Are Gps Partly Responsible For The Crisis In The N H S?

[naomi24]

//Ministers are under mounting pressure to respond to "intolerable and unsustainable" pressure facing the NHS.

Senior doctors described the NHS as on a knife edge, with some A&Es in a "complete state of crisis".//

https://www.bbc.co.uk/news/uk-politics-64148967

With GP appointments difficult to access, people are turning up at A&E with conditions that are due neither to an accident or an emergency which in my opinion is a big part of the problem. I can see no reason why GP surgeries haven't returned to normal working - but they haven't - and that serves only to exacerbate the problem. Quite shameful really.

[10ClarionSt]

I don't know, but I do know that people are going to A&E because they can't get an appointment at the doctors. Where else would they go?

[ToraToraTora]

Yes, I think the GPs have got used to not having those annoying patients in their surgeries.

[naomi24]

//I do know that people are going to A&E because they can't get an appointment at the doctors//

That's the gist of the OP.

[theshedman]

A while ago I phoned GP for doctor to come and see my wife who had just come out of hospital after having very bad fall. Receptionist told me I couldn't have even a call from GP and to call 999. Paramedic said that they were getting this type of call often as GPs didn't want to come out. End result 24 hours later she was back in hospital for over 2 weeks due to another fall.

[rowanwitch]

Our practice have decided to stick with the phone consultation first system only calling patients in if they feel they need to examine them. My experience today, Try for 30 mins to get into the phone queue, once in the queue wait 15 mins to be answered, now have to wait for a gp to call me 'some time today'. I know I will need to be seen face to face which will probably be late this afternoon then I will have to wait for the pharmay to get the online prescription ( they close at 5pm) so no chance of starting treatment today.
The practice say it cuts out the timewasters and reassurance seekers especially those with age related or mental health problems. The same groups that will most likely end up in the emergency system as failure to cope.

I accept there may not be adequate GP cover in some areas but mine is a very large group practice Others in the area are keeping their covid systems too.

[Peter Pedant]

well you have the walking wounded, and I dont see why this shouldnt be handled in a walking wounded clinic ( like a separate kids area) - treat them and street them. requires triage which has only been around for 100 y (*)

and the other area for initial treatment of those needing admission and admitting them - which is completely different.

and if there are no beds in a hospital say 'we are full'

(*) having taken a fren' in with (second, I waited) haemoptysis. The triage nurse was completely unmoved by this. So I showed her. SHE said o we dont need that. She moved to throw it away, whilst it went back into my pocket ( on a hankie). And they tried "oh he says he has had a haemoptysis but I dont think he can have". Which I was ready for
Admitted. working diagnosis - acute TB in a 77 y o.

[barry1010]

We can only hope this isn't buried and forgotten.
https://www.gov.uk/government/news/plan-set-out-to-improve-access-for-nhs-patients-and-support-gps

[Paul22118]

We were fortunate........... We were registered with a GP practice that during and after the pandemic the doctors were only undertaking telephone consultations. Usual saga of telephoning, retry, wait in massive telephone queue and finally be told by receptionist that you will receive a telephone consult some time during the day. I had had a particularly nasty condition which I well knew needed eyes on to treat. I got nowhere fast. I therefore asked around and to our great fortune found another surgery in our town who had reverted to conventional working practises. Apparently the main man did not believe in the diagnosis by landline method of doctoring.
We applied to change surgery and luckily got in. Apparently good news travelled fast and they are now full. Result, saw a doctor in surgery, thorough examination, proper diagnosis, drugs issued and four weeks later right as rain. That was our experience.

[rowanwitch]

PP should have been a GP case, early steps can all be done via them... Plain film CXR, sputum for analysis, and if TB was indicated as a possibility a skin test, Then an urgent referral directly to a chest out patients. This is exactly why the GP service is making things worse. There is also a need for more X-ray centres where a Gp can send patients rather than clog up hospital departments

[vulcan42]

When phoning my GP the first thing we're told is to dial 999 if we think it's an emergency. This is followed by a lengthy wait in a queue, this has varied between eighteen and fifty-one minutes. When we finally get to speak to a medically untrained receptionist, we have to relate our symptoms and are told a doctor will phone later that day or tomorrow. If a prescription is issued there is a 48 hour wait before collection.
On the first aid courses I attended we were told it's just as important to look as well as listen to the patient. A friend of mine had to hold his phone to his chest so the doctor could listen to his breathing and as it turned out later, made the wrong diagnosis.
Yes, the GP's are certainly partly, if not wholly responsible, for this mess.

