UK's largest GP chain replaces some doctors with less qualified staff.

It was actually a GP who ignored my breast problems last year, but I suspect a Physician Associate wouldn't have listened to me either because I didn't tick all the right diagnostic boxes. As a result, I'm due to have a mastectomy, which could possibly have been avoided if my cancer had been picked up earlier.

No, I don't think an appointment is better, if it's not done properly. I went away last October telling myself not to worry because the doctor told me it was nothing. I'm concerned that will happen more frequently if people are fobbed off with people they think are GPs, but aren't.

In some cases maybe, if the patient has a fair idea what's wrong and just needs monitoring, a change of medication or there's a very clear pathway. However, GPs see many patients who don't know what's wrong with them until the GP spots some warning sign.

For the first time in years, I had a proper face-to-face appointment with a GP last week. I had actually booked a telephone appointment because I want to change my diabetic medication and thought it would be simple. The GP insisted I see her, which could be something to do with the fact that I'm still considering legal action against the practice for not referring me, when they should have done.

So I walked in and sat down, discussed medication and the GP noticed my hands and asked what was wrong. I said I didn't know, but she said that she thought I had poor circulation and possibly some auto-immune condition, which was causing the painful red patches I've had for years. She'd also noted that I limp slightly, so she examined my hip and feet. While she was examining my feet, she noted that I have the beginnings of toenail fungus, so prescribed some medication. She's ordered full blood tests, including some I've never had before and has told me to go back to see her about my hip after my forthcoming cancer op. Oh! And she changed my diabetes medication and has told me to go back for monitoring.

The appointment lasted about 40 minutes and for the first time in years I felt that I was getting proper care. I know that not all appointments can be like that, but I seriously doubt whether a Physician Associate would have been so thorough, even if they did have the time. I'd be highly miffed if I was fobbed off with a Physician Associate for something serious.

The Physician Associate is a different role. They are generalists in the same way as GPs are and see all patients in the same way as a GP does, so they could be dealing with somebody with severe depression one minute and somebody else with cancer the next. They could also be dealing with the huge group of patients who don't know what's wrong with them. I think we all know that GPs are variable in diagnosing, but a good one can spot things patients don't even know they have.

This is all very well, but could it in a fair number of cases ( could it?) be better than not being able to get an appointment at all?

Just asking. Is the government counting the PAs in their figures, as filling the chronic shortage of GPs?

Yes.

And, since that takes quite a long time, what to do in the meantime?

Put pressure on the government to get more GPs trained.

growstuff

Baggs

If something unlawful was happening the anonymous GP should have reported it.

To be fair, given the shortage of GPs, what is a practice to do if it's to help all its registered patients? Without lowering standards of care, something has to give.

But accepting this is lowering standards of care, while the government can tick the boxes and claim that GP practices are fully staffed.

Who said anything about accepting what is wrong? I was merely putting forward a thought: What are GP practices to do given there are too few GPs?

Not having seen the BBC documentary, I don't know all the facts of the case in question. I do know that there aren't enough GPs.

So what are they to do?

Baggs

If something unlawful was happening the anonymous GP should have reported it.

To be fair, given the shortage of GPs, what is a practice to do if it's to help all its registered patients? Without lowering standards of care, something has to give.

But accepting this is lowering standards of care, while the government can tick the boxes and claim that GP practices are fully staffed.

Baggs

growstuff

But this isn't about Nurse Practitioners.

I think it could be in part, if it's an attempt to use what man doctorpower the practices have more efficiently.

That's why I asked about the reason for the investigation.

Nurse Practitioners are trained to do specific roles. They run clinics for specific conditions and deal with minor ailments. They are trained to spot anything outside their own expertise and refer it to doctors.

The Physician Associate is a different role. They are generalists in the same way as GPs are and see all patients in the same way as a GP does, so they could be dealing with somebody with severe depression one minute and somebody else with cancer the next. They could also be dealing with the huge group of patients who don't know what's wrong with them. I think we all know that GPs are variable in diagnosing, but a good one can spot things patients don't even know they have.

Very dangerous.
I know someone doing this, after following the science degree route and only scraping a pass after repeating two years at different universities, then failing to complete the hospital placements required to qualify as a GP. She refers to herself a doctor, and I doubt if her patients realise she isn't properly qualified.
Having known her all her life, I wouldn't trust her in a dolls' hospital.

If something unlawful was happening the anonymous GP should have reported it.

To be fair, given the shortage of GPs, what is a practice to do if it's to help all its registered patients? Without lowering standards of care, something has to give.

Then all is explained.

Up until this year , my father's surgery was superb .
I thought how incredibly lucky he was as I heard horror stories about the other surgeries .

When I phoned them a few weeks ago, I was refused a home visit for his distressing skin condition, which I 've cured myself .
.And then ,when his breathing was compromised his new GP blamed me for requesting a home visit too late and said, what had hell can I do about it ?
I'd tried to get the receptionist to understand the seriousness of my request . She wouldn't listen .
He had pneumonia in both lungs .

Our local hospital also discharged him with dangerously falling oxygen levels earlier in the year .
Within a day ,he was drifting in and out of consciousness .

Three months on within enormous amount of care on my part he is slowly improving -regaining his strength and eating /drinking .
I find that I really have to stand my ground these days .

Thanks, DL.

It seems that a GP and a Practice Manager had alerted them, according to the article, as they felt it was"unsafe practice".

"One GP, who wished to remain anonymous, said she had witnessed the way PAs had been used where she worked. "They were fantastic colleagues and trained to do certain roles, but not trained to basically do as much work as a GP. They were doing the same job as us, with less experience."

x posts gs

growstuff

But this isn't about Nurse Practitioners.

I think it could be in part, if it's an attempt to use what man doctorpower the practices have more efficiently.

That's why I asked about the reason for the investigation.

Baggs

Was the BBC undercover person sent to investigate because of complaints?

No idea, but I do know that there's been concern for ages, so maybe the BBC picked up on that and decided to find out for themselves.

But this isn't about Nurse Practitioners.

GrannyGravy13

Whitewavemark2

GrannyGravy13

We have Nurse Practitioners in our GP surgery and have had for many years. They see all the minor ailments (asthma, chest infections, ears, eyes, cuts, bruises etc) Ifmthey think you need to be seen by a Doctor they will call one in from the next room.

Is your practice run by a private company?

It is owned and run by the GP’s themselves.

All GP services are technically private They have agreements with the NHS, have done since it’s inception.

Bit different to an American health provider I would have thought, and hope

Was the BBC undercover person sent to investigate because of complaints?

Our practice has Nurse Practitioners too. I haven't encountered any problems with her overseeing annual blood and urine tests.

Also, because I had asthma diagnoses in the past, she suggested I do some peak flow readings and send them to the surgery, which I did. A more senior nurse rang me to find out if this was because of any breathing problems but I told her No, the nurse was just being thorough.

Callistemon21

It is happening everywhere, DiamondLily.

The NHS Hospital Consultant I see (or don't see!) has changed working practices so that pharmacists now deal with many of his patients by telephone.
It is not at all satisfactory.

It's ok if they're properly supervised. But, according to the undercover investigation, that's not happening.?

I was listening to this when it came up on Today. I assume it will be on Panorama. That will make interesting watching.

growstuff

They are dealing with the whole range of conditions which a GP does.

Right…

That is not acceptable unless they have the wherewithal to call in a GP to the consultation if needed, if of course they realise it’s needed ?

growstuff

Two years after a science degree, according to the article.

OK thanks, (sorry I should close the GN tab and get on with proper stuff ?)