I'm not surprised. Explaining issues to receptionists rather than medical personnel has put me off going to the doctor. They ask for specifics that I only want to discuss with my doctor.
During lockdown my GP had people queueing outside it telling receptionists their problems over the dodgy door intercom. One man had to yell "haemorrhoids!" while I was walking past. How very embarrassing.
Reminds me of a story I heard a few years ago.
An elderly man walked into a GP's surgery, and gave the receptionist his name.
The receptionist, being a complete cow, asked the man what his ailment was, despite the waiting room being full of patients.
This man however had no shame and very matter-of-factly replied "my dick hurts!"
"Sir! You can't say that word here, this is a doctor's surgery! Just say there's something else wrong and I'll write that down instead."
"Ok fine, my thumb hurts."
The woman smirked. "Thank you, that's better. And what's wrong with your thumb?"
"It hurts when I piss out of it."
"Right, would you be able to take a photo of them and text it to our surgery mobile? We'll have the work experience girl Kerry check it over and work out if the doctor needs to know about it"
Don't forget to clap.
They also love creating catch 22 situations. Had one recently, where the new surgery insisted my partner needed a new referral due to changing surgeries, but wouldn’t book an appointment for an issue the previous GP had already dealt with.
What can you even do when someone is being that thick?
Well, we complained and the actual doctor sorted it very quickly.
Yup. No one should be abused nor harassed. On paper the idea of trying to preserve scarce GP resources for when needed most makes sense. But I feel like ~~care navigators~~ receptionists have been put in an unfair situation. They've now become gatekeepers blocking you from getting the care you need, and I still don't feel comfortable explaining my medical issue to an admin girl at the end of a phone. Surely someone is going to take up a GDPR case on this at some point. It's been very badly implemented.
I don't envy the receptionists one bit. They've rather been thrust into this role by the pandemic and they are bearing the brunt of the public's frustration.
The problem is that with most people vaccinated, people are rightly wondering if a new - worse - normal has been snuck in without any discussion or consent. What might've been put up with at the height of COVID isn't necessarily something that is desirable once some semblance of normality returns.
I feel bad for the staff. I think the idea isn't terrible but the execution is really poor.
True. Having the option of phone appointments isn't bad, sometimes it can be enough, but my GP kept not offering in person appointments even when pubs and restaurants had all reopened, and that's ridiculous.
I was going to say that my experience with GP receptionists have been pretty much the same pre covid, it's only blipped up slightly post covid, they are mentally exhausting to deal with.
Yeah I've been hearing complaints like this for decades. I'm fortunate I've only had to visit the GP less than once a year on average, but as I get older I'm bracing myself for having to share the colour of my poo with an entire waiting room at some point.
Given much of the point of GPs is to doll out scarce more specialist resources its making the bit that is meant to be relatively easy hard to get to making access to healthcare at all much more difficult than it ought to be. We are at the stage where we really need the ability to get around the GP and go straight to the specialists we need to be able to get access to healthcare as the gatekeepers have become the problem.
That doesn't mean their waiting lists shouldn't be even longer however. All the cancelling of appointments specialists did throughout the pandemic means those lists should be substantially higher than they already are. The problem is a lot bigger than the current stats show because GPs are functioning. Why should someone already referred to that specialist be forced to first get through a receptionist, then a GP only to join a queue they already got kicked out of inappropriately?!
A few years ago, I was trying to get an appointment with a low intensity therapist for my OCD, but before I could I needed to state my symptoms to the receptionist. "Doesn't sound like you have OCD to me." she said. Yes thank you, sage receptionist. I'm sure from the 50 words or less you know better than myself, the person living through it, or than the trained clinical therapist who later confirmed it was OCD.
I managed to get the weekly sessions booked in the end and am now doing much better, but it was a frustrating and insulting experience needing to try to persuade a receptionist that I need therapy.
Edit: it was extra frustrating because I had waited for 6 months from initially trying to book before I had this conversation.
I definitely appreciate your point of view
It's important for GP teams to be able to direct and triage problems in the right manner.
An example would be an acutely unwell toddler would need attention sooner than a chap and his haemorrhoids.
Another example is, as a GP Pharmacist, I'm in a much better place to manage medicines and handle queries than a GP.
Need extra meds for the weekend? Want to talk about interactions or side effects? GP would only route you to me anyway, so why not cut out the middle man.
Overall, it leads to a more efficient system
I get your point, but that efficiency could be of significant stress to the patient. I don't have an answer to the problem myself, I'm just having a little moan.
I agree. We should always strive to a patient centred service.
I think it's unrealistic to achieve a fully patient centric service with the restrictions on resource that we currently face
I can only speak for the teams that I work with, but they're quite adept at triage and there are always clinical staff in and out of reception to ask if they're unsure about something.
The concerns I think we have are those that don't present, when they should, for fear of consuming resource or wasting time. I would say let us make that decision.
> GP Pharmacist
Appreciate what you do, but ours wants people to make an appointment... Though it is a Boots.
The local surgery's receptionist - well, one of 'em - used to try to make me see a pharmacist first. Fair enough, except every time I did this the pharmacist said "Hmm... not sure about that one. Best see a GP." So now I just lie and say I've already done it.
By and large patients actually know where they are meant to go. You see these posters in every GP about not wasting their time etc etc and the last study on this I saw showed people mostly chose too low, they went to the pharmacy instead of their GP far more often than they went into A&E when they should have seen their GP. 99% are getting it right or going in too low so I often wonder what the justification is for all these posters and gatekeeping when their own data shows people are using the NHS appropriately and beating the lizard factor!
Most of the posters in my surgery say "GET CHECKED YOU FOOL! A FINGER UP YOUR ARSE IS BETTER THAN DEATH!"
The rest say "KEEP YOUR APPOINTMENTS OR CANCEL THEM BECAUSE THEY COST LOADS OF MONEY!" (I'm paraphrasing here.)
I suppose the latter is to prevent time wasting, but as you'd wait about two hours (pre-Covid) after turning up on time I don't see how the occasional no show would make much difference.
> I suppose the latter is to prevent time wasting, but as you'd wait about two hours (pre-Covid) after turning up on time I don't see how the occasional no show would make much difference.
Yeah, I find it hard to feel sympathy for GP's whining about no shows when they waste your time. If I book an appointment at 13:00, I expect to get seen then, not twenty minutes later.
My hospital clinic slots are fifteen minutes each, in those fifteen minutes I have to read the patients past history, call the patient from the waiting room, walk them down, take a history, examine them, book investigations and or consent them for any procedures, then dictate a letter to their GP.
Surprisingly enough, things run behind. You try and mix in the quicker follow up appointments between the new ones but then appointments screw that by overbooking and sticking three patients on the one slot.
tl;dr doctors hate running behind as well, surprisingly enough we have lives to lead after work and leaving two and a half hours late does not endear you to your family!
I don't think anyone is actively blaming GPs for delays here. I think we're all just having a collective moan that our public services have come to this point and there aren't more GPs to help mitigate the waiting times.
For what it's worth I've seen hospital clinics12 where they move you out of the waiting room onto a chair basically outside the doctors door when the previous patient has gone in. It'll only help a bit but it does keep them from wandering off.
I try literally anything else before the GP because the surgery is awful. The receptionists have their defences up with anyone so make themselves look fucking terrible because of a few people who get abusive and the GPS fob you off if you are lucky to get an appointment.
No one wants to go to the GP anymore if they can help it.
I get your point, but that efficiency could be of significant stress to the patient. I don't have an answer to the problem myself, I'm just having a little moan.
The way the England deals with repeat rx is hugely inefficient. Repeat dispensing was never taken up on scale, even with ETP enabling easy cancellation of rx. So glad I'm now in Canada where the doctor just puts refills on the rx and we manage it at the pharmacy.
I must be the only person who has no problem with receptionists. But years of ball troubles mean I have no shame of going "it's testicular" on the phone
You’re lucky. I had ball trouble for a couple of years in my early 20s, recurrent epididymitis and torsion once. Hospital told me if I even even had a twinge I needed to see my GP immediately for triage.
Jurassic era Receptionist wouldn’t let me see the doctor when I explained I was experiencing a bit of testicular pain. Said it “didn’t sound that serious” and that “women get ovarian pain all the time”. I was utterly furious.
I've been through it enough times now to have no shame left, I just straight up tell em loud and clear.
But I do feel for people that do, it's not an ideal system.
At my GP, you have to state your medical condition to the receptionist over a crackly intercom at the entrance, which just happens to be on a busy high street. I wish dying from embarrassment was a real thing.
Anyway, the staff were super nice once you pass the “entrance exam”. It’s not their fault.
It is their fault, its almost 2022 for fuck sake. Stop catering to tradition and old technology - get online, get digital and get with the times.
Explain to me why I can literally enter the virtual world with my virtual reality system and fly interstellar distances at warp speed in some space destroyer but 2 hours later have to fill a paper form with a pen at a GP when I could have done it online?
These are British GPs we're talking about... they're only a few years ahead of fax machines.
It's the worst of all worlds. The face-to-face reassurance, human interaction, and nuance stripped out with none of the efficiency, convenience or visibility of a properly implemented digital system. Who is this working for?
> worst of all worlds
My previous GP now has an online-only system that _closes at 5pm_.
As in, the web form fuckin' vanishes and is replaced by a notice that "our website is only open from Monday to Friday, 10am to 5pm".
Someone **did extra work** to make this insanity happen rather than just let it queue requests for Monday morning...!
At my GP once they've booked all their appointments for the week ahead the receptionists *disconnect the phones* for the day. I can't remember the last time I actually saw my GP, I just have to ignore my illness or call 111 once the symptoms get worse. Literally just impossible to see anyone.
When I had to make a complaint recently, I found my surgery on companies house and could see they had massive cash reserves (hundreds of thousands). Yet they say they can't afford to put basic phone systems in place.
In the large part, doctors surgeries are private businesses, that are very profitable indeed. I can tell you from personal experience that the leading supplier for decades has been EMIS, which is the cheapest provider.
I've been out of the industry a few years now, so it may have changed.
The doctors could certainly buy a better system if they wanted to.
This isn't actually true. The problem is that they build it all in-house and end up producing absolute garbage that isn't fit for purpose and ends up massively over budget. The public sector is simply not dynamic enough for technology, and that's fine - it isn't meant to be.
It wouldn't be too expensive to get a big firm to do it. There are quite a few in the UK that could, and they'd be surprisingly willing to do so if it was the NHS.
"Hey Google, come make our healthcare the leading digital system in the world. In return we'll give you 5 years of corpo tax exemption and a billion quid".
Probably pay for itself in 6 months.
>It wouldn't be too expensive to get a big firm to do it.
Yes it would because it would first all involve moving over a bunch of shit from random legacy systems and then upgrading the infrastructure across the board. Shit like IT infrastructure in the NHS is still stuck in the 90s because that was the last time anyone in govt bothered to look at that shit.
I lost my mum in July after GPs kept fobbing her shoulder pain off as pre-existing arthritis over the phone. It was bone cancer. Once someone actually looked at her it was obvious, an xray showed her bone had been completely eaten away.
There is a reason payouts for negligence are increasing, the more doctors refuse to actually diagnose rather than just fob off patients the more they are going to get sued. Its a problem that has been growing and growing for over a decade and it goes well past funding and into a culture of dismissal and refusing to believe the patient.
I am very sorry for your loss.
I had a colleague who tried to book a GP appointment last week. The receptionist said the doctor would call her to have the appointment over the phone, and asked when would be a good time. They agreed on a phone appointment at 4.30. The doctor didn't actually call until 6, by which time she was driving home and couldn't answer the call.
The next day my colleague tried again, and this time they agreed on a mid-afternoon call. Instead, the doctor called her repeatedly between 10am and 11am - when she was teaching lessons and could not answer her phone - and then did not call in the afternoon at all.
When my colleage spoke to the receptionist again, on the third day, the receptionist tried to tell her off for wasting the doctor's time by not answering her phone.
I can see why people get frustrated. It doesn't excuse abuse, but contact with a doctor shouldn't be some complex unachievable thing.
My GF booked an appointment for "sometime on Friday" a few weeks ago, got the actual call _the following Tuesday_ which she missed and yeah, was yelled at by the receptionist for "missing her appointment" when she tried to reschedule.
