WAITING Times for GP andNurse Appointments

Jaxjacky

Just chatting to a friend, her surgery, about 8 miles away had 192 missed appointments last month, what is the matter with people?

What percentage of available appointments is that?

Delila I live in a small town (not an isolated village) and I had to travel 16 miles to get vaccinated. There are two GP practices in town, but for some reason it was decided to leave my age group to the national system, even though vaccinations were being done by GPs in a sports hall about 400m from where I live. It's annoying when things like that happen, but long-suffering patients put up with it. Goodness how people with poor mobility and no transport managed. Everybody I know is putting off seeing GPs whenever they can because they do appreciate that they're at breaking point. I object very strongly to being told that GPs are some kind of martyrs.

I doubt if it would help if you moved anyway. Although I don't live in a rural location, it's almost impossible to see a GP and the hospital is miles away. We don't have an out-of-hours service. Rather than constantly moaning about patients, maybe GPs' family members should campaign to address the underlying problems, which are caused by underfunding, outsourcing and profiteering.

Just chatting to a friend, her surgery, about 8 miles away had 192 missed appointments last month, what is the matter with people?

You seem fixated, Maddyone on defending medical members of your family whilst ignoring people’s valid concerns/complaints about the poor service they are receiving from their GPs. No-one has the slightest interest in “slagging-off” your relatives or their colleagues, and many posters have given credit where it’s due, but those of us who have had poor experiences are justified in complaining about it, and asking “why”?

I think many people appreciate the hard work & dedication of doctors, and recognise the enormous stresses of the job, but there are two sides to this story, and patients have need of and deserve a good GP service, which many cannot now rely on.

You will inevitably find yourself being challenged if you ignore the obvious fact that GP provision has declined drastically in the last months.

By the way, when elderly and infirm non-drivers in my village had to travel 14 miles to receive their covid vaccinations those of us who could drive ferried them back & forth. As I said, we are pretty self-sufficient, but it makes no sense for people to travel so far for something that used to be available a mile down the road. Apart from other considerations, it’s unnecessarily wasteful of energy.

maddyone

I can’t help but notice that many Gransnetters talk about seeing/not seeing their GP over the last few months or through Covid. I have a number of conditions that are managed by my own GP Practice, but I have only consulted by telephone, about one of these conditions. I also consulted, by telephone, after I was discharged from hospital when I had serious Covid, as I needed ongoing medication for a while. Otherwise I have not consulted my GP and I don’t normally consult with my GP at all during a normal year. So it strikes me that a lot of people are consulting their GP far more often than I do normally, and the verified numbers of consultations across the country over the last year bears this out.
Delia I am not being patronising when I say that if accessing health care is difficult because someone chooses to live in an isolated village, I am merely being practical. It is unfair to complain that medical services are difficult to reach whilst continuing to live far away from medical services. If you do not have a car so that in fact ten miles is not so very far, and you live in a village without services (even a bus service) then that is your choice so you shouldn’t be complaining.

I too have a number of health conditions but rarely need to see my gp. That’s fine as long as things remain stable but if something gets out of control or escalates, then I do need to consult with a doctor or have some tests. That’s when, during the pandemic, I have struggled to get an appointment as the system for booking them changed and made it very difficult.

For instance, my blood pressure was far too high ( picked up by the nurse at my flu jab) and I was asked to monitor it by taking readings twice a day for eight days then emailing to results in before a telephone conversation with a doctor. It took three cycles of eight day readings and tweaking my meds to get it under control again. Hence my struggles to get an appointment, I was asked by the doctor to make the appointment but the system in place defeated me! It was only after making a complaint online that I managed to get an appointment.

But now the system has returned to the previous method, I phoned one day and was given an appointment for the following day - under the Covid system, they were only giving appointments for the day you phoned, no advance ones.

I am more than happy to have a telephone conversation if that saves time for the doctor but there will be times when I need a face to face one. Hopefully if that happens I will now be able to get one.

