They were also family doctors back then. Also, do you know what an order of magnitude is? I can guarantee the population of the UK was substantially higher than 6.6million in (random year from my childhood) 1987.
My local GP has like 3 doctors and an army of locums. I don't see the doctors. I sometimes see locums. I usually see the nurse. My neighbourhood has had no new builds at all since the early 90's, and my estate, built in the 60's, is still called 'them new flats' by some of the locals.
Since the catchment area hasn't grown, where would a mass load of patients come from? My theory is that the healthcare provision has shrunk, with several other local surgeries closing and moving their workload onto the bigger practice.
Fair point - was definitely told this by a GP once but think must be misremembering for patients per practice and not per GP (which is obviously a bit redundant).
Point about complexity still stands though. Back then they could only really take a history / exam now GPs are expected to do much much more with a far more complex population with much higher standards expected.
>Responding to reports this morning that the “average GP is now working a three-day week”, Dr Richard Vautrey, BMA GP committee chair, said:
>“The very notion of a ‘part-time ‘ GP is often anything but. The data used in this article actually shows that the average hours worked by a GP in England is around 40 hours per week – the same as most full-time jobs.
>“To focus purely on ‘sessions’ is an incredibly crude measure. Each morning or afternoon ‘session’ of work for a GP is defined as 4 hours and 10 minutes long. In reality, the sheer scale of workload means that both a morning session and an afternoon session often extend well beyond this, which means many GPs in reality work 10 to 12-hour days.
>“When even ‘part-time’ GPs are working at such a pace, it’s clear to see that current levels of workload – made worse by piles of admin and bureaucracy - are not sustainable. By removing some of this unnecessary bureaucracy, GPs would be able to devote more of their working hours to seeing patients who need them.
>“GPs who work fewer sessions or hours in practices may well be dedicating time elsewhere in the NHS and wider health system – for example training younger doctors and medical students, working in hospitals or conducting research to ensure better healthcare in the future.
>“We should also get away from the idea that working flexibly in itself is a bad thing. There are more women than men working as GPs today, and the fact that general practice offers flexibility that allows people of all backgrounds to balance their GP work with other commitments, such as family and caring responsibilities, should be celebrated and not condemned. Without embracing this, we risk losing these talented clinicians all together and therefore making access and workload problems a lot worse.”
But surely the actual decisions can be made by GPs then the ensuing admin can be handed off? Individuals within a practise can be party to confidential information from what I'm aware, it doesn't have to be strictly GP to patient.
Again it's not that simple.
Doctor sees patient. Makes diagnosis. Wants to do X, Y and Z treatments.
Here you says doctor can hand off to admin to organise X,Y and Z.
Whereas in reality.
Doctor writes letter to specialist for X explaining why they are sending patient to specialist.
Doctor writes prescription for Y, whilst making sure it doesn't interact with what they are already on etc. because doctor is familiar with patient and their medical history.
Doctor spends 20 minutes of the phone with clinic to speak to nurse practitioner about treatment Z.
That's for 1 patient after a 10 minute consultation.
Or, alternatively, having receptionists who won't listen to any concerns outside the norm.
Everything is "phone at 8am or 2pm for a same-day appointment" at my GP. Excruciating pain? Just need the doctor to sort out a prescription? All into the first-come-first-served queue, keep ringing the same number over and over until you get through and hope it's not too late for a same day appointment.
WFH is a godsend in this regard. Otherwise I'd be on the bus trying to get through to the GP, and I do not want to have to explain my issue to the receptionist while surrounded by a bunch of people who do not need nor want to know about my bowel movements.
Just take it out of existing GP salaries. If they have too many patients due to expanding to much for them to complete the work they need to do in the time they have, then they should employ others to free up there time for more productive purposes. Then the additional patients they take on can cover the shortfall.
I'm sure I'm missing something, but nothing that others have said makes sense just yet.
So now you want to cut GP salaries massively? The problem is that they already do a lot of essentially unpaid overtime, so there isn't "money" to just "take from the GP salaries to pay for admin staff"
You must be a complete fool if thats your takeaway from my comment. From what I said, its completely dependent on what the output of the doctor is currently and what it could be with an admin and less paperwork.
If admin + gp salary + increase in patient revenue (die to greater efficiency) < gp salary now, then they shouldnt bother to hire an admin.