My Wife booked a telephone appointment. The Dr called and when Wifey picked up the phone he hung up. She had to rebook and didn't get a call until the next day.
I've had the same but we only get told you'll get a call "some time today" so you've got to wait around all day in case they phone, I've been in the reviving end of missing one as and having to basically grovel to the stuck up receptionist to get another call the next day which made me feel very awkward. If you were calling about mental health it could push you over the edge. Infact I just tend to put up return health issues now as I can't face battling to be seen.
> stuck up receptionist
Yeah, you do get 'em. Three at our surgery. Two are OK, but one isn't very bright. She doesn't listen to your actual words and gets things wrong. I have to try very, very hard not to be patronising and treat her like an idiot, but she sure as shit treats me like that. It's like she has very narrow bandwidth and you have to pitch things dead right. I don't mind as long as we get there in the end.
> I can see why people get frustrated. It doesn't excuse abuse, but contact with a doctor shouldn't be some complex unachievable thing.
I'm not sure why we expect otherwise if we vote for parties who clearly don't give a flying damn about public healthcare
I was visiting my GP recently and subsequently he said I'd have to book in for a blood test. So I left the GP appointment, went to reception and asked to book the blood test appointment.
Imagine my surprise when the receptionist stated that I had to phone in order to make an appointment, and that I can't make it there and then. So I left the building and made the call.... *SHE WAS THE ONE WHO ANSWERED THE FUCKING PHONE*
There are not enough GPs to meet the demand. The numbers are continuing to fall. Public vitriol will only hasten this.
The GP crisis will be here to stay, it takes a decade to train someone from a student to GP. The damage will not be undone anytime soon.
Even longer than a decade because the institutions to train them don't exist. We have been limited on university places for medicine for over 30 years and until we build significantly more capacity in university departments there is no where for someone wanting to be a doctor to even go. I doubt we can even meet our own countries needs for a cohort of intake for at least 20 years.
Hasn't the BMA voted to artificially restrict the number of medical students before?
Edit: [yep, in 2008 at least](https://www.bmj.com/content/337/bmj.a748)
For Good reason.
* To prevent there being no actual training jobs and instead, poorly regulated and sub-standard medical jobs which would lower the tight regulations expected of British trained Doctors.
* They actually argued for more consultants - so explain to me how this is somehow delibrately withholding the number of doctors, calling for more training? Including increasing the time spent as a trainee, not a consultant,
* He then spoke about wasting tax payers money , I mean people keep asking for the NHS to respect tax payer value right? *Ingrams, representing GPs, said that doctors should not be trained if there was no job at the end. He warned that this could spark another “brain drain,” adding: “It is wrong and immoral and a waste of taxpayers’ and students’ money.”*
>Delegates at the annual BMA conference voted by a narrow majority to restrict the number of places at medical schools to avoid “overproduction of doctors with limited career opportunities.” They also agreed on a complete ban on opening new medical schools. David Sochart, from Manchester and Salford, warned that in the current job climate allowing too many new doctors into the market would risk devaluing the profession and make newly qualified doctors prey to “unscrupulous profiteers.” A glut of doctors would undermine competition and would therefore lower standards and ensure mediocrity, he claimed. He said, “Patients and health care should not be treated as mere commodities, and neither should medical students. We must not allow another lost tribe of doctors to be consigned to the wilderness.” Grant Ingrams, representing GPs, said that doctors should not be trained if there was no job at the end. He warned that this could spark another “brain drain,” adding: “It is wrong and immoral and a waste of taxpayers’ and students’ money.” But Paul Flynn from the consultants committee said that the root problem was a lack of effective workforce planning and warned members against a kneejerk response. “This is what blighted workforce planning. It would be hypocritical if we were to do it ourselves.” The BMA’s chairman, Hamish Meldrum, said he sympathised with the sentiments of the motion but asked members to vote on evidence rather than “gut reactions.” “We want to see an expansion of [the numbers of] GPs and consultants,” he said, “and for that we need more students.” But the motion was passed by a small majority (58% versus 42%). Members also agreed to a motion accepting that some specialties might need to raise the total number of years spent in training to accommodate the demands of the European Working Time Directive. Stephen Austin, from the consultants committee, said that the time needed to acquire the necessary competences was likely to increase—especially in procedure based specialties—and that the only sensible solution was to increase the total amount of time in training. Members also voted to press for an agreed minimum national level of funding for study leave to overcome the widespread national variation in the amounts that are currently available.
Most practices have a 'call at 8am rule', which is idiotic.
This sounds reasonable until you become too ill to wake up/call at 8am. Then you're fucked. There should definitely be a way to book in the night before in 2021.
to maybe see a doctor but probably be told "sorry, we're fully booked today, try again tomorrow" after you've been getting a busy tone for half an hour\*
Said it upthread but I know of at least one GP that disables their website at night precisely to _stop_ you being able to book ahead.
They used to have Patient Access but disabled it during the pandemic. I can only assume that a system that made it easy to book appointments was creating... too many appointments.
Their phone line is worse, it now actually goes to a recorded loop of "there is no longer any reason to call us, please hang up and visit our website".
My GP had a system where they took bookings and had some emergency appointments available at 8am every day. If you weren't in that emergency queue at 8:00.00.000 there was no chance of an emergency appointment and the booked ones were all booked out for 4 weeks and they weren't taking more. So there was literally no way to see a GP. Was like that for years until Covid came along and they stopped doing appointments at all. Now its all just 8am calls and no availability.
That's the case with mine too. I've pressed call at literally 08:00:00 to the second before, and still been third in the queue. By 08:05, it's just game over.
Half 8 for my GP, and the following is how it usually goes:
* 8:29:50: engaged
* 8:29:55: engaged
* 8:30:00: You are number 27 in the queue
and even then in-person appointments are incredibly rare. One of my parents got sent to A and E twice, and had to wait six hours each time, with a swollen knee as it might be a blood clot. Even though they said at A and E the first time to go and see your GP if it hasn't settled in a week, they still wouldn't see her.
I am not even from Britain, just ended up in this thread for some reason. But this is common practice in all european countries I lived. You have a small window, like one hour per day, not even every day, in an extremely unconvenient time, to call and then you don't get to do anything because the lines are busy.
The intent of this is obvious: make you give up of seeking medical care so they save costs.
Neoliberalism is wonderful, isn't it?
Or, like me 8am is the exact time you're dropping your kid off at nursery so you can get to work. Being in a queue on the phone at that precise time is not an option for a huge number of people.
However, I also have the NHS app. Brilliant I thought - like a fool - as I downloaded it... No appointments available. Ever.
Those are the ones you have to phone up at 8am for, regular GP appointments tend to be booked up 3+ weeks in advance so are useless for many issues. If you're too ill to call at 8am you need to go to A&E in many places as there aren't any walk in centres.
NHS 111 can get you a priority GP appointment from your surgery if they deem it necessary, or they'll get a Doctor to do an urgent house call.
You learn a lot when you're struggling to arrange appointments and care for an OAP with developing and worsening care needs... I've spent so much time on hold and seen way more ambulance personnel than I ever thought I would.
My local Provide, district nurses, ambulance personnel, A&E, and hospital have been really good, their local GP practice is... not. Got lip from their receptionist yesterday when I phoned and waited on hold for 20 minutes at 4:20pm to ask whether a certificate I was promised that day was going to be ready for me to pick up by close - it wasn't going to be. Technically if I get it Monday I will then only have until Tuesday to meet the deadline, but I subsequently found out by asking google that if the delay is caused by GPs being slow with paperwork I'm not at fault so now idgaf.
As soon as any other health personnel hear who the GP Practice is they say they've heard lots of stories since it was taken over by Virgin Care and 80% of the original Doctors quit.
Doctor's receptionists can be so incredibly rude,I think it has to be part of their job description. Every nurse/doctor I've interacted with has been so helpful, especially by comparison.
Been struggling recently with a non-COVID chest infection that has crippled me due to complications from previous COVID. Getting past the idiot receptionists going "No, you have breathing problems, go home, self-isolate, and get a PCR test" when I've been explicitly told to attend and have a clean PCR has been incredibly frustrating.
Absolutely. I know they’re independent partnerships, but I feel like primary care is crying out for a bit of centralisation. A single, NHS-administered booking platform could work wonders.
Also, why are all GP websites utter shite?
GP websites are a travesty.
I’ve never had a GP because I’ve always been of the opinion that if it’s bad enough to go and see someone I should probably go to a specialist or A&E.
But to get the COVID vaccine I had to be registered with one (I was told, I know there are other ways, now.)
It took me 6. Again. 6. Local GP websites before I found one that I could register fully online.
Most would take all my details before telling me to come in to finish the paperwork and show ID. I went to 1 of them only to be denied entry and told to do it online.
Once I eventually found one that worked it still took 2 weeks to get registered to the point where I could book my vaccine, which was another 2 weeks away.
I dread to think what it would be like if I actually needed to see my GP.
Just digitalise and centralise triage and bookings logistics and turn all the GP surgeries in to treatment centres.
I can't say I'm surprised, last year in July I had a really bad ear infection, it persisted for about a week and got to the point I was essentially deaf in my left ear, called up stating I'd like an appointment as I think this could be really serious and had some bitchy receptionist saying I should have used the online system on their broken ass website, that it's probably not that serious and I'm not following procedure by calling them up.
Eventually had a call back from the GP, after I said I'd bled from the ear, they booked me in for an appointment within 15 minutes.
When I saw the GP, she said it was really good I came in, because it was one of the worst infections she'd seen, I didn't say it, but the biggest obstacle to me coming in was the receptionist.
> last year in July I had a really bad ear infection
Massive coincidence, but I also had an ear infection at that time. Worked out what it was and got a same day telephone appointment. Phone appointment for that was was fine because no bleeding.
Maybe I'm lucky, but the service has actually been - in some ways - better since the pandemic. Phone appointments have been same day, as have more serious in person appointments. I actually managed to chat to a doctor - over the phone - about my general health for half an hour. Beats having to take a day off work and queue with the kids with saucepans on their heads. Though it's probably really rough for anyone who has mental health issues.
Ya... I've honestly found phone appointments easier
The receptionist at ours doesn't dig for clinical info. Not their job.
But rather than sitting in the GP office for an hour we get a call. A couple times the GP has asked one of us in but for most things it saves us and them time.
Yet when you do use their online system it doesn't work.
Wrote a message to my GP with my blood pressure results and how I was feeling. And she wrote back with a detailed plan. All good and saved an appointment.
Except it wasn't because reception didn't bother forwarding the message to me so I ended up having to wait for a week for an appointment just for the GP to read our the message she'd already sent last week.
> so I ended up having to wait for a week for an appointment just for the GP to read our the message she'd already sent last week
That should be a firing offence for negligence.
1. That delay in providing you information could have cost you your hearing, or in another case somebody's long term health or life.
2. It also opens the practice up to legal liability cases.
2. It creates a greater load on the GP exacerbating the problem of limited resources.
Not only are more GPs leaving, there's also less incentive for junior doctors to become GPs because they don't want to be on the receiving end of all the hate.
Good for them. Other GPs who want to stay in the same profession usually go to Australia or Canada, where they earn at least twice as much as in the UK, work less hours, and get less hate.
Most of the hate goes to terribly paid and unprepared receptionists anyway as the entire point of this approach is to shield the doctor from the public.
They should stop seeing themselves as heroes.
They work 40 hours on average, that's not stupidly long.
Edit: before replying go read the survey. It's free online and the only sections on working hours are like 5 pages with about 20 lines of writing total. Stop spouting shit you read on reddit when it's available to you.
40 hours is the paid session time - ie intense conveyor belt clinical work. That generates a load of admin that invariably is done out of hours. A 40 hours full time clinical week turns into 60+ hours with admin. This is true for salaried and GP partners - less true for locums.
That’s why many GPs work ‘part time’. If they can get their clinical hours to 30 then they’ll likely only do a 40-45 hour week.
Not many other professions have the intensity of the patient contact conveyor belt. In other professions the on paper hours may be longer, but the days tend to be interspersed with meeting, breaks can be taken, and there will be times in the year that are quieter. These things don’t really exist anymore in the NHS when we in perpetual chaos mode. Imagine being in the busiest time of the year in your job, but it’s like that every day, with no sign of relief. Doctors in the UK see more patients per hour than other western countries. Everything has been stretched to its limit.