The reason for these changes was not staffing problems, it was changes being made for Covid reasons. I have a very close friend who is part of the group that oversees the practice so I know that staffing levels did not change much during this time except they were not accepting trainee doctors as they normally did.

I feel that any changes that were made to booking appointments should not have impacted on patients as much as they did, it was very stressful and confusing. Once my blood pressure is sorted out, I don’t anticipate needing to see my doctor for a long time - but who knows, I did not anticipate having a TIA!

Delia thank you for explaining and I’m not being patronising when I say that. Obviously I understand that it is a big loss when the GP services appear to disappear as it were. When my elderly mother lived at home in her sheltered apartment, when we could no longer take her in our car for vaccinations or routine appointments (because she was no longer safe getting into or out of a car) the services came to her in her flat. She received her Covid vaccination at home, delivered by a paramedic the first dose and a nurse the second dose. She’s now in a nursing home so she will vaccinated there. I am surprised that no such service exists, and I feel it should exist in villages such as yours, as some disabled or very elderly people are unable to even get in car safely, even if people like yourself who drive, offered to take them.
Obviously I don’t know where you live, and wouldn’t expect you to say on a public forum, but my daughter was involved in the delivery of services across the south eastern corridor, and the provision of vaccines, especially the Covid vaccine, was part of her job. We had a very efficient system here, excellent vaccination centres, and vaccination at home as well. I’m justifiably proud that my daughter was involved in this, and despite what some people think (not you) I obviously know a lot more about this than some others as my daughter talked to me a great deal about what she was doing. Obviously this job took her out of the surgery for one day a week, and so she was only there two days a week as she worked part time, unsurprisingly as she has seven year old twins and a three year old.
It would be interesting to know how your very elderly residents received their flu/Covid vaccines as they wouldn’t be able to travel fourteen miles without assistance and without home vaccination visits, it must have been very difficult.
I am not in charge of health nor do I allocate the money, but I reiterate that the main reason that people are finding it difficult to see a GP is because there are too few of them. There is no way I can influence government to provide more GPs, but because I know how hard my family members worked, especially throughout Covid, I will not allow ‘slagging off’ GPs to go unchallenged.

Maddyone, I do drive and fortunately I’m able-bodied & rarely have cause to consult a GP. My concern is on behalf of others, who face problems caused by a substandard GP service, compounded by the difficulties of distance from alternative sources of care. I emphasise that we were well provided for before lockdown, with no cause for complaint.

For example, before covid patients went to the GP surgery for their ‘flu jab, just over a mile away in the next village. We are now required to attend a health centre in town 14 miles away to receive the jab with no public transport available. The public transport issue wouldn’t be a problem if we didn’t now have to make a round trip of 28 miles to be vaccinated instead of 2 miles.

This isn’t a problem of an ageing rural population stubbornly insisting on staying put while expecting services to come to them, this is the decline in/removal of a service that used to work perfectly well for two villages, and no longer does. It’s a huge loss.

As you like growstuff.

maddyone

I can’t help but notice that many Gransnetters talk about seeing/not seeing their GP over the last few months or through Covid. I have a number of conditions that are managed by my own GP Practice, but I have only consulted by telephone, about one of these conditions. I also consulted, by telephone, after I was discharged from hospital when I had serious Covid, as I needed ongoing medication for a while. Otherwise I have not consulted my GP and I don’t normally consult with my GP at all during a normal year. So it strikes me that a lot of people are consulting their GP far more often than I do normally, and the verified numbers of consultations across the country over the last year bears this out.
Delia I am not being patronising when I say that if accessing health care is difficult because someone chooses to live in an isolated village, I am merely being practical. It is unfair to complain that medical services are difficult to reach whilst continuing to live far away from medical services. If you do not have a car so that in fact ten miles is not so very far, and you live in a village without services (even a bus service) then that is your choice so you shouldn’t be complaining.

How dare you assume that people who have tried to consult with their GP have done so unnecessarily? Just because your daughter is a GP doesn't mean that you have any medical expertise. Just because people need more consultations than you does not mean that you are in any way the "norm".