[choux]

naomi, I cannot understand why contact to our surgery is so protracted and, at times, nigh impossible to achieve. The reputation it has locally is going down all the while among the locals and neighbours. It has been discussed at great length on our Nextdoor group. I looked up details on the CQC and was surprised to see the overall rating (last reviewed Sept 2022) was the same as one some miles away from us but preferred by quite a few locals who had transferred there following recommendations.

If some of the staff at my surgery moved into the Channel they would reduce vastly the number of irregular immigrants.

[choux]

The surgery has changed its computerised system which is only employed during business hours. Patients want to be able to book appointments, pass details to doctors, throughout the 24 hour clock to alleviate the pressure of more urgent calls during the surgery opening hours. I have not used the system. I type full details out, print off the letter, mark it "Urgent" for our GP (who happens to be Head of Practice") and hand deliver it, putting the date and time of delivery on the envelope. It gets attended to quite quickly when the contents are of a serious nature.

[Samuraisan]

Certainly not the " envy of the world" anymore is it. Sounds chaotic to me.

[youngmafbog]

Well its certainly one reason but not the only one. Of course indirectly it is also the cause of 111 sending people to A&E as people phone 111 who realise they are on the hook if no one is seen.

The NHS has been going downhill for decades, but of course when you mention this you get howled down (as I have been on here many times over the years) as it is a sacred cow.

[New Judge]

//Certainly not the " envy of the world" anymore is it.//

It never was. There were people who said it was and those who believed it was. But it never was. If the rest of the world was so envious of it, at least a few countries would have copied it by now and none has.

The GP service is an utter disgrace. It was a disgrace before the pandemic, many GPs behaved abominably during it and have worsened since. There is no justification for this. GPs are paid too much to do too little and much of the blame for this lies with the Blair era "reforms", where they saw their pay double and their work halved. But that’s no excuse for the current farce.

I have said before and I will repeat that the GP service needs to be abandoned. In fact the NHS in its entirety needs to be abandoned, but that’s outside the scope of this question. Many patients can now self-refer for a number of conditions and that facility needs to be expanded. The role of pharmacies needs to be widened; they should be able to dispense common drugs such as broad spectrum antibiotics and the like and they can assist people who need to self refer. Premises currently used as GP surgeries can be converted to minor injury clinics. The GPs might be gainfully employed in them, provided they agree to work as employees and provide a 24/7 service. If not they can spend more time on the golf course and counting the money they have accumulated in the last twenty years. All the GP service in its current form provides is a hindrance for patients who want to see somebody who can help with their problems.

[david small]

These shirking GPs should be held to account. They do not take responsibility for the disaster that the NHS has sunken to. Directly or indirectly they have contributed to the deaths of many people who if seen face to face could/should have been given priority treatment. This callous indifference, this reluctance to be bothered brings shame upon the entire medical profession. There are still some excellent Doctors out there, unfortunately they are in the minority. Yet another Blair screwup.

[fbg40]

All the emergency services work 7 days per week, 52 weeks per year. My Doctor only attends our surgery 3 days per week ! Very good doctor but when you are assigned a particular GP at the practice it makes it hard to get an appointment. I honestly believe that GPs should work 7 days per week and this would take a lot of the strain off of the A & E depts at hospitals. Just a thought.
FBG40

[rowanwitch]

Part time GPs are ok in a large group practice, most of the ones in my practice work 5 days a week, either mornings or afternoons, and the rest of their hours doing paperwork and a few housecalls. But you are not assigned to one only, you can see any of them. You soon get to know what their individual strengths are.or at least you can book a call from any of them if they are available.

[david small]

Consider yourself fortunate rowanwitch. Very many ill folk cannot even get them to speak on the telephone. A shocking consequence of covid overreaction and arrogant indifference.

[rowanwitch]

Today I spoke to a gp, given an appointment lunchtime, in the interim one of the Rheumatology nurses phoned Me with the results of Friday's chest xray. I should have a CT within 2 weeks