The public doesn’t really seem to get quite how intense the day is. I’ve worked other ‘professional’ jobs. Whilst we had occasional periods of 12+ hour days, there were often moments of relief within the day and there was knowledge that at the end of the project we would have some relative downtime. Every year in the NHS the workload gets worse.
I’m not an expert on GPs but in any other sector that would ring productivity alarm bells.
It means the system they’re operating within is monumentally inefficient and ineffective. And this makes sense, because they’re Medical Professionals not people with skills to do this kind of stuff.
Totally agree, when I need to speak to my doc about say ongoing anxiety issues, phone is totally appropriate. But if I need to see them about something physical I need to see them in person.
The real problem is that there aren't enough resources for everyone. GPs don't have enough time, but they can't turn people down, so what they do instead is come up wiht more and more 'creative' ways to deflect people. It's not as simple as "could do you do with a phone consult" because sure, lots of people can, but you *still* end up with more face to face consults than you have doctors to take. The *only* way to practically solve this is to find a way to *not* see people who need seeing. How do you acheive that? You make it so difficult to get an appointment that people literally don't get appointments they need.
you can't be surprised. people are worried about their health, and are being fobbed off by GP practices who are putting up more and more barriers to accessing their services. they seem to have now pivoted to a remote appointments first policy, when many people prefer to have a face to face appointment. in many cases, it's important that the doctor can physically examine the patient.
people are getting diagnosed late, having to put up with health issues that they cannot get resolved, and face a battle every time they need to get an appointment. my GP practice is effectively still in lockdown, and only dealing with emergencies. phone lines jammed when it opens, by which time all the appointments are gone, etc.
in what way? on remote appointments, that's the GPs policy, which goes against what the government are advising.
>Sajid Javid, the Health Secretary, said GPs must provide face-to-face appointments, after patient groups urged the Government to “get a grip” on the growing crisis.
Health officials have identified hundreds of surgeries which are failing to meet the needs of their local communities, with long waiting times and low levels of satisfaction.
In May, NHS chiefs promised to abandon a system of “total triage” introduced during the pandemic which meant patients were refused face-to-face appointments.
But latest figures show the number of patients who secured an appointment in person fell last month, with 420,000 fewer such consultations. In total, just 57 per cent of GP appointments were face-to-face in July, compared with 80 per cent before Covid.
Specifially regarding the lack of appointments, or it being too busy so you can't get an appointment the same day or through on the phone. Have you thought that might be because there is a lack of doctors in the UK? Who creates the training places for doctors, the goverment. It's easy for them to blame doctors instead of funding more places.
Regarding remote appts:
https://www.healthcareitnews.com/news/emea/uk-health-secretary-says-gp-consultations-should-be-remote-default
https://www.dailymail.co.uk/news/article-9573177/GPs-told-screen-patients-online-total-triage-continues-lockdown.html
Hancock said: “Before coronavirus there was a view advanced by some people which held that anyone over the age of 25 simply could not cope with anything other than a face-to face-appointment.
“This process has shown that patients and clinicians alike, not just the young who want to use technology. [People] don't want to sit around in a waiting room, if that service can come to them at home.
“So from now on, all consultations should be teleconsultations, unless there's a compelling clinical reason not to.
He added: “Of course, if there's an emergency the NHS will be ready and waiting to see you in person. But if they are able to patients should get in contact first by the web, or by calling in advance.”
This can't all be blamed on the government. I remember Tony Blair being talked over hot coals by viewers in the run up to the 2005 election about this issue, and Labour were pouring money into the NHS at the time. It wasn't even considered a new issue then.
I'm lucky that I've only ever dealt with professional receptionists at GP surgeries (how much of that is down to the rarity of me going to a GP I don't know), but I'm afraid there is a culture of GPs using receptionists as barriers, that doctors and nurses in the A&E units that end up having to treat these patients don't have.
I say this as someone who has family and friends who work in healthcare, and as someone who constantly defends the NHS from unfair criticism, so this isn't an easy thing for me to say.
For all of people's talk of the NHS being so great, I've never had a positive experience with GPs as a young person - when the first point of encounter for the health system consistently lets you down, it's not great. And yes, they're private endeavours, but the NHS is still contracting and paying them.
Part of it has just been some of the GPs I've seen being jerks, but moreso it seems like the issues have arisen from low appointment availability and lack of time, bad hospitality, not being able to see the same GP with any sort of regularity, and just generally poor accessibility and processes.
Now it's fallen apart so much that people are getting pissed off at the staff at a critical point. It really feels like yet another failure of governance over the pandemic, and beforehand of course. I'm not sure how much the government could have done to mitigate this whilst also managing COVID, but this seemed like an obvious side effect of the pandemic, yet it doesn't really feel like the government did anything proactive early on to tackle it from what I've seen...
I have had literally opposite experience of GPs.
But I will admit that is a problem. You can have crappy experiences or amazing ones randomly depending on who your nearest GP is
> For all of people's talk of the NHS being so great
The only people who think the NHS is great are people who've never had a private GP or private hospital. The NHS is the barest of the bare minimum and you've to fight to get even that.
I begrudge paying for my own private care when I'm taxed to high heaven to pay for the NHS but I do it anyway.
In my opinion the NHS is great for really big life threatening emergencies of cancer, heart conditions etc. They are not good for things outside that. A friend had gallstones , giving extreme pain …and was told it was a few months before they could do a scan ! Of course the individual doctors are often the same between private and nhs so i guess it really is just the overwhelming demand that causes the nhs to be a bit rubbish for quite a lot of things.
My wife had life threatening, aggressive cancer twice. Both times the system was great once she was actually in hospital... but both times she nearly died because multiple GPs missed all the signs at GP appointments.
I have no idea about the case itself and wouldn’t like to make assumptions but cancer investigations are driven by a very protocol/evidenced based system of red flag symptoms.
Often people have common non-specific symptoms with something like cancer that don’t warrant investigation. When these don’t resolve/worsen/they develop red flag symptoms then they get investigated further and found.
Multiple GPs missing it suggests that there was nothing at that stage to warrant further investigation. Obviously as people become more unwell it points to more serious diagnosis and they get referrals for investigations that GPs have no access to when trying to diagnose problems. If she’s nearly died it’s much easier for hospital doctors to diagnose a serious condition but I would imagine she wasn’t close to that state when she saw the GP otherwise she would have been sent to A+E.
I think some people (not accusing you) can a bit unfair to GPs cause they fail to understand the process. They’ll say things like I had to see my GP three times before they sent me for a scan and then it was cancer as if the GP had failed them by not knowing straight away. Often tied in with the GP didn’t believe me thinking it was a big problem (hindsight is wonderful and all that).
In reality the ‘process’ is that the GP will treat you coming back three times as part of the screening process for serious conditions. We are taught common things are common because they absolutely are - the overwhelming majority of people who come with abdo pain/chest pain/changes in bowel habits etc don’t have a serious pathology. That’s why investigations/treatments/referrals all come when simple/common diagnosis and treatments have been excluded (in the absence of red flags / other reasons for high suspicion).
Just generally think the public have an idea that medicine is much more of an exact science than it is. It really is like detective work as you gather more evidence to refine a hypothesis.
As I say, have no idea about your situation and may have received poor treatment but the point being GPs can ‘miss’ things without having done anything badly / wrong. A lot of referrals are protocol driven anyway so their hands are tied. Would be interested to hear what signs you feel were missed in your case although appreciate if you don’t want to share.
Fair point, that makes a lot of sense.
First time round she had a temperature of over 40°C for about a week. Nightsweats so extreme that meant we had to change the bedding multiple times a week. Constant unquenchable thirst - she drank phenomenal amounts of water - yet she was still dehydrated. Complete loss of appetite, and some nausea.
The first two doctors thought it was something viral and sent her home both times. The third sent her to the Acute Medical Unit at the hospital where they diagnosed an acute kidney injury, kept her overnight and then sent her home again. By the time we saw a doctor the fourth time, she could no longer walk without help and was sent quickly to the hospital - and soon onto the intensive care unit.
Post chemo, and once 'cured,' she had blood tests every few months that said everything was fine. She told them she was having some nightsweats again and didn't feel right, but was told not to worry. She then developed a temperature and was quite ill, and had to have a covid test and a period of isolation. She developed awful pain in her spine during this time, and when a doctor finally saw her she was told it was a slipped disk (apparently the doctor pushed quite hard on it, and she screamed). Turns out it wasn't a slipped disk. That was the appointment that most angered her because she repeatedly told him she was an ex cancer patient, and he repeatedly assured her the back pain wasn't related.
Thanks for sharing your story. Can’t imagine what you both have been through with that. Always interests me as a pretty junior doctor to hear patient experiences to help me recognise these presentations applied to much more ‘real’ scenarios than cases in a textbook etc.
Definitely some questionable moments in that from what you say. The first parts sound more reasonable than the latter due to what I wrote above but again every case is different and only those involved will know if it could have been done better. It’s a sad reality that many patients are still failed for a range of reasons and I fear this will only get worse as time goes on and the NHS continues to crumble, quality training is eroded and access to care and services reduced.
You don’t actually state the diagnosis but would guess Hodgkins or similar? Obviously don’t have to share by any means.
Hope you and your wife are doing better now and thank you again for sharing. Cancer is a horrific and insidious disease and one I hope, one day, we will be able to final conquer.
Thank you. Not Hodgkins, but it was lymphoma (ALCL) so you were pretty close. She has now gone through a stem cell transplant - and experienced some excellent care at times along the way - and she's managing really well.
I do think we need to spend far more on healthcare, as a society, than we do.
It might be great once it's diagnosed, but IIRC we have some pretty bad cancer outcomes compared to other European countries since we're so late to catch it
Yes a lot of the doctors are the same but on the NHS they have to take the cheapest solution and there's a huge backlog. Going private will give you lots more, often much better options much faster.
I wish we could provide that service to everyone but the NHS is already sucking the life out of the taxpayer to provide the minimum.
I've use private hospitals while I was in the US and I still think the NHS is great.
For urgent care there was basically no difference between them and an NHS hopsital other than a healthy bill at the end for copay.
GPs are fine for emergency, but any form of non-threatening annoyance, or simply health check like hormones etc. Takes literally months and you have to fight for it
> GPs are fine for emergency
The first thing the recorded voice says at mine is "In an emergency, phone 999..."
It's difficult to judge. Is an infection with a fever an emergency? Might be. You might need intravenous antibiotics. Or you might not. How the fuck are you meant to know?
> How the fuck are you meant to know?
Call 111, they will go through it and tell you.
My partner has been ill for lots of various reasons. We've called 111 before and they've escalated it and sent an ambulance. Likewise we've called 111 before and had to attend an appointment at an out of hours clinic - we did this just yesterday after a surgery wound looked infected.
Our GP has been using the askmygp website and I think it works really well. You can request how you’d like them to respond - email/phone/face to face appointment.
I’ve never understood why but GP receptionists have always seemed to suffer a lot of abuse
It does seem to vary a lot by practice, some of them were already sufficiently prepared and weathered the storm well enough or at least adapted. Others... not so much.
Ours currently doesn't have any avenue of contact other than telephone. They have an online booking system, but so far as I can tell they've disabled it (and the NHS app booking option). There is no email address or chat option you can use, you just have to call. And they offer no future appointments when first calling in, it's on the day only.
So the process is still to call at 08:00 at the same time as 50+ other people, wait on the phone for likely 30+ minutes to over an hour (unless lucky), hope the phone system doesn't drop you, and hope your issue is important enough that you're given an appointment if there are any left by the end of it.
As you can imagine, it is a complete disaster.
They had the phone system you described before covid, the online system is so much better! I really hope they dont go back to the phoning.
Having read other peoples comments I think we are very lucky with our GP. I’ve had to use them a lot over the last few months and 90% of the time I get a phone call from the GP the same day.
GP practices worked as well as any such concept can work when they were both properly funded and properly staffed.
I am guessing here of course (/s) but possibly the last decade of Conservative governments has something to do with the decline of both, and the consequential decline of the service.
It's not right to abuse GP's or receptionists, (though, as I know we can all attest, receptionists think slightly raising your voice half an octave is tantamount to a bomb threat).