BTW I agree with the poster who saw your post as patronising - and ignorant of her situation.

Meanwhile the GP problem we have here has a knock on effect in that patients, frustrated at their inability to even have a telephone consultation with a GP, results in them pitching up at A and E in pure frustration.

This inevitably clogs up the emergency services, dealing with folk who should really have been seen by their GP.

I can’t help but notice that many Gransnetters talk about seeing/not seeing their GP over the last few months or through Covid. I have a number of conditions that are managed by my own GP Practice, but I have only consulted by telephone, about one of these conditions. I also consulted, by telephone, after I was discharged from hospital when I had serious Covid, as I needed ongoing medication for a while. Otherwise I have not consulted my GP and I don’t normally consult with my GP at all during a normal year. So it strikes me that a lot of people are consulting their GP far more often than I do normally, and the verified numbers of consultations across the country over the last year bears this out.
Delia I am not being patronising when I say that if accessing health care is difficult because someone chooses to live in an isolated village, I am merely being practical. It is unfair to complain that medical services are difficult to reach whilst continuing to live far away from medical services. If you do not have a car so that in fact ten miles is not so very far, and you live in a village without services (even a bus service) then that is your choice so you shouldn’t be complaining.

3nanny6 Totally agree with you..feels quite sad doesn't it when you don't see/hear the GP you know and know all your history...I've had a designated GP for last 5yrs + and actually had a callback from him recently - felt quite emotional it was lovely to hear his voice as I was also concerned how he has coped with covid within his own family...talking to locums who don't know your history takes more time but appreciate they are trying to keep the surgeries going..also had an Army medic who was super enthusiastic and helpful over the past 6 mths on callbacks...

I am interested in understanding about the health service and no I am not just interested about my own needs to get a face to face appointment although when you can manage to get one it is almost a treat these days.
I have been with my surgery for about 15 years now and it has certainly changed.
There were two doctors that I found particularly excellent in their profession and a few years ago it could be guaranteed that an appointment would result in seeing one of those doctors. Both of those doctors are still at my surgery but I have not had an appointment with either of them for TWO YEARS and as I have already said getting an appointment is difficult enough. The last two appointments I have had has been with sessional doctors who I didn't know and one of those has left and is not coming back.
I still wait and hope maybe in the future I just might get an appointment with one of those doctors it would be welcome after 2 years.

Maddyone, you are making too many assumptions and your advice may be well-meant but be careful not to be patronising. People of all ages and means have many reason for choosing where they live and, who knows, may be just as capable as you of recognising when things might or might not need to change as they age.

You know, we have all sorts of people here and many and varied opinions on a multitude of issues affecting us, but most of us agree that we are not well-served here in respect of health-care from our GP practice, that the service has declined markedly since Covid resulted in lockdown.

Yes, distances to hospitals and the absence of walk-in centres are a disadvantage of rural life, but the lack of GP care gives the biggest cause for concern, and that seems to be almost universal these days, so I don’t think the solution is to up-sticks and move into town.

Gwyneth saying I’m giving excuses simply tells me that you are disinterested in the stress of working in General Practice. Telling you why many GPs opt for part time work, whilst working in other areas of the NHS is not an excuse, it is one of the reasons why some GPs work part time in their Practice. You are not interested at all in understanding anything about the health service, over and above your own need to get a face to face appointment.
There have been a number of complimentary posts on this thread saying that they are happy with the good service they have received from their GPs. Including mine.

Gwyneth the solution obviously is that we need more GPs, but I don’t have a magic wand and cannot provide that solution. However complaining on Gransnet, when the vast majority of GPs are doing their level best to provide a good service, is not only not going to help, but is likely to put potential GPs off. This is the World Wide Web and GPs know that there is a lot of negative press about them, which is very demotivating for those trying their best. There are people who perform badly in every walk of life, but the majority of GPs are actually performing very well, and seeing more patients than ever before. In March this year it was reported that GPs consulted a record number of patients, more than ever before in one month. Inews:Heath reported that GPs are consulting 70 patients a day, which is apparently three times as many as is considered safe.