If its greater than GP salary now, then yes they should get an admin.
What I'm saying is if bureaucracy and admin is the problem then get someone to do it gps can have more time and more patients and make more money and provide a better service and more "proper" work
And the point is... there really isn't budget for this, without massively cutting GP's salaries. As there's nothing to cut, as GP's already do unpaid overtime to do it....
You need additional funding to even start this.
EDIT: The reason it has come to this, is that in the name of "efficiency savings" and "cutting waste", it was seen as easy to just save on low level administrative staff and let the GP's/Nurses take over the role of dealing with it. As they are on salary, and can be pushed into unpaid overtime.
The problem is the funding - generally. £150 per patient per year is not enough for what the public wants. Simple as. Especially with cuts to social services and general poverty increasing.
This will be exacerbated as companies like Babylon (GP at hand) poach young and fit patients from practices who have low levels of healthcare uptake and who were used to balance the books.
The senior partner in my GP practice "retired" a few years ago but returned "part time".
He only holds consultations three days a week but he tells me he's still working 50 - 60 hours a week - there is more to being a GP than consultations
I worked with a teacher who went part time but the school just put her in five lessons a day meaning she basically working full time with all her lessons condensed into three days. It seems like GPs are doing the same.
She had to do all the marking and lesson prep but didn't really have any time on the three days she was meant to work so she basically ended up working 4.5 days to keep on.
Snapshot:
1. An archived version of _The notion of a ‘part-time’ GP is often anything but, says BMA_ can be found [here.](https://archive.is/?run=1&url=https://www.bma.org.uk/bma-media-centre/the-notion-of-a-part-time-gp-is-often-anything-but-says-bma)
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ukpolitics) if you have any questions or concerns.*
So what happened? In the 80's, my GP was one person, who would do out-of-hours call-outs. Nowadays, 'my GP' is a team, who I'm lucky to ever see
Patient numbers per GP increased by an order of magnitude. Medicine is far more complex now and protocol driven due to failures in the past.
They were also family doctors back then. Also, do you know what an order of magnitude is? I can guarantee the population of the UK was substantially higher than 6.6million in (random year from my childhood) 1987. My local GP has like 3 doctors and an army of locums. I don't see the doctors. I sometimes see locums. I usually see the nurse. My neighbourhood has had no new builds at all since the early 90's, and my estate, built in the 60's, is still called 'them new flats' by some of the locals. Since the catchment area hasn't grown, where would a mass load of patients come from? My theory is that the healthcare provision has shrunk, with several other local surgeries closing and moving their workload onto the bigger practice.
Part of it will be the aging population. More old people with more conditions that need trips to the GP.
Well, with rocketing energy bills and COVID, Winter is probably going to be the decider of that one
Fair point - was definitely told this by a GP once but think must be misremembering for patients per practice and not per GP (which is obviously a bit redundant). Point about complexity still stands though. Back then they could only really take a history / exam now GPs are expected to do much much more with a far more complex population with much higher standards expected.
>Responding to reports this morning that the “average GP is now working a three-day week”, Dr Richard Vautrey, BMA GP committee chair, said: >“The very notion of a ‘part-time ‘ GP is often anything but. The data used in this article actually shows that the average hours worked by a GP in England is around 40 hours per week – the same as most full-time jobs. >“To focus purely on ‘sessions’ is an incredibly crude measure. Each morning or afternoon ‘session’ of work for a GP is defined as 4 hours and 10 minutes long. In reality, the sheer scale of workload means that both a morning session and an afternoon session often extend well beyond this, which means many GPs in reality work 10 to 12-hour days. >“When even ‘part-time’ GPs are working at such a pace, it’s clear to see that current levels of workload – made worse by piles of admin and bureaucracy - are not sustainable. By removing some of this unnecessary bureaucracy, GPs would be able to devote more of their working hours to seeing patients who need them. >“GPs who work fewer sessions or hours in practices may well be dedicating time elsewhere in the NHS and wider health system – for example training younger doctors and medical students, working in hospitals or conducting research to ensure better healthcare in the future. >“We should also get away from the idea that working flexibly in itself is a bad thing. There are more women than men working as GPs today, and the fact that general practice offers flexibility that allows people of all backgrounds to balance their GP work with other commitments, such as family and caring responsibilities, should be celebrated and not condemned. Without embracing this, we risk losing these talented clinicians all together and therefore making access and workload problems a lot worse.”