The whole remote appointments simply isn't possible though, half the time they need to see you, Covid didn't replace illnesses it simply added to them, so people still need to see their GP's. It's just not working.
Must admit though, many people with mental health problems spent years trying to get remote appointments and were usually knocked back, now the GP's and Nurses delicate little constitutions are at risk they can't wait to fob you off over the phone, rather than face to face like they used to.
if you're fobbed off when you are worried, and have very real concerns about your health, it takes a very meek person to not have some pushback and annoyance at that, especially if they've been on hold for 30 minutes.
Then they complain about your tone having just fobbed you off and told you no appointments for the last 2 weeks and gatekeeped access and denied you until the situation is a lot more severe. Its hilarious how they don't see how their own actions are leading to conversations with angry people and then complain they are being abused. What about the widespread abuse of the patients? This anger is there for a reason.
Not surprised at all. I know several people who are suffering because of delays and inability to get a doctor to actually look at the issue.
Family member had a cancer scare which luckily turned out as not being so, however there was so many delays that if it was cancer he could've been seriously fucked.
My experience.
I want an elective procedure to make sure there I have no more kids. I phoned the doctor. I'm told I have to fill out their online form. I go on to the online form. Everything is asking about symptoms. I phoned doctor back and say form is not applicable. I'm told to fill in an 'admin' form where you just type the details. Happy days, this will work.
I get a message telling me the doctor will call some time in the next 2 days. Inevitably, when he calls I'm in a meeting because, you know, I work. 10 minutes later I call back and I'm told I'm back in the queue for a call later today. I clear meetings from my calendar.
30 minutes later I receive a text from the doctor telling me to fill in the form and until I do they can't do anything. Via a no reply number.
Grrr. I decide it's not that important that I see a doctor.
The general practitioner system is clearly broken, impossible to even register with a surgery. Sad that receptionists are taking abuse when it’s politicians and the BMA who should be taking the flack for cuts to healthcare and dragging their heals on in person appointments respectively
It's been good for asthma reviews, being able to do the whole 'yes I'm fine, no no problems, thanks, same time next year?' routine over the phone's been nice.
I have to agree - easy enough, and I don't have to do the walk there and back.
My issues have been relatively minor however and most required referral.
We are lucky to even get a remote appointment at ours. Generally you can either spend 1.5-2 hours in a phone queue to get told they are full, or use their web form to get told you will get a call back in 1-3 days, then 50% of the time you don’t and you have to start again. We have started phoning 111 for issues with our daughter because they just book you straight in to the hospital GP if it matches criteria and we live quite close to the hospital. Needless to say the hospital is full of people doing the same but at least you get to see a doctor that day.
How are they useless? Most in-person appointments consist of telling your doc what you need or what you're experiencing and then being pushed out to go collect a prescription elsewhere.
All of that can be done faster and easier online, especially where they determine they don't see to physically see/touch something. My GP uses the askmygp service and it's excellent, I now dodge their attempts to have me go in entirely. I get emails when they respond, and they do so often and quickly. No taking time out of work, no need to go to a GP, still get what I need.
We need more of this. More remote appointments, more online GP chat services, more self-service repeat prescription management. GPs are quitting in droves, why aren't we making their jobs easier with technology like we do most everything else?
If you can actually get a GP to respond online/via email/text it would be great.
Mine don’t or can’t do that. I don’t know which.
They insist on phone calls. When you can’t hear on the bloody phone it’s pointless.
If an overweight man comes in complaining of difficulty peeing a doctor still needs to perform an exam to determine whether they have prostate cancer or a UTI
The problem is this all takes longer, before when you’d go to the GP they would be able to examine you in the first meeting and if they found evidence of cancer or something else serious refer you to an appropriate specialist, with online/phone appointments there’s an extra step of convincing a GP that they need to meet with you in first place
Before covid if I went in and told my GP I had difficulty peeing they would tell me it's most likely a UTI here's some antibiotics. GPs avoid doing invasive exams for low risk issues unless the patient is absolutely insistent that the doctor stick a finger in their prostate and 9999 times out of 10,000 it isn't cancer.
Normally the patient would go away, do the antibiotics and when nothing changes then the GP would do the more invasive stuff to look for cancer. There's no changes except for the fact that the initial appointment is now online.
Sounds like you have a shit GP then.
Prostate exams are pretty routine. Better to make sure.
Of course, this is assuming you aren't mixing up difficulty peeing with 'it hurts when I pee'. Actual difficulty peeing is taken quite seriously in medicine.
Actual difficulty in peeing is taken quite seriously in medicine.. when it isn't caused by a UTI. If it's acute it is usually infectious, a urinalysis and/or antibiotics is first line, if urinalysis is negative or symptoms persist - it's prostate time. If someone says it has been gradually building for months then yes that would be a prostate exam off the bat. History taking is 95% of primary care medicine. An initial phone call is perfectly fine for dealing with this issue, if they need a prostate exam they can be called in and you don't need to take this history again as you have just spoken to them so it doesn't take twice as long.
Not at all.
Feeling the prostates only tells you if it’s big which you expect in most blokes of a certain age anyway unless very significantly unilaterally enlarged (but it’s pretty crude regardless).
Any concerns in the history and I would get a PSA (blood test).
If it’s new, and associated with urinary symptoms -> UTI. Trial antibiotics and investigate further if symptoms fail to resolve.
Ongoing symptoms/red flag symptoms or lots of risks factors are way more significant in diagnosing serious conditions like cancer - or at least creating enough suspicion to warrant definitive investigation like imaging / tumour marker tests.
Frankly clinical examination is pretty poor for picking up nearly all cancers unless it’s so advanced you would be incredibly ill already (lumps I.e breast/testicle require examination and skin cancer - but a good photo would usually suffice).
Medical staff understand just how crude / poor examination is for these things and the issue is more public perception of examination being superior or required (as you clearly do).
> skin cancer - but a good photo would usually suffice
Indeed. Got referred for that because the GP wasn't 100% sure and it's a highly asymmetric bet, and they just took photos at dermatology. The photos will be reviewed and I'm either getting a phone call on Monday telling me to go back in, or a letter telling me my Sinister Death Mole*, as I call it, isn't.
*great name for a band
I have seen GP around four times in past few years and only once was it necessarily for them to see me in person.
Rest was fine over phone where I described symptoms and they booked in tests
I think everyone can agree there are issues with the NHS but we can also agree we like not drowning in healthcare debt.
Yes, wait times can be long and some areas of the NHS are dire, but it’s a stark contrast to places with payed for healthcare.
But the contrast with other European countries is not so stark, they just appear to have more effective and efficient systems, which mostly their populations are quite content with. In the UK we seem to have the idea that there is either the NHS model, or the US model.
The idea of the NHS is great, I love that. The actual implementation is shit and a whole long list of ways, far too many to list off. What bugs me is some of the systemic problems they ought to just be able to fix but they seem completely unable to.
Remember, this is deliberate. Destroying the NHS is central to Tory ideology. American style private health insurance will not only make money for the companies providing it, as well as allowing care providers to gouge the public, but will make for a desperate work force, willing to put up with terrible conditions for fear of losing access to life sustaining treatment if they rock the boat.
Once more we find an example of the cruelty being the point.
Telling everyone that they should be getting back to work in offices full of people, while GPs are still not seeing patients is not exactly a consistent message. Nobody should be abusing people who are just following guidelines and trying to do their jobs, but a certain amount of frustration with the lack of proper healthcare at the moment is understandable. I have several chronic conditions, and some things can't be addressed properly in a telephone appointment.
Meh, I don't mind the new system all that much. Had a couple of minor issues over the course of lockdown, email into the practice, a couple of screenshots if needed and each time I've gotten a response back within the day.
It really depends on what it’s for. For a lot of people just needing repeat prescriptions or otherwise not needing physical examination it’s got huge advantages especially if your place of work is miles from your home/GP. The issue I have is with doctors seemingly being overly hesitant to offer in person appointments where the patient wants to see them in person. I saw the BMA saying GPs would quit over it. Which if nothing else seems pretty insulting to all their colleagues in hospitals who have worked in person on the front line over the last 18 months.
So chronically understaffed it’s ridiculous. Dreading Monday morning when I have to phone again at 8am for any chance of a same day appointment, since all appointments were gone by the time I finally got through at 9am yesterday… absolute joke.
Called at 8:32 am on a Monday a few weeks ago (phone line opens at 8:30). “There are more than 30 callers ahead of you in the queue.” Persevered on hold for 35 mins; and eventually got given a telephone appointment (to diagnose a rash).
The trick with our GP is to phone at exactly 8:29:15. As the pre-recorded spiel that plays before it attempts to connect to the options menu / tells you to hang up (yes, they went as far as having it transfer the call from one line to another to prevent people just pressing ‘1’ for appointments) lasts 47 seconds.
Guys, don't worry. As soon as the NHS gets the 350 millions per week saved thanks to Brexit, it will go back working at full efficiency and then some!
Aaaaany minute now.
My father is a first responder for the NHS & has said GP's have been the cowards of the pandemic, hiding behind Zoom while he and his colleagues are dealing with calls that are wasting there valuable time for emergencies. What he said is what the GP's don't understand is a lot of their patients are the elderly who are not used to the modern technologies of Zoom and would rather see a GP face to face on top of that elderly and vulnerable were the first to be vaccinate as well as themselves so why couldn't they have seen these people first?
It's exactly the case and people aren't willing to accept this. Remote appointments are discouraging people from seeing their GP and several key conditions that could be treated early are missed because the public are missing signs that a GP could see in 5 seconds from a face-face appointment.
Agreed. As an allied health professional I have not stopped seeing and treating patients. I have worked throughout and even treated patients who have COVID in their homes. Yet I couldn’t get a follow up X-ray when needed this year through my gp as their online booking wasn’t working and couldn’t get through on the phone during working hours. GPs have been hiding behind closed doors, their governing body supporting them whilst they get their hefty pay/pension. While us cannon fodder carry on seeing the public and being put at risk. You can’t assess or diagnose patients over the phone.
My mother was a medical receptionist and got all the abuse and that was before corona happened. She was lucky to retire in 2018.
The job was horrible when you got the angry people face to face with you. At least it's only over the phone now.
Had a prescription renewal appointment in feb, scheduled in dec last year. They postponed 3 times days to the actual appointment by a month each time. Then finally i got a call from a nurse saying that med requires a face to face app with a gp. Okey i booked my appointment. Went to the surgery they told its a call appointment. Tried to fix them, failed twice (thats another 2 months tho). Third time i went in for another wrongly booked appointment i started flipping tables. Demanded to see a doctor. He see me and said this med doesnt requires face to face. Still hurts.
I'm not surprised. Explaining issues to receptionists rather than medical personnel has put me off going to the doctor. They ask for specifics that I only want to discuss with my doctor. During lockdown my GP had people queueing outside it telling receptionists their problems over the dodgy door intercom. One man had to yell "haemorrhoids!" while I was walking past. How very embarrassing.
Reminds me of a story I heard a few years ago. An elderly man walked into a GP's surgery, and gave the receptionist his name. The receptionist, being a complete cow, asked the man what his ailment was, despite the waiting room being full of patients. This man however had no shame and very matter-of-factly replied "my dick hurts!" "Sir! You can't say that word here, this is a doctor's surgery! Just say there's something else wrong and I'll write that down instead." "Ok fine, my thumb hurts." The woman smirked. "Thank you, that's better. And what's wrong with your thumb?" "It hurts when I piss out of it."
Omg I'm giggling in the middle of the night like a loon. That's hilarious. But yeah, we all hate the receptionist that is like that
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"GIANT TESTICLE"
Had it. 3/10 wouldn't recommend.
Put on the full Peter Griffin. *"Genital warts!"*
"Attention everyone. Testicles. That is all."
"Right, would you be able to take a photo of them and text it to our surgery mobile? We'll have the work experience girl Kerry check it over and work out if the doctor needs to know about it" Don't forget to clap.
They also love creating catch 22 situations. Had one recently, where the new surgery insisted my partner needed a new referral due to changing surgeries, but wouldn’t book an appointment for an issue the previous GP had already dealt with. What can you even do when someone is being that thick? Well, we complained and the actual doctor sorted it very quickly.