There is much in the press about the shortage of GPs if you care to look. The BBC reported six days ago that the shortage of GPs is putting safe care at risk. The BMA has reported on the pressures in General Practice. But some posters on Gransnet prefer to complain than actually have any real understanding of the pressures GPs are working under and to ask me, another Gransnetter, to provide a solution is ridiculous, just as it would be if I asked you to provide a solution. Whatever the solution is, it won’t come from me. Perhaps you can suggest how we can recruit more GPs. Complaining on social media and the constant negative headlines in The Telegraph or The Daily Mail isn’t going to make the job more appealing to young doctors just about to specialise. My own GP has left, she was made ill with the constant pressure from government and patients. She was replaced by another who has also left already. My Practice continues to look after me, even though I don’t have a named doctor now, and I consulted by phone with a GP today about an ongoing illness.

Delia, thank you for your lovely message. I understand completely that you are very happy in your present home and that your friends and neighbours are helpful and kind. Obviously I don’t know your age, but as you get older and need more hospital visits it may be an idea to consider a sheltered apartment nearer to the hospital. My mother moved into a sheltered apartment when she was ninety and was very happy there, with (pre Covid) a lot of social activities. However she’s now in a nursing home as she can no longer manage in her apartment. Carry on enjoying living in your lovely village, but do remember that there are other options available if it does become too difficult to access health care.

maddy with the greatest of respect instead of repeating the same thing over and over again why don’t you answer the question I have asked you several times. What is your solution to the difficulties that many posters are having in accessing healthcare? Solutions are needed not excuses. I just give up.

My surgery have just gone back to pre Covid method of booking appointments - early each day for emergency appointments and non urgent ones can be booked up to two weeks ahead again. They are still using phone consultations and I had a lovely conversation with a doctor this afternoon about my diagnosis of having a TIA. I was referred by my optician after she identified some problems in my right eye and was seen by the consultant ten days later. I am now on blood thinners. At the appointment my blood pressure was far too high and I requested the gp appointment to discuss that.

The lovely doctor wants me to see a nurse next week to get a base line bp ( he felt that a one off reading at the hospital when I was under a lot of stress needs more in depth investigation before changing my medication) He agreed that I should take my own bp machines ( an upper cuff one and a wrist one) to the nurse so we can check their accuracy and make sure I am using them correctly.

This doctor took his time to listen to all my questions, did not rush me and made me feel valued - I think I love him!

I’m so relieved it seems easier to get an appointment as it was almost impossible a few months ago.

maddyone, your point is taken, but in this lovely place we overcome our transport/NHS shortcomings by helping each other out. We are resilient and largely self-sufficient. Before covid we had a perfectly good GP service albeit in the next village, the least any community should expect, in my opinion, That’s no longer the case. The GP is still there but the service provided is minimal. Of course we don’t expect a hospital in our village, but access to decent primary care would be a welcome starting point.
Should all small communities migrate to the towns - I don’t think so. Our quality of life here is wonderful in so many ways & I wouldn’t like to spend my “old age” anywhere else, but thankyou for your thoughtful suggestion.
We consider ourselves very lucky. However, I have an observation to make about the provision of NHS services in many rural areas.

Gwyneth

Maddy Firstly I didn’t say that most GPS who are part time are woman. Secondly, I have read somewhere, sorry I can’t give chapter and verse, that again well over 60% of medical students who are accepted into med school are women. I don’t know the reason for this. Perhaps one solution may be to encourage and accept at least an equal ratio of male students who are prepared and able to work full time. I have not suggested in any way that women GPS should not be allowed to work part time. You have brought up the question of gender. But logically if you have a particular profession that has a higher ratio of one gender and that gender choose to work part time there is going to be a shortage. This would happen in any profession. The other question is as you yourself point out that it is mainly female GPS who work part time so what is the percentage of them who return full time after their children are in school full time. I think most people accept that the shortage of GPS is only going to worsen but something has to done and solutions have to be found.

