unfortunately this doesn’t identify how many start but don’t stay for each specialty, and there’s quite a mismatch in some areas. It’s interesting though, isn’t it - look how much competition there was for Public Health Medicine - wow. Compare that with General Practice, and you start to see where the problems are. Unless it’s changed in the last few years, the number of applicants doesn’t imply they all have the right skills, or are cleared from a visa perpective to apply, I don’t know if that has changed.

medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratio

Forgot the link

As foxie says, all medical routes are lengthy and difficult, but I know the Anaesthetics is particularly a long training time. I’m not surprised that some give it up.
GP training is easier to get on to, but the previous government introduced Physician Associates, who are not doctors, but GP Practices were encouraged to employ them. They can’t even prescribe! I’d rather see a Nurse Practitioner than a Physician Associate because at least they can prescribe.

I think if you’re fortunate enough to live in an area where you have good GP provision and get the services you need, it’s almost impossible to understand how it feels to have virtually no service and to feel frightened of becoming ill. It is irrelevant how hard individual doctors might be working or how difficult their job might be if the service as a whole is broken, which it is where I live.

It is actually impossible in my area to get a face to face GP appointment even in two or three weeks time. They are just not available. My husband had his third heart attack in May and I had to take him to hospital as the ambulance wait time was at least two hours. The less said about the treatment he received at A&E the better. He was eventually admitted to a cardiac ward for two weeks. The only follow up has been by phone both from the GP and the hospital (one call with each). It is simply not acceptable.

Lisaangel10

SueDonim

My dd is on a GP training scheme. She is one of the Covid graduates. She had a breakdown a couple of years ago and now works PT. Her PT work consists of four 12 hours shifts a week plus weekend on call work. She is supposed to have regular paid study days but none has been forthcoming and she does that in her own time.

I wonder how many others jobs there are where 48+hrs a week is considered part time?

They know all this when they enter the profession.

They know all this when they enter the profession.

Ah - so that makes it OK then?

I used that 'argument' when I was about, oh - 15 or 16 years of age, against workers who were asking for better pay and conditions.

I don't know what you do, or have done, for a living - but any benefits you've enjoyed in the workplace have come about because workers - people, professionals, ordinary workers, have refused to accept that they can be treated like a pack-horse, exploited, with few or no rights, forced to accept the pay and conditions that might destroy their health or make family-life impossible.

Those entering the medical profession might well have some idea of what they are getting into - but why should they not try to change it?

It’s interesting to know that you were a fully-fledged woman of the world at eighteen years of age, Lisaangel. Most youngsters of that age that I’ve known are just starting out in life and are idealistic and maybe unrealistic about life in the grown up world.

Maybe you should run courses for teens so they can also be men/women of the world at eighteen.

I was waiting in line to see the receptionist and the lady in front of me was begging for help for a lady in her 80s. It wasn't going to happen.

Most of the responses to this thread have involved poor communications . There is no excuse for poor communications at any level or from any worker including the practice manager, the GP and the receptionist. All of these should be trained in good communications, about a three hour training should be more than enough for each level.

I think the problems in my area go far beyond poor communications Caleo

no gp home visits here. Nigh impossible to get an appointment. You have to get past the receptionist and the option to book on line has been removed. Dropping in to the pharmacy to collect medication the whole place is like the Marie Celeste. Most doctors are part time and even if you ask to see a doctor you get a health assistant - it used to be a fabulous surgery - not any more.

nightowl, so sorry to read the dreadful experience you and your husband had. You’re right, it’s not good enough. A young friend aged 38 had a double mastectomy as she has the gene, her mum died of breast cancer aged 42. Long story short, infection. Admitted via A and E query sepsis, on a ward 4 days with antibiotics and morphine, not seen by a doctor. Discharged home on antib’s. Developed rash reaction, seem by GP advised to continue antibiotics and go to A and E if she felt her throat was closing up

I rang surgery at 8.00a.m. today, I had an appointment for 11.15 a.m. to see the GP I asked for. Ok I wasn't seen until 11.35 but why would I complain? My surgery is great - Bodreinallt, Conwy.

I’m so sorry Iam. The night we were in A&E brought home to me just how bad things have become. My daughter was with us, she looked around and I could see the fear in her eyes. I knew exactly what she was thinking, not only worry about her dad, but fear for her own children. How on earth have we come to this?

I absolutely blame the previous government for this situation (and I’m not even a Labour voter!)
I’m disgusted at what the previous administration have done to our NHS!

Sadly since the NHS is run by non clinicians it seems to have lost the fact that it’s there for patients.
Many GPsurgeries are run by private companies , They seem to want to take the cash but not give a service ,
Many parts of the NHS are subcontracted out to private companies, Sadly the NHS is now just a cash cow ,

I don't think any of us are blaming individual doctors and most of us remember occasions where we have been especially grateful to them. It is the system in general that is the problem. I have just had to ring my own surgery. Twenty minutes of waiting while repeatedly being told I could hang up and have a ring back call instead. When I eventually got through to a receptionist, the first thing I was asked for was the date of birth and name of "the patient", third person, which is not very encouraging. The next part was about symptoms - fair enough - which I told her about, stressing that l have had two major operations in the past. I think that because the affected part of the body is the ear and that most ear infections are relatively minor, she had a checklist of possible symptoms. I was told that a doctor would call me at some point today and then decide whether or not l need to be seen in person. I cannot fault the receptionist - she was polite and simply doing her job as she had been trained, but the system itself is at fault and serious illnesses could easily be missed. Also, I really dislike having to tell a receptionist, who is no more medically qualified than I am, my symptoms.

Casdon and foxie 48

Thank you for your informative posts.