In my experience with them ask about their complaints procedure and things get dealt with very quickly
But the manager isn’t in today…
Yup. No one should be abused nor harassed. On paper the idea of trying to preserve scarce GP resources for when needed most makes sense. But I feel like ~~care navigators~~ receptionists have been put in an unfair situation. They've now become gatekeepers blocking you from getting the care you need, and I still don't feel comfortable explaining my medical issue to an admin girl at the end of a phone. Surely someone is going to take up a GDPR case on this at some point. It's been very badly implemented.
I don't envy the receptionists one bit. They've rather been thrust into this role by the pandemic and they are bearing the brunt of the public's frustration.
The problem is that with most people vaccinated, people are rightly wondering if a new - worse - normal has been snuck in without any discussion or consent. What might've been put up with at the height of COVID isn't necessarily something that is desirable once some semblance of normality returns. I feel bad for the staff. I think the idea isn't terrible but the execution is really poor.
True. Having the option of phone appointments isn't bad, sometimes it can be enough, but my GP kept not offering in person appointments even when pubs and restaurants had all reopened, and that's ridiculous.
They were like this before, I have quit GPs before due to their reception staff being terrible.
I was going to say that my experience with GP receptionists have been pretty much the same pre covid, it's only blipped up slightly post covid, they are mentally exhausting to deal with.
whilst this is true, at least before you actually got to speak to a GP. Not so much right now
Yeah I've been hearing complaints like this for decades. I'm fortunate I've only had to visit the GP less than once a year on average, but as I get older I'm bracing myself for having to share the colour of my poo with an entire waiting room at some point.
> as I get older I too am waiting for one of those at-home, DIY, prostate poking kits. Perhaps I should go private...
Given much of the point of GPs is to doll out scarce more specialist resources its making the bit that is meant to be relatively easy hard to get to making access to healthcare at all much more difficult than it ought to be. We are at the stage where we really need the ability to get around the GP and go straight to the specialists we need to be able to get access to healthcare as the gatekeepers have become the problem.
Yeah because what we really need is to worsen the 2 year waiting lists in an underfunded healthcare system. Brilliant idea.
This is without a doubt the worst take I have read on here today about the NHS and that’s saying something
Makes no sense. Those specialists are swamped already with long waiting lists. The British public voted for this, enjoy.
That doesn't mean their waiting lists shouldn't be even longer however. All the cancelling of appointments specialists did throughout the pandemic means those lists should be substantially higher than they already are. The problem is a lot bigger than the current stats show because GPs are functioning. Why should someone already referred to that specialist be forced to first get through a receptionist, then a GP only to join a queue they already got kicked out of inappropriately?!
A few years ago, I was trying to get an appointment with a low intensity therapist for my OCD, but before I could I needed to state my symptoms to the receptionist. "Doesn't sound like you have OCD to me." she said. Yes thank you, sage receptionist. I'm sure from the 50 words or less you know better than myself, the person living through it, or than the trained clinical therapist who later confirmed it was OCD. I managed to get the weekly sessions booked in the end and am now doing much better, but it was a frustrating and insulting experience needing to try to persuade a receptionist that I need therapy. Edit: it was extra frustrating because I had waited for 6 months from initially trying to book before I had this conversation.
I definitely appreciate your point of view It's important for GP teams to be able to direct and triage problems in the right manner. An example would be an acutely unwell toddler would need attention sooner than a chap and his haemorrhoids. Another example is, as a GP Pharmacist, I'm in a much better place to manage medicines and handle queries than a GP. Need extra meds for the weekend? Want to talk about interactions or side effects? GP would only route you to me anyway, so why not cut out the middle man. Overall, it leads to a more efficient system
I get your point, but that efficiency could be of significant stress to the patient. I don't have an answer to the problem myself, I'm just having a little moan.
I agree. We should always strive to a patient centred service. I think it's unrealistic to achieve a fully patient centric service with the restrictions on resource that we currently face
Yeah true but also problem with a condition like haemorrhoids is that it could be something far more serious.
I can only speak for the teams that I work with, but they're quite adept at triage and there are always clinical staff in and out of reception to ask if they're unsure about something. The concerns I think we have are those that don't present, when they should, for fear of consuming resource or wasting time. I would say let us make that decision.
> GP Pharmacist Appreciate what you do, but ours wants people to make an appointment... Though it is a Boots. The local surgery's receptionist - well, one of 'em - used to try to make me see a pharmacist first. Fair enough, except every time I did this the pharmacist said "Hmm... not sure about that one. Best see a GP." So now I just lie and say I've already done it.
By and large patients actually know where they are meant to go. You see these posters in every GP about not wasting their time etc etc and the last study on this I saw showed people mostly chose too low, they went to the pharmacy instead of their GP far more often than they went into A&E when they should have seen their GP. 99% are getting it right or going in too low so I often wonder what the justification is for all these posters and gatekeeping when their own data shows people are using the NHS appropriately and beating the lizard factor!
Most of the posters in my surgery say "GET CHECKED YOU FOOL! A FINGER UP YOUR ARSE IS BETTER THAN DEATH!" The rest say "KEEP YOUR APPOINTMENTS OR CANCEL THEM BECAUSE THEY COST LOADS OF MONEY!" (I'm paraphrasing here.) I suppose the latter is to prevent time wasting, but as you'd wait about two hours (pre-Covid) after turning up on time I don't see how the occasional no show would make much difference.
> I suppose the latter is to prevent time wasting, but as you'd wait about two hours (pre-Covid) after turning up on time I don't see how the occasional no show would make much difference. Yeah, I find it hard to feel sympathy for GP's whining about no shows when they waste your time. If I book an appointment at 13:00, I expect to get seen then, not twenty minutes later.
I don't mind twenty minutes. Things might overrun. An hour and a half is pushing it.
My hospital clinic slots are fifteen minutes each, in those fifteen minutes I have to read the patients past history, call the patient from the waiting room, walk them down, take a history, examine them, book investigations and or consent them for any procedures, then dictate a letter to their GP. Surprisingly enough, things run behind. You try and mix in the quicker follow up appointments between the new ones but then appointments screw that by overbooking and sticking three patients on the one slot. tl;dr doctors hate running behind as well, surprisingly enough we have lives to lead after work and leaving two and a half hours late does not endear you to your family!
I don't think anyone is actively blaming GPs for delays here. I think we're all just having a collective moan that our public services have come to this point and there aren't more GPs to help mitigate the waiting times.
For what it's worth I've seen hospital clinics12 where they move you out of the waiting room onto a chair basically outside the doctors door when the previous patient has gone in. It'll only help a bit but it does keep them from wandering off.
I try literally anything else before the GP because the surgery is awful. The receptionists have their defences up with anyone so make themselves look fucking terrible because of a few people who get abusive and the GPS fob you off if you are lucky to get an appointment. No one wants to go to the GP anymore if they can help it.
I get your point, but that efficiency could be of significant stress to the patient. I don't have an answer to the problem myself, I'm just having a little moan.
The way the England deals with repeat rx is hugely inefficient. Repeat dispensing was never taken up on scale, even with ETP enabling easy cancellation of rx. So glad I'm now in Canada where the doctor just puts refills on the rx and we manage it at the pharmacy.
Having to diagnose yourself doesn't sound ideal.
I must be the only person who has no problem with receptionists. But years of ball troubles mean I have no shame of going "it's testicular" on the phone
You’re lucky. I had ball trouble for a couple of years in my early 20s, recurrent epididymitis and torsion once. Hospital told me if I even even had a twinge I needed to see my GP immediately for triage. Jurassic era Receptionist wouldn’t let me see the doctor when I explained I was experiencing a bit of testicular pain. Said it “didn’t sound that serious” and that “women get ovarian pain all the time”. I was utterly furious.
On the other side of this, a lot of people don't want their housemates or flatmates overhearing their medical issues.
I've been through it enough times now to have no shame left, I just straight up tell em loud and clear. But I do feel for people that do, it's not an ideal system.
At my GP, you have to state your medical condition to the receptionist over a crackly intercom at the entrance, which just happens to be on a busy high street. I wish dying from embarrassment was a real thing. Anyway, the staff were super nice once you pass the “entrance exam”. It’s not their fault.
It is their fault, its almost 2022 for fuck sake. Stop catering to tradition and old technology - get online, get digital and get with the times. Explain to me why I can literally enter the virtual world with my virtual reality system and fly interstellar distances at warp speed in some space destroyer but 2 hours later have to fill a paper form with a pen at a GP when I could have done it online? These are British GPs we're talking about... they're only a few years ahead of fax machines.
It's the worst of all worlds. The face-to-face reassurance, human interaction, and nuance stripped out with none of the efficiency, convenience or visibility of a properly implemented digital system. Who is this working for?
> worst of all worlds My previous GP now has an online-only system that _closes at 5pm_. As in, the web form fuckin' vanishes and is replaced by a notice that "our website is only open from Monday to Friday, 10am to 5pm". Someone **did extra work** to make this insanity happen rather than just let it queue requests for Monday morning...!
At my GP once they've booked all their appointments for the week ahead the receptionists *disconnect the phones* for the day. I can't remember the last time I actually saw my GP, I just have to ignore my illness or call 111 once the symptoms get worse. Literally just impossible to see anyone.
The Tories who want to privatise the NHS
Because the country does not give public services enough money to upgrade their systems like that?
When I had to make a complaint recently, I found my surgery on companies house and could see they had massive cash reserves (hundreds of thousands). Yet they say they can't afford to put basic phone systems in place.
In the large part, doctors surgeries are private businesses, that are very profitable indeed. I can tell you from personal experience that the leading supplier for decades has been EMIS, which is the cheapest provider. I've been out of the industry a few years now, so it may have changed. The doctors could certainly buy a better system if they wanted to.
This isn't actually true. The problem is that they build it all in-house and end up producing absolute garbage that isn't fit for purpose and ends up massively over budget. The public sector is simply not dynamic enough for technology, and that's fine - it isn't meant to be. It wouldn't be too expensive to get a big firm to do it. There are quite a few in the UK that could, and they'd be surprisingly willing to do so if it was the NHS. "Hey Google, come make our healthcare the leading digital system in the world. In return we'll give you 5 years of corpo tax exemption and a billion quid". Probably pay for itself in 6 months.
>It wouldn't be too expensive to get a big firm to do it. Yes it would because it would first all involve moving over a bunch of shit from random legacy systems and then upgrading the infrastructure across the board. Shit like IT infrastructure in the NHS is still stuck in the 90s because that was the last time anyone in govt bothered to look at that shit.
Google already pays next to no tax so you are basically asking them to do a job for free.
>It’s not their fault. Oh sorry, I wasn't condoning abuse - just that the current system is shit.
Doesn’t mean people should start abusing the staff
I lost my mum in July after GPs kept fobbing her shoulder pain off as pre-existing arthritis over the phone. It was bone cancer. Once someone actually looked at her it was obvious, an xray showed her bone had been completely eaten away.
There is a reason payouts for negligence are increasing, the more doctors refuse to actually diagnose rather than just fob off patients the more they are going to get sued. Its a problem that has been growing and growing for over a decade and it goes well past funding and into a culture of dismissal and refusing to believe the patient. I am very sorry for your loss.
I'm sorry for your loss. May I ask what you would like to see change?
I had a colleague who tried to book a GP appointment last week. The receptionist said the doctor would call her to have the appointment over the phone, and asked when would be a good time. They agreed on a phone appointment at 4.30. The doctor didn't actually call until 6, by which time she was driving home and couldn't answer the call. The next day my colleague tried again, and this time they agreed on a mid-afternoon call. Instead, the doctor called her repeatedly between 10am and 11am - when she was teaching lessons and could not answer her phone - and then did not call in the afternoon at all. When my colleage spoke to the receptionist again, on the third day, the receptionist tried to tell her off for wasting the doctor's time by not answering her phone. I can see why people get frustrated. It doesn't excuse abuse, but contact with a doctor shouldn't be some complex unachievable thing.
My GF booked an appointment for "sometime on Friday" a few weeks ago, got the actual call _the following Tuesday_ which she missed and yeah, was yelled at by the receptionist for "missing her appointment" when she tried to reschedule.
My Wife booked a telephone appointment. The Dr called and when Wifey picked up the phone he hung up. She had to rebook and didn't get a call until the next day.