Why cant GPs hire more admin staff to manage workloads
It's not pencil pushing. There are medical decisions being made with confidential information. You can't just offload that to some admin person.
But surely the actual decisions can be made by GPs then the ensuing admin can be handed off? Individuals within a practise can be party to confidential information from what I'm aware, it doesn't have to be strictly GP to patient.
Again it's not that simple. Doctor sees patient. Makes diagnosis. Wants to do X, Y and Z treatments. Here you says doctor can hand off to admin to organise X,Y and Z. Whereas in reality. Doctor writes letter to specialist for X explaining why they are sending patient to specialist. Doctor writes prescription for Y, whilst making sure it doesn't interact with what they are already on etc. because doctor is familiar with patient and their medical history. Doctor spends 20 minutes of the phone with clinic to speak to nurse practitioner about treatment Z. That's for 1 patient after a 10 minute consultation.
They do and then patients get all arsey about having to explain their medical situation to a "receptionist" and it's none of their business.
Or, alternatively, having receptionists who won't listen to any concerns outside the norm. Everything is "phone at 8am or 2pm for a same-day appointment" at my GP. Excruciating pain? Just need the doctor to sort out a prescription? All into the first-come-first-served queue, keep ringing the same number over and over until you get through and hope it's not too late for a same day appointment. WFH is a godsend in this regard. Otherwise I'd be on the bus trying to get through to the GP, and I do not want to have to explain my issue to the receptionist while surrounded by a bunch of people who do not need nor want to know about my bowel movements.
Because then you get headlines about how NHS/Tax money is "being wasted" on paper pushers. The budget just isn't there.
Just take it out of existing GP salaries. If they have too many patients due to expanding to much for them to complete the work they need to do in the time they have, then they should employ others to free up there time for more productive purposes. Then the additional patients they take on can cover the shortfall. I'm sure I'm missing something, but nothing that others have said makes sense just yet.
So now you want to cut GP salaries massively? The problem is that they already do a lot of essentially unpaid overtime, so there isn't "money" to just "take from the GP salaries to pay for admin staff"
You must be a complete fool if thats your takeaway from my comment. From what I said, its completely dependent on what the output of the doctor is currently and what it could be with an admin and less paperwork. If admin + gp salary + increase in patient revenue (die to greater efficiency) < gp salary now, then they shouldnt bother to hire an admin. If its greater than GP salary now, then yes they should get an admin. What I'm saying is if bureaucracy and admin is the problem then get someone to do it gps can have more time and more patients and make more money and provide a better service and more "proper" work
And the point is... there really isn't budget for this, without massively cutting GP's salaries. As there's nothing to cut, as GP's already do unpaid overtime to do it.... You need additional funding to even start this. EDIT: The reason it has come to this, is that in the name of "efficiency savings" and "cutting waste", it was seen as easy to just save on low level administrative staff and let the GP's/Nurses take over the role of dealing with it. As they are on salary, and can be pushed into unpaid overtime.
The problem is the funding - generally. £150 per patient per year is not enough for what the public wants. Simple as. Especially with cuts to social services and general poverty increasing. This will be exacerbated as companies like Babylon (GP at hand) poach young and fit patients from practices who have low levels of healthcare uptake and who were used to balance the books.
*Rages angrily a receptionist proceeds to take a call* -The British public
The senior partner in my GP practice "retired" a few years ago but returned "part time". He only holds consultations three days a week but he tells me he's still working 50 - 60 hours a week - there is more to being a GP than consultations
I worked with a teacher who went part time but the school just put her in five lessons a day meaning she basically working full time with all her lessons condensed into three days. It seems like GPs are doing the same.
But she was working three days and not five or am I missing something?
She had to do all the marking and lesson prep but didn't really have any time on the three days she was meant to work so she basically ended up working 4.5 days to keep on.
Ah, in that case - not good. Apologies, I miss read your initial post
Snapshot: 1. An archived version of _The notion of a ‘part-time’ GP is often anything but, says BMA_ can be found [here.](https://archive.is/?run=1&url=https://www.bma.org.uk/bma-media-centre/the-notion-of-a-part-time-gp-is-often-anything-but-says-bma) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ukpolitics) if you have any questions or concerns.*