Gwyneth
Do you have a problem with over 60% of medical students being women? Your comments about female doctors are coming across as rather old fashioned really as you appear to believe that female doctors shouldn’t really be working part time, and that too many female medical students are doctors. You query why female doctors cannot work full time once their children are at school. You may not be aware but children in this country start school at four years old. Are you seriously suggesting that a busy doctor, working full time, usually in an evening surgery until between 6pm and 7pm, can somehow manage to collect and care for her children at 3.30pm, or that four year olds do not need the care of a mother at least some days in the week. Many grandparents take on the childcare, collecting and feeding the children, we did this ourselves till our daughter emigrated, but most grandparents would not want to do this five days a week, plus full time care in school holidays, because they are getting older and get tired. And most doctor mothers do not want to abdicate all childcare of their children, leaving them in the care of others every evening and every school holiday. Perhaps they actually want to do some hands on parenting with their own children! Plus male doctors are often involved in childcare of their own children these days and so work part time, juggling the childcare with their wives and the grandparents. Men are involved with bringing up their children these days Gwyneth, no longer do they leave all that to the women as it probably was in your time as a young mother.

Additionally both male and female doctors work part time in the GP surgery for a myriad of reasons, including they sometimes work in the local hospital as well as a GP, they have an additional job in area management (my daughter did this, one day per week working on the provision and delivery of services across the South Eastern Corridor, and she was heavily involved in this role in setting up vaccination centres across the south east) they also choose to work in the out of hours services as my son in law did. Who do you think the doctor is who rings you back if you ring 111? Yes, it’s a local GP! Out of hours also includes home visits where necessary.Who do you think does that? Yes, it’s a local GP! My son in law also worked in the local Covid Hub. He worked many hours there in addition to his not quite full time commitment in his GP surgery. In fact he usually worked appropriately 60 hours a week, at the surgery, at the Covid Cub, and doing out of hours services. But his patients might have said ‘Oh Dr M only works part time.’ But he did 60 hours a week delivering GP services in a variety of situations. So when you complain about part time GPs, perhaps you should have a think about why they may appear to be part time in your surgery. And instead of complaining think about what you’re saying, because in actual fact, you don’t know where your GPs are, or what they’re doing, when they’re not working in your surgery.

One place they are not, is on the golf course!

MerylStreep

I phoned this morning at 9. Asked to see a doctor, told her what’s wrong; I’ll be seeing a doctor at 1.40 this afternoon.
Can’t knock that.

From my post above you will see that I was at the Drs at 1.40 ( Wednesday) from there I was sent to the hospital from where I didn’t get home until midday Thursday.
I told my doctor that if I was younger I would have his babies ?

Delila I’m sorry to hear that it’s difficult for you to access health care, but since you live in a village some ten miles away from the hospital, and fourteen miles from a vaccination centre, with no buses, and from what you say, possibly no car, you really need to consider whether living in an isolated village is the right place for you to be as you get older. Older people need services, and if they’re not in your village, perhaps a move to a sheltered apartment in a town near the hospital would be a wise move. Hospitals, vaccination centres, and GP surgeries are not going to be built in isolated villages.

We have a GP in the next village, but he will rarely see a patient face to face these days. There is no walk-in centre at all, the nearest A&E is 10 miles away, & we have to travel 14 miles for a ‘flu/covid jab. Our village has no bus service & many people have no car. There is a limited & expensive volunteer car service available, which has to be booked in advance, not always possible in an emergency. Ambulances have a long journey to get here and we often have to rely on an air ambulance (thank goodness for that wonderful service). Many of us are feeling that the NHS no longer exists for us.

Bea65

Josianne I record GPs behind closed doors as find it interesting especially the Hall Green Centre (live in same city) it enlightens/educates and amuses/irritates in equal parts as, the services they seem to offer their patients are far better than my present surgery ..perhaps it allocation of monies from different Health Trusts.

Yes all the patients seem to get referred very promptly, in fact the doctors are often filmed on the phone to the hospital departments during the consultation! I think it is because it is going on national TV.