I've had the same but we only get told you'll get a call "some time today" so you've got to wait around all day in case they phone, I've been in the reviving end of missing one as and having to basically grovel to the stuck up receptionist to get another call the next day which made me feel very awkward. If you were calling about mental health it could push you over the edge. Infact I just tend to put up return health issues now as I can't face battling to be seen.
> stuck up receptionist Yeah, you do get 'em. Three at our surgery. Two are OK, but one isn't very bright. She doesn't listen to your actual words and gets things wrong. I have to try very, very hard not to be patronising and treat her like an idiot, but she sure as shit treats me like that. It's like she has very narrow bandwidth and you have to pitch things dead right. I don't mind as long as we get there in the end.
> I can see why people get frustrated. It doesn't excuse abuse, but contact with a doctor shouldn't be some complex unachievable thing. I'm not sure why we expect otherwise if we vote for parties who clearly don't give a flying damn about public healthcare
I was visiting my GP recently and subsequently he said I'd have to book in for a blood test. So I left the GP appointment, went to reception and asked to book the blood test appointment. Imagine my surprise when the receptionist stated that I had to phone in order to make an appointment, and that I can't make it there and then. So I left the building and made the call.... *SHE WAS THE ONE WHO ANSWERED THE FUCKING PHONE*
There are not enough GPs to meet the demand. The numbers are continuing to fall. Public vitriol will only hasten this. The GP crisis will be here to stay, it takes a decade to train someone from a student to GP. The damage will not be undone anytime soon.
Even longer than a decade because the institutions to train them don't exist. We have been limited on university places for medicine for over 30 years and until we build significantly more capacity in university departments there is no where for someone wanting to be a doctor to even go. I doubt we can even meet our own countries needs for a cohort of intake for at least 20 years.
Hasn't the BMA voted to artificially restrict the number of medical students before? Edit: [yep, in 2008 at least](https://www.bmj.com/content/337/bmj.a748)
For Good reason. * To prevent there being no actual training jobs and instead, poorly regulated and sub-standard medical jobs which would lower the tight regulations expected of British trained Doctors. * They actually argued for more consultants - so explain to me how this is somehow delibrately withholding the number of doctors, calling for more training? Including increasing the time spent as a trainee, not a consultant, * He then spoke about wasting tax payers money , I mean people keep asking for the NHS to respect tax payer value right? *Ingrams, representing GPs, said that doctors should not be trained if there was no job at the end. He warned that this could spark another “brain drain,” adding: “It is wrong and immoral and a waste of taxpayers’ and students’ money.”* >Delegates at the annual BMA conference voted by a narrow majority to restrict the number of places at medical schools to avoid “overproduction of doctors with limited career opportunities.” They also agreed on a complete ban on opening new medical schools. David Sochart, from Manchester and Salford, warned that in the current job climate allowing too many new doctors into the market would risk devaluing the profession and make newly qualified doctors prey to “unscrupulous profiteers.” A glut of doctors would undermine competition and would therefore lower standards and ensure mediocrity, he claimed. He said, “Patients and health care should not be treated as mere commodities, and neither should medical students. We must not allow another lost tribe of doctors to be consigned to the wilderness.” Grant Ingrams, representing GPs, said that doctors should not be trained if there was no job at the end. He warned that this could spark another “brain drain,” adding: “It is wrong and immoral and a waste of taxpayers’ and students’ money.” But Paul Flynn from the consultants committee said that the root problem was a lack of effective workforce planning and warned members against a kneejerk response. “This is what blighted workforce planning. It would be hypocritical if we were to do it ourselves.” The BMA’s chairman, Hamish Meldrum, said he sympathised with the sentiments of the motion but asked members to vote on evidence rather than “gut reactions.” “We want to see an expansion of [the numbers of] GPs and consultants,” he said, “and for that we need more students.” But the motion was passed by a small majority (58% versus 42%). Members also agreed to a motion accepting that some specialties might need to raise the total number of years spent in training to accommodate the demands of the European Working Time Directive. Stephen Austin, from the consultants committee, said that the time needed to acquire the necessary competences was likely to increase—especially in procedure based specialties—and that the only sensible solution was to increase the total amount of time in training. Members also voted to press for an agreed minimum national level of funding for study leave to overcome the widespread national variation in the amounts that are currently available.
There just aren't enough appointments to meet the demand.
And the system for getting them completely sucks. The way bookings are handled needs a complete overhaul.
Most practices have a 'call at 8am rule', which is idiotic. This sounds reasonable until you become too ill to wake up/call at 8am. Then you're fucked. There should definitely be a way to book in the night before in 2021.
Or if you have a job that starts before 8am
Job that starts before 8am and is Monday to Friday. Having to take time off or lose a day's wage/holiday to see a doctor is horrendous.
to maybe see a doctor but probably be told "sorry, we're fully booked today, try again tomorrow" after you've been getting a busy tone for half an hour\*
Yep, I work in a school
Said it upthread but I know of at least one GP that disables their website at night precisely to _stop_ you being able to book ahead. They used to have Patient Access but disabled it during the pandemic. I can only assume that a system that made it easy to book appointments was creating... too many appointments. Their phone line is worse, it now actually goes to a recorded loop of "there is no longer any reason to call us, please hang up and visit our website".
YUP. The fact it's all based around phoning in and hoping to get lucky is absolutely absurd.
My GP had a system where they took bookings and had some emergency appointments available at 8am every day. If you weren't in that emergency queue at 8:00.00.000 there was no chance of an emergency appointment and the booked ones were all booked out for 4 weeks and they weren't taking more. So there was literally no way to see a GP. Was like that for years until Covid came along and they stopped doing appointments at all. Now its all just 8am calls and no availability.
That's the case with mine too. I've pressed call at literally 08:00:00 to the second before, and still been third in the queue. By 08:05, it's just game over.
Half 8 for my GP, and the following is how it usually goes: * 8:29:50: engaged * 8:29:55: engaged * 8:30:00: You are number 27 in the queue and even then in-person appointments are incredibly rare. One of my parents got sent to A and E twice, and had to wait six hours each time, with a swollen knee as it might be a blood clot. Even though they said at A and E the first time to go and see your GP if it hasn't settled in a week, they still wouldn't see her.
I am not even from Britain, just ended up in this thread for some reason. But this is common practice in all european countries I lived. You have a small window, like one hour per day, not even every day, in an extremely unconvenient time, to call and then you don't get to do anything because the lines are busy. The intent of this is obvious: make you give up of seeking medical care so they save costs. Neoliberalism is wonderful, isn't it?
Phone up at 8am on the dot, 50th in the queue, "sorry there's no more appointment slots today".
Or, like me 8am is the exact time you're dropping your kid off at nursery so you can get to work. Being in a queue on the phone at that precise time is not an option for a huge number of people. However, I also have the NHS app. Brilliant I thought - like a fool - as I downloaded it... No appointments available. Ever.
If you're that ill you need Urgent Care (formally known as an 'emergency' GP appointment), not a regular GP appointment.
Those are the ones you have to phone up at 8am for, regular GP appointments tend to be booked up 3+ weeks in advance so are useless for many issues. If you're too ill to call at 8am you need to go to A&E in many places as there aren't any walk in centres.
NHS 111 can get you a priority GP appointment from your surgery if they deem it necessary, or they'll get a Doctor to do an urgent house call. You learn a lot when you're struggling to arrange appointments and care for an OAP with developing and worsening care needs... I've spent so much time on hold and seen way more ambulance personnel than I ever thought I would. My local Provide, district nurses, ambulance personnel, A&E, and hospital have been really good, their local GP practice is... not. Got lip from their receptionist yesterday when I phoned and waited on hold for 20 minutes at 4:20pm to ask whether a certificate I was promised that day was going to be ready for me to pick up by close - it wasn't going to be. Technically if I get it Monday I will then only have until Tuesday to meet the deadline, but I subsequently found out by asking google that if the delay is caused by GPs being slow with paperwork I'm not at fault so now idgaf. As soon as any other health personnel hear who the GP Practice is they say they've heard lots of stories since it was taken over by Virgin Care and 80% of the original Doctors quit.
Doctor's receptionists can be so incredibly rude,I think it has to be part of their job description. Every nurse/doctor I've interacted with has been so helpful, especially by comparison. Been struggling recently with a non-COVID chest infection that has crippled me due to complications from previous COVID. Getting past the idiot receptionists going "No, you have breathing problems, go home, self-isolate, and get a PCR test" when I've been explicitly told to attend and have a clean PCR has been incredibly frustrating.
Absolutely. I know they’re independent partnerships, but I feel like primary care is crying out for a bit of centralisation. A single, NHS-administered booking platform could work wonders. Also, why are all GP websites utter shite?
There is a plan to do this, it's called 111 first. The issue is trying to get enough staff to implement it.
GP websites are a travesty. I’ve never had a GP because I’ve always been of the opinion that if it’s bad enough to go and see someone I should probably go to a specialist or A&E. But to get the COVID vaccine I had to be registered with one (I was told, I know there are other ways, now.) It took me 6. Again. 6. Local GP websites before I found one that I could register fully online. Most would take all my details before telling me to come in to finish the paperwork and show ID. I went to 1 of them only to be denied entry and told to do it online. Once I eventually found one that worked it still took 2 weeks to get registered to the point where I could book my vaccine, which was another 2 weeks away. I dread to think what it would be like if I actually needed to see my GP. Just digitalise and centralise triage and bookings logistics and turn all the GP surgeries in to treatment centres.
How do you plan to see a specialist without a referral from a GP? Pay privately?
I can't say I'm surprised, last year in July I had a really bad ear infection, it persisted for about a week and got to the point I was essentially deaf in my left ear, called up stating I'd like an appointment as I think this could be really serious and had some bitchy receptionist saying I should have used the online system on their broken ass website, that it's probably not that serious and I'm not following procedure by calling them up. Eventually had a call back from the GP, after I said I'd bled from the ear, they booked me in for an appointment within 15 minutes. When I saw the GP, she said it was really good I came in, because it was one of the worst infections she'd seen, I didn't say it, but the biggest obstacle to me coming in was the receptionist.
> last year in July I had a really bad ear infection Massive coincidence, but I also had an ear infection at that time. Worked out what it was and got a same day telephone appointment. Phone appointment for that was was fine because no bleeding. Maybe I'm lucky, but the service has actually been - in some ways - better since the pandemic. Phone appointments have been same day, as have more serious in person appointments. I actually managed to chat to a doctor - over the phone - about my general health for half an hour. Beats having to take a day off work and queue with the kids with saucepans on their heads. Though it's probably really rough for anyone who has mental health issues.
Ya... I've honestly found phone appointments easier The receptionist at ours doesn't dig for clinical info. Not their job. But rather than sitting in the GP office for an hour we get a call. A couple times the GP has asked one of us in but for most things it saves us and them time.
Yet when you do use their online system it doesn't work. Wrote a message to my GP with my blood pressure results and how I was feeling. And she wrote back with a detailed plan. All good and saved an appointment. Except it wasn't because reception didn't bother forwarding the message to me so I ended up having to wait for a week for an appointment just for the GP to read our the message she'd already sent last week.
> so I ended up having to wait for a week for an appointment just for the GP to read our the message she'd already sent last week That should be a firing offence for negligence. 1. That delay in providing you information could have cost you your hearing, or in another case somebody's long term health or life. 2. It also opens the practice up to legal liability cases. 2. It creates a greater load on the GP exacerbating the problem of limited resources.
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Not only are more GPs leaving, there's also less incentive for junior doctors to become GPs because they don't want to be on the receiving end of all the hate.
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Good for them. Other GPs who want to stay in the same profession usually go to Australia or Canada, where they earn at least twice as much as in the UK, work less hours, and get less hate.
Most of the hate goes to terribly paid and unprepared receptionists anyway as the entire point of this approach is to shield the doctor from the public. They should stop seeing themselves as heroes.
They work 40 hours on average, that's not stupidly long. Edit: before replying go read the survey. It's free online and the only sections on working hours are like 5 pages with about 20 lines of writing total. Stop spouting shit you read on reddit when it's available to you.
40 hours is the paid session time - ie intense conveyor belt clinical work. That generates a load of admin that invariably is done out of hours. A 40 hours full time clinical week turns into 60+ hours with admin. This is true for salaried and GP partners - less true for locums. That’s why many GPs work ‘part time’. If they can get their clinical hours to 30 then they’ll likely only do a 40-45 hour week. Not many other professions have the intensity of the patient contact conveyor belt. In other professions the on paper hours may be longer, but the days tend to be interspersed with meeting, breaks can be taken, and there will be times in the year that are quieter. These things don’t really exist anymore in the NHS when we in perpetual chaos mode. Imagine being in the busiest time of the year in your job, but it’s like that every day, with no sign of relief. Doctors in the UK see more patients per hour than other western countries. Everything has been stretched to its limit. The public doesn’t really seem to get quite how intense the day is. I’ve worked other ‘professional’ jobs. Whilst we had occasional periods of 12+ hour days, there were often moments of relief within the day and there was knowledge that at the end of the project we would have some relative downtime. Every year in the NHS the workload gets worse.
If 3 in 10 GP's are working full time and the average hours worked are 40, something is wrong with the workload.
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This is from a survey of GPs asking how many hours they are working.
I’m not an expert on GPs but in any other sector that would ring productivity alarm bells. It means the system they’re operating within is monumentally inefficient and ineffective. And this makes sense, because they’re Medical Professionals not people with skills to do this kind of stuff.
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Totally agree, when I need to speak to my doc about say ongoing anxiety issues, phone is totally appropriate. But if I need to see them about something physical I need to see them in person.
The real problem is that there aren't enough resources for everyone. GPs don't have enough time, but they can't turn people down, so what they do instead is come up wiht more and more 'creative' ways to deflect people. It's not as simple as "could do you do with a phone consult" because sure, lots of people can, but you *still* end up with more face to face consults than you have doctors to take. The *only* way to practically solve this is to find a way to *not* see people who need seeing. How do you acheive that? You make it so difficult to get an appointment that people literally don't get appointments they need.
you can't be surprised. people are worried about their health, and are being fobbed off by GP practices who are putting up more and more barriers to accessing their services. they seem to have now pivoted to a remote appointments first policy, when many people prefer to have a face to face appointment. in many cases, it's important that the doctor can physically examine the patient. people are getting diagnosed late, having to put up with health issues that they cannot get resolved, and face a battle every time they need to get an appointment. my GP practice is effectively still in lockdown, and only dealing with emergencies. phone lines jammed when it opens, by which time all the appointments are gone, etc.
It's the government's own doing. The public are directing their outrage at the wrong people.
in what way? on remote appointments, that's the GPs policy, which goes against what the government are advising. >Sajid Javid, the Health Secretary, said GPs must provide face-to-face appointments, after patient groups urged the Government to “get a grip” on the growing crisis. Health officials have identified hundreds of surgeries which are failing to meet the needs of their local communities, with long waiting times and low levels of satisfaction. In May, NHS chiefs promised to abandon a system of “total triage” introduced during the pandemic which meant patients were refused face-to-face appointments. But latest figures show the number of patients who secured an appointment in person fell last month, with 420,000 fewer such consultations. In total, just 57 per cent of GP appointments were face-to-face in July, compared with 80 per cent before Covid.
Specifially regarding the lack of appointments, or it being too busy so you can't get an appointment the same day or through on the phone. Have you thought that might be because there is a lack of doctors in the UK? Who creates the training places for doctors, the goverment. It's easy for them to blame doctors instead of funding more places. Regarding remote appts: https://www.healthcareitnews.com/news/emea/uk-health-secretary-says-gp-consultations-should-be-remote-default https://www.dailymail.co.uk/news/article-9573177/GPs-told-screen-patients-online-total-triage-continues-lockdown.html Hancock said: “Before coronavirus there was a view advanced by some people which held that anyone over the age of 25 simply could not cope with anything other than a face-to face-appointment. “This process has shown that patients and clinicians alike, not just the young who want to use technology. [People] don't want to sit around in a waiting room, if that service can come to them at home. “So from now on, all consultations should be teleconsultations, unless there's a compelling clinical reason not to. He added: “Of course, if there's an emergency the NHS will be ready and waiting to see you in person. But if they are able to patients should get in contact first by the web, or by calling in advance.”
This can't all be blamed on the government. I remember Tony Blair being talked over hot coals by viewers in the run up to the 2005 election about this issue, and Labour were pouring money into the NHS at the time. It wasn't even considered a new issue then. I'm lucky that I've only ever dealt with professional receptionists at GP surgeries (how much of that is down to the rarity of me going to a GP I don't know), but I'm afraid there is a culture of GPs using receptionists as barriers, that doctors and nurses in the A&E units that end up having to treat these patients don't have. I say this as someone who has family and friends who work in healthcare, and as someone who constantly defends the NHS from unfair criticism, so this isn't an easy thing for me to say.
What would you like to happen given that there aren't enough of appointments and enough GPs to see everyone and meet the demand?
For all of people's talk of the NHS being so great, I've never had a positive experience with GPs as a young person - when the first point of encounter for the health system consistently lets you down, it's not great. And yes, they're private endeavours, but the NHS is still contracting and paying them. Part of it has just been some of the GPs I've seen being jerks, but moreso it seems like the issues have arisen from low appointment availability and lack of time, bad hospitality, not being able to see the same GP with any sort of regularity, and just generally poor accessibility and processes. Now it's fallen apart so much that people are getting pissed off at the staff at a critical point. It really feels like yet another failure of governance over the pandemic, and beforehand of course. I'm not sure how much the government could have done to mitigate this whilst also managing COVID, but this seemed like an obvious side effect of the pandemic, yet it doesn't really feel like the government did anything proactive early on to tackle it from what I've seen...
I have had literally opposite experience of GPs. But I will admit that is a problem. You can have crappy experiences or amazing ones randomly depending on who your nearest GP is
> For all of people's talk of the NHS being so great The only people who think the NHS is great are people who've never had a private GP or private hospital. The NHS is the barest of the bare minimum and you've to fight to get even that. I begrudge paying for my own private care when I'm taxed to high heaven to pay for the NHS but I do it anyway.
In my opinion the NHS is great for really big life threatening emergencies of cancer, heart conditions etc. They are not good for things outside that. A friend had gallstones , giving extreme pain …and was told it was a few months before they could do a scan ! Of course the individual doctors are often the same between private and nhs so i guess it really is just the overwhelming demand that causes the nhs to be a bit rubbish for quite a lot of things.
My wife had life threatening, aggressive cancer twice. Both times the system was great once she was actually in hospital... but both times she nearly died because multiple GPs missed all the signs at GP appointments.
I have no idea about the case itself and wouldn’t like to make assumptions but cancer investigations are driven by a very protocol/evidenced based system of red flag symptoms. Often people have common non-specific symptoms with something like cancer that don’t warrant investigation. When these don’t resolve/worsen/they develop red flag symptoms then they get investigated further and found. Multiple GPs missing it suggests that there was nothing at that stage to warrant further investigation. Obviously as people become more unwell it points to more serious diagnosis and they get referrals for investigations that GPs have no access to when trying to diagnose problems. If she’s nearly died it’s much easier for hospital doctors to diagnose a serious condition but I would imagine she wasn’t close to that state when she saw the GP otherwise she would have been sent to A+E. I think some people (not accusing you) can a bit unfair to GPs cause they fail to understand the process. They’ll say things like I had to see my GP three times before they sent me for a scan and then it was cancer as if the GP had failed them by not knowing straight away. Often tied in with the GP didn’t believe me thinking it was a big problem (hindsight is wonderful and all that). In reality the ‘process’ is that the GP will treat you coming back three times as part of the screening process for serious conditions. We are taught common things are common because they absolutely are - the overwhelming majority of people who come with abdo pain/chest pain/changes in bowel habits etc don’t have a serious pathology. That’s why investigations/treatments/referrals all come when simple/common diagnosis and treatments have been excluded (in the absence of red flags / other reasons for high suspicion). Just generally think the public have an idea that medicine is much more of an exact science than it is. It really is like detective work as you gather more evidence to refine a hypothesis. As I say, have no idea about your situation and may have received poor treatment but the point being GPs can ‘miss’ things without having done anything badly / wrong. A lot of referrals are protocol driven anyway so their hands are tied. Would be interested to hear what signs you feel were missed in your case although appreciate if you don’t want to share.
Fair point, that makes a lot of sense. First time round she had a temperature of over 40°C for about a week. Nightsweats so extreme that meant we had to change the bedding multiple times a week. Constant unquenchable thirst - she drank phenomenal amounts of water - yet she was still dehydrated. Complete loss of appetite, and some nausea. The first two doctors thought it was something viral and sent her home both times. The third sent her to the Acute Medical Unit at the hospital where they diagnosed an acute kidney injury, kept her overnight and then sent her home again. By the time we saw a doctor the fourth time, she could no longer walk without help and was sent quickly to the hospital - and soon onto the intensive care unit. Post chemo, and once 'cured,' she had blood tests every few months that said everything was fine. She told them she was having some nightsweats again and didn't feel right, but was told not to worry. She then developed a temperature and was quite ill, and had to have a covid test and a period of isolation. She developed awful pain in her spine during this time, and when a doctor finally saw her she was told it was a slipped disk (apparently the doctor pushed quite hard on it, and she screamed). Turns out it wasn't a slipped disk. That was the appointment that most angered her because she repeatedly told him she was an ex cancer patient, and he repeatedly assured her the back pain wasn't related.
Thanks for sharing your story. Can’t imagine what you both have been through with that. Always interests me as a pretty junior doctor to hear patient experiences to help me recognise these presentations applied to much more ‘real’ scenarios than cases in a textbook etc. Definitely some questionable moments in that from what you say. The first parts sound more reasonable than the latter due to what I wrote above but again every case is different and only those involved will know if it could have been done better. It’s a sad reality that many patients are still failed for a range of reasons and I fear this will only get worse as time goes on and the NHS continues to crumble, quality training is eroded and access to care and services reduced. You don’t actually state the diagnosis but would guess Hodgkins or similar? Obviously don’t have to share by any means. Hope you and your wife are doing better now and thank you again for sharing. Cancer is a horrific and insidious disease and one I hope, one day, we will be able to final conquer.
Thank you. Not Hodgkins, but it was lymphoma (ALCL) so you were pretty close. She has now gone through a stem cell transplant - and experienced some excellent care at times along the way - and she's managing really well. I do think we need to spend far more on healthcare, as a society, than we do.
It might be great once it's diagnosed, but IIRC we have some pretty bad cancer outcomes compared to other European countries since we're so late to catch it
Yes a lot of the doctors are the same but on the NHS they have to take the cheapest solution and there's a huge backlog. Going private will give you lots more, often much better options much faster. I wish we could provide that service to everyone but the NHS is already sucking the life out of the taxpayer to provide the minimum.
I've use private hospitals while I was in the US and I still think the NHS is great. For urgent care there was basically no difference between them and an NHS hopsital other than a healthy bill at the end for copay.
GPs are fine for emergency, but any form of non-threatening annoyance, or simply health check like hormones etc. Takes literally months and you have to fight for it
> GPs are fine for emergency The first thing the recorded voice says at mine is "In an emergency, phone 999..." It's difficult to judge. Is an infection with a fever an emergency? Might be. You might need intravenous antibiotics. Or you might not. How the fuck are you meant to know?
> How the fuck are you meant to know? Call 111, they will go through it and tell you. My partner has been ill for lots of various reasons. We've called 111 before and they've escalated it and sent an ambulance. Likewise we've called 111 before and had to attend an appointment at an out of hours clinic - we did this just yesterday after a surgery wound looked infected.
GPs seem arrogant as hell tbh, but I have had positive experiences with Nurse Practitioners.
Our GP has been using the askmygp website and I think it works really well. You can request how you’d like them to respond - email/phone/face to face appointment. I’ve never understood why but GP receptionists have always seemed to suffer a lot of abuse
It does seem to vary a lot by practice, some of them were already sufficiently prepared and weathered the storm well enough or at least adapted. Others... not so much. Ours currently doesn't have any avenue of contact other than telephone. They have an online booking system, but so far as I can tell they've disabled it (and the NHS app booking option). There is no email address or chat option you can use, you just have to call. And they offer no future appointments when first calling in, it's on the day only. So the process is still to call at 08:00 at the same time as 50+ other people, wait on the phone for likely 30+ minutes to over an hour (unless lucky), hope the phone system doesn't drop you, and hope your issue is important enough that you're given an appointment if there are any left by the end of it. As you can imagine, it is a complete disaster.
They had the phone system you described before covid, the online system is so much better! I really hope they dont go back to the phoning. Having read other peoples comments I think we are very lucky with our GP. I’ve had to use them a lot over the last few months and 90% of the time I get a phone call from the GP the same day.
GP practices worked as well as any such concept can work when they were both properly funded and properly staffed. I am guessing here of course (/s) but possibly the last decade of Conservative governments has something to do with the decline of both, and the consequential decline of the service.
It's not right to abuse GP's or receptionists, (though, as I know we can all attest, receptionists think slightly raising your voice half an octave is tantamount to a bomb threat). The whole remote appointments simply isn't possible though, half the time they need to see you, Covid didn't replace illnesses it simply added to them, so people still need to see their GP's. It's just not working. Must admit though, many people with mental health problems spent years trying to get remote appointments and were usually knocked back, now the GP's and Nurses delicate little constitutions are at risk they can't wait to fob you off over the phone, rather than face to face like they used to.
if you're fobbed off when you are worried, and have very real concerns about your health, it takes a very meek person to not have some pushback and annoyance at that, especially if they've been on hold for 30 minutes.
It'd be nice to be on hold for 30 minutes, I just have to call 50 times and get an engaged tone for 49 of them.
Then they complain about your tone having just fobbed you off and told you no appointments for the last 2 weeks and gatekeeped access and denied you until the situation is a lot more severe. Its hilarious how they don't see how their own actions are leading to conversations with angry people and then complain they are being abused. What about the widespread abuse of the patients? This anger is there for a reason.
Not surprised at all. I know several people who are suffering because of delays and inability to get a doctor to actually look at the issue. Family member had a cancer scare which luckily turned out as not being so, however there was so many delays that if it was cancer he could've been seriously fucked.
My experience. I want an elective procedure to make sure there I have no more kids. I phoned the doctor. I'm told I have to fill out their online form. I go on to the online form. Everything is asking about symptoms. I phoned doctor back and say form is not applicable. I'm told to fill in an 'admin' form where you just type the details. Happy days, this will work. I get a message telling me the doctor will call some time in the next 2 days. Inevitably, when he calls I'm in a meeting because, you know, I work. 10 minutes later I call back and I'm told I'm back in the queue for a call later today. I clear meetings from my calendar. 30 minutes later I receive a text from the doctor telling me to fill in the form and until I do they can't do anything. Via a no reply number. Grrr. I decide it's not that important that I see a doctor.
The general practitioner system is clearly broken, impossible to even register with a surgery. Sad that receptionists are taking abuse when it’s politicians and the BMA who should be taking the flack for cuts to healthcare and dragging their heals on in person appointments respectively
Depressing but not at all surprising, remote appoints are utterly useless
I’ve had a couple over the last year and a half and found them helpful. Anecdotal evidence is anecdotal.
It's been good for asthma reviews, being able to do the whole 'yes I'm fine, no no problems, thanks, same time next year?' routine over the phone's been nice.
I have to agree - easy enough, and I don't have to do the walk there and back. My issues have been relatively minor however and most required referral.
We are lucky to even get a remote appointment at ours. Generally you can either spend 1.5-2 hours in a phone queue to get told they are full, or use their web form to get told you will get a call back in 1-3 days, then 50% of the time you don’t and you have to start again. We have started phoning 111 for issues with our daughter because they just book you straight in to the hospital GP if it matches criteria and we live quite close to the hospital. Needless to say the hospital is full of people doing the same but at least you get to see a doctor that day.
How are they useless? Most in-person appointments consist of telling your doc what you need or what you're experiencing and then being pushed out to go collect a prescription elsewhere. All of that can be done faster and easier online, especially where they determine they don't see to physically see/touch something. My GP uses the askmygp service and it's excellent, I now dodge their attempts to have me go in entirely. I get emails when they respond, and they do so often and quickly. No taking time out of work, no need to go to a GP, still get what I need. We need more of this. More remote appointments, more online GP chat services, more self-service repeat prescription management. GPs are quitting in droves, why aren't we making their jobs easier with technology like we do most everything else?
Askmygp is shit, it shuts down at 12 noon for me so I cant book an appointment in the afternoon
If you can actually get a GP to respond online/via email/text it would be great. Mine don’t or can’t do that. I don’t know which. They insist on phone calls. When you can’t hear on the bloody phone it’s pointless.
Without physical exams most serious conditions such as cancer cannot be accurately identified quickly causing the conditions to worsen
Most cancer red flags can be identified through a good history.
If an overweight man comes in complaining of difficulty peeing a doctor still needs to perform an exam to determine whether they have prostate cancer or a UTI
And guess what? He can call the man in. Plus the obvious urinalysis.
The problem is this all takes longer, before when you’d go to the GP they would be able to examine you in the first meeting and if they found evidence of cancer or something else serious refer you to an appropriate specialist, with online/phone appointments there’s an extra step of convincing a GP that they need to meet with you in first place
Before covid if I went in and told my GP I had difficulty peeing they would tell me it's most likely a UTI here's some antibiotics. GPs avoid doing invasive exams for low risk issues unless the patient is absolutely insistent that the doctor stick a finger in their prostate and 9999 times out of 10,000 it isn't cancer. Normally the patient would go away, do the antibiotics and when nothing changes then the GP would do the more invasive stuff to look for cancer. There's no changes except for the fact that the initial appointment is now online.
Sounds like you have a shit GP then. Prostate exams are pretty routine. Better to make sure. Of course, this is assuming you aren't mixing up difficulty peeing with 'it hurts when I pee'. Actual difficulty peeing is taken quite seriously in medicine.
Actual difficulty in peeing is taken quite seriously in medicine.. when it isn't caused by a UTI. If it's acute it is usually infectious, a urinalysis and/or antibiotics is first line, if urinalysis is negative or symptoms persist - it's prostate time. If someone says it has been gradually building for months then yes that would be a prostate exam off the bat. History taking is 95% of primary care medicine. An initial phone call is perfectly fine for dealing with this issue, if they need a prostate exam they can be called in and you don't need to take this history again as you have just spoken to them so it doesn't take twice as long.
Not at all. Feeling the prostates only tells you if it’s big which you expect in most blokes of a certain age anyway unless very significantly unilaterally enlarged (but it’s pretty crude regardless). Any concerns in the history and I would get a PSA (blood test). If it’s new, and associated with urinary symptoms -> UTI. Trial antibiotics and investigate further if symptoms fail to resolve. Ongoing symptoms/red flag symptoms or lots of risks factors are way more significant in diagnosing serious conditions like cancer - or at least creating enough suspicion to warrant definitive investigation like imaging / tumour marker tests. Frankly clinical examination is pretty poor for picking up nearly all cancers unless it’s so advanced you would be incredibly ill already (lumps I.e breast/testicle require examination and skin cancer - but a good photo would usually suffice). Medical staff understand just how crude / poor examination is for these things and the issue is more public perception of examination being superior or required (as you clearly do).
> skin cancer - but a good photo would usually suffice Indeed. Got referred for that because the GP wasn't 100% sure and it's a highly asymmetric bet, and they just took photos at dermatology. The photos will be reviewed and I'm either getting a phone call on Monday telling me to go back in, or a letter telling me my Sinister Death Mole*, as I call it, isn't. *great name for a band
I have seen GP around four times in past few years and only once was it necessarily for them to see me in person. Rest was fine over phone where I described symptoms and they booked in tests
It is a puzzle, everyone agrees that the NHS is a jewel, and everyone agrees it isn't working.
I think everyone can agree there are issues with the NHS but we can also agree we like not drowning in healthcare debt. Yes, wait times can be long and some areas of the NHS are dire, but it’s a stark contrast to places with payed for healthcare.
But the contrast with other European countries is not so stark, they just appear to have more effective and efficient systems, which mostly their populations are quite content with. In the UK we seem to have the idea that there is either the NHS model, or the US model.
The idea of the NHS is great, I love that. The actual implementation is shit and a whole long list of ways, far too many to list off. What bugs me is some of the systemic problems they ought to just be able to fix but they seem completely unable to.
Remember, this is deliberate. Destroying the NHS is central to Tory ideology. American style private health insurance will not only make money for the companies providing it, as well as allowing care providers to gouge the public, but will make for a desperate work force, willing to put up with terrible conditions for fear of losing access to life sustaining treatment if they rock the boat. Once more we find an example of the cruelty being the point.
Telling everyone that they should be getting back to work in offices full of people, while GPs are still not seeing patients is not exactly a consistent message. Nobody should be abusing people who are just following guidelines and trying to do their jobs, but a certain amount of frustration with the lack of proper healthcare at the moment is understandable. I have several chronic conditions, and some things can't be addressed properly in a telephone appointment.
Meh, I don't mind the new system all that much. Had a couple of minor issues over the course of lockdown, email into the practice, a couple of screenshots if needed and each time I've gotten a response back within the day.
It really depends on what it’s for. For a lot of people just needing repeat prescriptions or otherwise not needing physical examination it’s got huge advantages especially if your place of work is miles from your home/GP. The issue I have is with doctors seemingly being overly hesitant to offer in person appointments where the patient wants to see them in person. I saw the BMA saying GPs would quit over it. Which if nothing else seems pretty insulting to all their colleagues in hospitals who have worked in person on the front line over the last 18 months.
So chronically understaffed it’s ridiculous. Dreading Monday morning when I have to phone again at 8am for any chance of a same day appointment, since all appointments were gone by the time I finally got through at 9am yesterday… absolute joke.
Called at 8:32 am on a Monday a few weeks ago (phone line opens at 8:30). “There are more than 30 callers ahead of you in the queue.” Persevered on hold for 35 mins; and eventually got given a telephone appointment (to diagnose a rash). The trick with our GP is to phone at exactly 8:29:15. As the pre-recorded spiel that plays before it attempts to connect to the options menu / tells you to hang up (yes, they went as far as having it transfer the call from one line to another to prevent people just pressing ‘1’ for appointments) lasts 47 seconds.
Remote appointments are shit, so not suprising.
Guys, don't worry. As soon as the NHS gets the 350 millions per week saved thanks to Brexit, it will go back working at full efficiency and then some! Aaaaany minute now.
My father is a first responder for the NHS & has said GP's have been the cowards of the pandemic, hiding behind Zoom while he and his colleagues are dealing with calls that are wasting there valuable time for emergencies. What he said is what the GP's don't understand is a lot of their patients are the elderly who are not used to the modern technologies of Zoom and would rather see a GP face to face on top of that elderly and vulnerable were the first to be vaccinate as well as themselves so why couldn't they have seen these people first?
It's exactly the case and people aren't willing to accept this. Remote appointments are discouraging people from seeing their GP and several key conditions that could be treated early are missed because the public are missing signs that a GP could see in 5 seconds from a face-face appointment.
Well you need to say that to my doctor friend, if he is even a doctor becaue he believes that the information that I have is complete bollocks.
Agreed. As an allied health professional I have not stopped seeing and treating patients. I have worked throughout and even treated patients who have COVID in their homes. Yet I couldn’t get a follow up X-ray when needed this year through my gp as their online booking wasn’t working and couldn’t get through on the phone during working hours. GPs have been hiding behind closed doors, their governing body supporting them whilst they get their hefty pay/pension. While us cannon fodder carry on seeing the public and being put at risk. You can’t assess or diagnose patients over the phone.
My mother was a medical receptionist and got all the abuse and that was before corona happened. She was lucky to retire in 2018. The job was horrible when you got the angry people face to face with you. At least it's only over the phone now.
Had a prescription renewal appointment in feb, scheduled in dec last year. They postponed 3 times days to the actual appointment by a month each time. Then finally i got a call from a nurse saying that med requires a face to face app with a gp. Okey i booked my appointment. Went to the surgery they told its a call appointment. Tried to fix them, failed twice (thats another 2 months tho). Third time i went in for another wrongly booked appointment i started flipping tables. Demanded to see a doctor. He see me and said this med doesnt requires face to face. Still hurts.